Is weight loss surgery a magic pill? Can one bariatric procedure solve your obesity problems forever?

In 2013, the American Medical Association (AMA) officially recognized obesity as a disease. It is defined in terms of BMI (Body Mass Index). If a person has a BMI above 30, he is defined as obese. BMI readings higher than 40 are considered severe or morbid obesity. This condition results from inherited, physiological and environmental factors combined with diet, physical activity, and exercise choices. The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. The need to recognize obesity as a disease arose as obese people were more likely to develop a number of potentially serious health problems, including heart diseases and strokes, Type 2 diabetes, certain cancers, sleep apnea, and osteoarthritis. Obesity can diminish the overall quality of life.

WHEN IS BARIATRIC SURGERY AN OPTION?

Bariatric surgery could be an option for a person if their BMI is 40 or higher or the BMI ranges between 35 and 39.9 with weight-related health problems. It is the only choice today that effectively treats morbid obesity in people for whom more conservative measures such as diet, exercise, and medicines have failed. Bariatric surgeries are either malabsorptive, restrictive, or a combination of both. But without lifestyle management, the unwanted weight can return.

WHY WEIGHT CAN RETURN POST-PROCEDURE?

Restrictive procedures like gastric banding or sleeve gastrectomy severely reduce the size of the stomach to hold less food, but the digestive functions remain intact. Weight can be regained following this procedure with a large remnant stomach pouch that grows in size with food, increased sweet consumption and portion size, emotional eating, and binge eating.

The malabsorptive procedures change the way the digestive system works. Food is rerouted past a large portion of the stomach and part of the small intestine that absorbs the same calories and nutrients. Typically, malabsorptive procedures result in more weight loss than restrictive procedures but they also lead to more nutritional deficiencies.

With some procedures, a portion of the stomach is removed. These are commonly referred to as “gastric bypass” procedures or the more aggressive duodenal switch with biliopancreatic diversion. Weight loss is maximum around one year after surgery after which it plateaus. Over time, the smaller stomach pouch, along with the common connection between the pouch and the intestine can stretch. In a majority of cases, the weight gain is diet-related. Many begin to eat more and exercise less. Their weight loss slows down and plateaus before beginning to climb.

WHY DIET, EXERCISE, AND LIFESTYLE MANAGEMENT ARE THE KEYS TO MANAGING EVEN POST-SURGERY WEIGHT

Bariatric surgery is a tool, not a magic wand. Bariatric surgery alone isn’t a permanent solution to obesity. It’s just a tool for losing weight. Once it occurs, you need to exercise and eat smart to stay slim. Follow the bariatric protocol for nutrition and stay active or risk the return of comorbidities. Success is defined as retaining 50 percent of your weight loss five years after the initial procedure was performed. So a single bariatric surgery cannot solve your obesity problems forever.

A person needs to meet certain medical guidelines and extensive screening to qualify for weight loss surgery. You must also be willing to make permanent changes to lead a healthier lifestyle. You will be required to participate in long-term follow-up plans that include monitoring your nutrition, your lifestyle and behavior, and your medical conditions. Regardless of the type or combination of obesity treatment, goal-setting is an important part of any obesity treatment plan. Treatment goals work best if they are tailored to a person’s needs.