Is Bariatric Surgery Right For You? Common Question You Should Ask

Written by Marixie Ann Obsioma, MT, undergrad MD on October 06, 2021

Over the last five decades, the number of people who are obese has increased by almost 300%. Recent data that was published by the World Health Organization suggests that more than 650 people over the world are obese (1). In the United States alone, the prevalence of obesity among adults is 42.4%, almost half of the adult population, according to the CDC (2). Once your BMI hits 30, you are at a significantly higher risk of suffering many health conditions that could ultimately put your life in danger. Plus, there is the fact that extra fat is likely to cause self-esteem issues.

Losing weight often turns out to be such a difficult goal to reach. You change your diet, you cut out unhealthy foods, and you start to exercise. Every time you get on the scale, you are faced with the fact that you hardly left weight – if any at all.

This is why people often look at alternative options that they can opt for when it comes to losing weight quickly – and bariatric surgery has become quite a popular procedure. One report explains that an estimated 113,000 people in the United States now undergo a surgical procedure that is classified as bariatric surgery each year (3).

If you are looking to undergo such a surgical procedure yourself, then continue reading to find the answer to some common questions that people tend to ask when it comes to bariatric surgery.

What Are The Qualifying Criteria For Bariatric Surgery?

There are certain criteria that you would have to meet if you are interested in undergoing bariatric surgery to help reduce your weight. It is important that you do ensure that you meet the criteria before considering this particular surgical procedure. A physician will still need to analyze your case to determine if you are a good candidate, but meeting the specific requirements that have been set out definitely makes the process easier.

Your BMI will usually need to be 40 or higher before a surgeon would suggest this type of surgery. There are certain cases where a person would be able to undergo bariatric surgery if their BMI exceeds 35. This will be a possibility if you are experiencing health problems induced by your obesity. More precisely, men and women with BMI≥ 35 need to have at least one obesity-related comorbidity. Common conditions associated with obesity include diabetes, heart disease, hypertension (high blood pressure), other respiratory disorders like sleep apnea, osteoarthritis, non-alcoholic fatty liver disease, and gastrointestinal diseases.

Calculate your BMI here.

You are an eligible candidate for bariatric surgery if you weigh less than 450 pounds (204kg), the maximum weight the radiology equipment in hospitals can handle. Persons who weigh more than 450 lbs will need to lose weight in order to be able to undergo the surgery. In these cases, a nutritionist helps by creating a diet plan to follow.

It should also be noted that individuals interested in the surgery should not have any existing addiction to alcohol or drugs. The person should also have tried out other types of weight loss programs, such as an exercise plan and an appropriate diet.

To be considered a serious and eligible candidate for bariatric surgery you need to agree to long-term follow-up after the procedure. You will need to attend check-ups regularly and make several lifestyle changes.

What Are The Benefits Of Bariatric Surgery?

When it comes to the benefits of bariatric surgery, it is crucial to understand that the main immediate effect would be an instantly reduced waist size, but this is not the most important benefit. If you put in the effort to comply with the new lifestyle changes that come with this type of surgery, then you will be able to maintain the weight loss that was achieved through the surgical procedure. This, in turn, yields a number of potential long-term benefits.

The lifestyle changes would include the elimination of caffeine and alcohol for a certain period after you had surgery. Portions will be kept small, and you will need to adjust your way of taking in fluids. Sugary foods will need to be limited considerably, along with fried foods and all types of fast foods.

Let’s take a look at the most important benefits of bariatric surgery.

Cardiovascular Health

Obese men and women require more blood to supply oxygen and much-needed nutrients to their bodies. This leads to increased blood pressure. When left unmanaged, high blood pressure in combination with other problems such as high cholesterol can lead to atherosclerosis and cardiovascular diseases. Weight loss is crucial for cardiovascular health, but easier said than done for many.

