Weight loss isn’t just about numbers on a scale. It’s about improving health and transforming your life.
Bariatric surgery, once considered a last resort, is now recognized as a powerful tool in the fight against obesity. But, is it the right choice for everyone? Weight loss surgery is a significant decision that requires careful consideration.
Aimee Hymel, MD, Board Certified and Fellowship-trained bariatric and general surgery specialist with Our Lady of Lourdes Health, joins us for this episode of The Doctor Will Hear You Now, to offer her expert insights.
Defining Morbid Obesity
Dr. Hymel stresses that bariatric surgery is not a quick fix but rather a journey toward better health. “The point of bariatric surgeries is to aid patients in losing weight to optimize their health and improve medical conditions associated with being morbidly obese,” she says.
Morbid obesity is a medical diagnosis given to patients who reach a certain weight compared to their height, including those who have medical problems associated with being overweight.
“We have found that there is a certain weight associated with your height that puts you at increased risk for medical problems,” she says.
Some of the more common medical problems associated with being morbidly obese include high blood pressure, high cholesterol, Type 2 diabetes and obstructive sleep apnea. Patients also tend to see improvements in osteoarthritis, or arthritis of your joints, chronic pain and depression after weight loss surgery.
Shifting Societal Mindsets
“Shame, embarrassment and frustration are very common feelings for patients to come to my office with initially,” Dr. Hymel says. “The important thing about bariatric surgery is that it’s so much more than coming to my office and having surgery. It’s months of preparation for the ultimate life changes this process is going to bring about.”
The societal perception of morbid obesity significantly impacts treatment options. Healthcare providers who treat morbidly obese patients actively strive to fight negative connotations.
“It’s a medical diagnosis that deserves treatment in and of itself,” Dr. Hymel says. “The barrier to treatment when morbid obesity is not viewed as a disease really ties our hands.”
She remains hopeful as these barriers are slowly coming down, promising a brighter future for bariatric surgery and obesity management. Insurance coverage for bariatric surgery is more accessible than ever before, and Dr. Hymel encourages patients to explore their options.
Understanding Bariatric Surgery
All bariatric surgeries involve some form of alteration of the gastrointestinal (GI) tract, the system in our body that allows us to digest food. The result of the changes is a fairly rapid weight loss in the first year after surgery.
The three types of bariatric surgery are sleeve gastrectomy, which leads to an average of 80 pounds of weight loss, gastric bypass and duodenal switch, which typically result in more weight loss.
“Your chances of complications are higher but also your ultimate weight loss is higher as well,” Dr. Hymel says. An individualized, patient-specific approach to considering surgery ensures the right balance of risk and weight loss.
Sometimes the decision may be not to have surgery at all.
“I have had plenty of patients who come in planning on having bariatric surgery and with preparation, education and maybe use of some medications find they’re able to lose the weight without surgery,” Dr. Hymel says. “I think that’s fantastic every time a patient does not have to undergo the risk of surgery and still achieves their goals in health. At the end of the day, my goal is for my patients to be healthy.”
Considerations for Pregnancy
The decision to have bariatric surgery is a personal one. For women wanting to have children Dr. Hymel provides thoughtful guidance.
“Bariatric surgery before pregnancy can be a good tool for patients who are struggling with fertility and other diagnoses, such as PCOS,” she says.
Patients experiencing rapid weight loss after surgery should wait at least a year before attempting to conceive. “You don’t want to try to grow a baby under those circumstances,” Dr. Hymel advises. After the first year, pregnancy is safe for most patients, and in some cases, safer than for those with morbid obesity.
Advances in Bariatric Medicine
“Bariatric surgery is a relatively young surgical field and we have changed drastically in the last 20 years,” Dr. Hymel says. This rapid evolution promises continued improvements, making the specialty more effective and accessible.
One advancement that’s exciting for Dr. Hymel is weight-loss medications. She describes the role of one such medication, GLP-1 agonists, in treating morbid obesity.
“As we become smarter in medicine, we begin to actually focus on morbid obesity as a disease and treating it,” Dr. Hymel says. “We can actually start to make permanent headway not only in making patients just a little thinner, with a little less body fat, but in truly taking them from unhealthy to healthy and having it last.”
What to Expect Before Weight Loss Surgery
While bariatric surgery is minimally invasive, which means the surgeon uses small incisions across the abdomen. It is a major abdominal procedure that require general anesthesia.
“Part of the preoperative process is determining the patient’s other medical problems and medically optimizing the patient to decrease the chances of having any type of complication from the surgery,” Dr. Hymel says.
There is no one-size-fits all approach to the pre-op process. The process is individualized to the patient with the goal of making them as healthy and safe as possible before undergoing surgery.
“Every patient has different needs when it comes to what they eat and how they move their body,” Dr. Hymel says. “We educate you and give you the tools to make those decisions for yourself.”
Life After Weight Loss Surgery
Along with the surgery and resulting weight loss, learned lifestyle changes may lead to lasting changes and a more healthful life for patients. Within the first year most medical problems associated with weight are improving if not resolved.
“Once you hit that year mark the fun’s not over,” Dr. Hymel says. “The goal is that patients now have a very healthy relationship with food. They are able to make solid, healthful choices when it comes to their diet. They have a better relationship with their body and moving their body on a regular basis.”
The follow-up process after bariatric surgery is more detailed than after some other general surgeries.
“Having appropriate support and follow-up is critical to success,” Dr. Hymel says. She sees patients at least four times in the year after their surgery and annually after that.
Dr. Hymel also shares that life after weight loss doesn’t mean you’ll never eat delicious food again, like the Cajun and Creole dishes so love throughout the South.
“I tell my patients your health is made up of what you do every single day, not what you do every now and then,” she says. “Our habits are what we do every single day on a regular basis. Habits do not change on a timeline of weeks. They change on a timeline of months to years.”
Lifestyle changes, education and support are crucial before and after bariatric surgery for long-term success.