Your cardiovascular well-being will gradually improve following bariatric surgery. For instance, a study from the journal PLoS One found bariatric surgery can prevent morbidities associated with cardiovascular diseases such as myocardial infarction, stroke, hypertension, heart failure, and stable angina pectoris (4).

Joint Pain Relief

You will also start to experience a reduction in joint pain that might have been previously caused by your excess weight. After all, carrying excess weight forms pressure on your joints and eventually causes chronic pain and joint damage. The problem is mainly present in weight-bearing joints. However, significant weight loss achieved through bariatric surgery can alleviate pressure on joints and thereby reduce pain while increasing your flexibility and range of motion.

Type 2 Diabetes Management or Remission

Furthermore, you may also experience a remission of certain existing medical conditions, such as type 2 diabetes, that was caused by your obesity. A study from the Annals of Surgery found that bariatric Roux-en-Y bypass surgery has the potential to cause long-term remission for obese patients with type 2 diabetes. More precisely, 52.6% of patients achieved complete remission of diabetes whereas 6.4% had a partial remission. Some patients, 15.4%, had diabetes recurrence after remission (5). However, subjects from the control group did not experience partial or complete remission.

For your reference, diabetes remission means the blood sugar levels are below the diabetes range without a person having to take medications. Remission occurs when the HbA1c level is below 48mmol/mol or 6.5% for at least six months. On your blood test results, HbA1c indicates long-term blood glucose levels. The ability of bariatric surgery to promote weight loss and the potential to promote diabetes remission is particularly important if we bear in mind that obesity and diabetes tend to go hand in hand. In fact, 30% of overweight or obese persons have diabetes and 85% of diabetics have excess weight (6).

Other Benefits of Bariatric Surgery

Other potential health benefits that have also been associated with long-term weight loss maintenance following a bariatric surgical procedure include:

A reduction in symptoms associated with depression. A growing body of evidence confirms obesity can increase the risk of depressive symptoms. This is especially the case for central obesity where most excess weight is present in the abdominal region. The underlying mechanisms that increase depression risk in obese individuals remain unclear. However, scientists explain inflammatory pathways and insulin sensitivity, the impaired balance of neurotransmitters, and other factors are to blame (7). The link between obesity and depression is also related to lifestyle and socioeconomic factors. Social stigma and negative body image may pave the way to depression among obese individuals. It’s also useful to mention depression may lead to weight gain and obesity due to increased food intake over time. Some people may binge on food to cope with their emotions. For these reasons, the benefits of bariatric surgery become even more important. This surgery can reduce symptoms of depression. One report showed subjects who underwent bariatric surgery experienced a 32.7% reduction in depression at the time of the procedure and a 16.5% decrease six to 12 months post-op. The improvement in depression symptoms also comes with adherence to instructions after the surgery (8). Keep in mind you will still need to eat a healthy diet and exercise.
If you had experienced obstructive sleep apnea prior to the procedure, then these symptoms may be eliminated. Sleep apnea is a sleep disorder wherein breathing stops and starts repeatedly. One of the biggest risk factors for sleep apnea is excess weight. You see, fat deposits surrounding the upper airway can obstruct your breathing (9). Evidence shows bariatric surgery can help treat obstructive sleep apnea (10). This also means you can reduce the risk of complications associated with sleep apnea such as excessive daytime fatigue, liver problems, metabolic syndrome, and even disturbing your partner when they sleep.
You may experience improvements in your fertility. One of the most difficult consequences of obesity is infertility. Many obese men and women struggle with fertility problems and are unable to start a family. For example, in women obesity can contribute to ovulatory disorders and impair endocrine mechanisms that may interfere with ovarian functions (11). Not only do obese women have a higher risk of infertility, but they also take longer to conceive than normal-weight women and are more likely to experience complications in pregnancies including miscarriage. Bariatric surgery significantly improves hormonal balance and sexual functions in men and women, sperm count in men, and pregnancy in females (12).

There are other conditions that may also be improved with the help of this particular surgery. Many people find that issues such as metabolic syndrome and gallbladder disease significantly improved. Additionally, women are also less likely to experience pregnancy complications if they can keep the weight off.

What Are The Risks Of Bariatric Surgery?

Although the benefits of this surgery are truly great, you should note that certain risks have also been associated with the procedure. All procedures carry certain risks and bariatric surgery is not the exception.

Understanding these risks is important but, at the same time, you are less likely to experience complications if you choose a certified surgeon with extensive experience and training in this field.

Short-term risks of bariatric surgery are:

Acid reflux
Anesthesia-related risks
Obstruction of stomach
Infection
Chronic nausea and/or vomiting
Inability to eat certain foods
Esophagus dilation
Failure to lose weight or weight regain

Potential long-term risks you may face after bariatric surgery include:

Leakage, which occurs when stomach acids and content leak through one of the anastomoses that is created during the surgical procedure.
An increased risk for the development of gallstones.
A possible risk for developing a hernia following the procedure.
Perforation of surrounding intestines, as well as the stomach.
Bowel obstruction, which occurs when there is a blockage that causes food content in the stomach and gastrointestinal tract to be unable to move down toward the anus. Symptoms often include a swollen stomach, as well as abdominal pain.
Dumping syndrome, a condition that causes certain symptoms to develop after having a meal. The condition develops in some patients who opted for bariatric surgery. Symptoms tend to include weakness, rapid bowel evacuation, and oftentimes also abdominal discomfort.
Internal bleeding, a rare complication that happens in 1% to 4% of cases (13). In most cases the bleeding is self-limited, but it can result in additional complications. The doctor discovers the cause of internal bleeding via endoscopy and performs the most suitable treatment approach for that specific problem.
Low blood sugar, or hypoglycemia, occurs due to metabolic changes that cause excessive production of insulin.
Ulcers, sores on the lining of the stomach, small intestine, or esophagus. Some of the symptoms that indicate the presence of ulcers include nausea and/or vomiting, heartburn, bloating, among others.
Malnutrition due to decreased absorption of nutrients and reduced amount of food a patient can eat (14). Patients who don’t adhere to diet-related instructions after the procedure are more likely to develop malnutrition .
Vomiting, which usually happens when the operated area in the stomach becomes too narrow while it tries to heal. Additionally, neurotransmitter pathways in the brain could also be responsible for the physiology behind nausea and vomiting (15).

Keep in mind specific risks and complications may vary from one type of bariatric surgery to another. Your healthcare provider will inform you about potential complications that may arise should you decide to undergo this procedure. They will also help you manage these complications.

Am I Ready For Bariatric Surgery?

A very important question that you need to ask yourself if you are considering bariatric surgery is whether or not you are ready. First, understanding how the procedure works, the benefits offered, and the risks involved are crucial. In addition to this knowledge, you should also be aware of the lifestyle changes that need to be implemented once you have undergone surgery.

There are several rules that you will need to start following for long-term success. You will start to focus a lot on proteins, as well as including more fruits and vegetables into your diet. Healthy fats and nutritious starches also play an important role.

You will need to follow other rules as well. Your meal portions will need to be reduced in terms of size, you will need to include multivitamins as part of your daily routine, and it is not advised to have a glass of water or any other fluids with food.

In other words, there is no right or wrong answer here. To understand whether you are truly ready for weight-loss surgery you need to take into consideration both benefits and risks. Your doctor can help you out. Keep in mind bariatric surgery is a life-saving procedure for many. But, as mentioned above, you need to be ready to commit to lifestyle changes afterward.

Conclusion

Bariatric surgery is now utilized by over 100,000 people each year in the United States alone to help individuals who are obese lose weight and reduce the risk of the many health conditions that have been associated with obesity. If you are considering this particular surgery, then the questions we answered in this post may certainly make the process easier.