Evaluation for Bariatric Surgery

Bariatric surgery may help you lose a large amount of extra weight and keep it off if you commit to the diet and lifestyle changes needed. This can help prevent or treat health problems linked to obesity such as:

• Diabetes

• Osteoarthritis

• High blood pressure

• Heart disease

• Stroke

• Sleep apnea

• Liver disease

• Gastrointestinal problems

• Infertility

• Some lung diseases such as asthma

• Certain cancers

• Psychological problems

In some cases, a health problem linked to weight may go away after weight loss. But in other cases, it may only partly go away. Or it may not improve at all. People who get surgery tend to lose more weight than people who get medical treatment for their weight loss. Surgery is likely to help with problems linked to obesity, such as diabetes or sleep apnea. But the results aren't the same for everyone. Some people don't lose as much weight as they want after surgery.

All surgery has risks. Your risks may be different according to your general health, your age, the type of surgery you choose, and the amount of weight you need to lose. Talk with your healthcare provider about the risks that most apply to you. Risks of bariatric surgery include:

• Bleeding

• Infection, including sepsis

• Leakage where your bowel is connected (anastomotic leak)

• Blockage of your bowels (intestinal obstruction)

• Blood clots

• Heart attack

• Need for follow-up surgery

• Gallstones (a later problem)

• Nutritional deficiencies (a later problem)

• Psychological difficulties after the procedure

• Regaining some weight after surgery

Healthcare providers most often advise bariatric surgery to people with a body mass index (BMI) of 40 or more. BMI is a method of screening for a weight category using a person’s height and weight for calculation. A BMI of 25 to 29.9 means overweight. A BMI higher than 30 means obese. Your healthcare provider may also suggest bariatric surgery if your BMI is between 35 and 40 and you have a health problem that may get better with weight loss. To find your BMI, use this BMI calculator.

Bariatric surgery is not the only treatment for obesity. Your healthcare provider may want you to try other treatments first. These may include working with a dietitian or using a weight-loss medicine.

Your healthcare team will only do the surgery if they know it will give you health benefits. For the surgery to be a success, you will need to make lifelong changes to your diet and lifestyle. Your healthcare team will want to know that you are ready for the life changes that go with surgery.

You will need to go through an in-depth process to be approved for bariatric surgery. This is done to find out if you are ready for the surgery, and if it will help you. And you will need to find out if your health insurance plan will cover the costs of the surgery.

You’ll need to meet with healthcare providers, who may include:

• A surgeon, who must confirm that you are a good candidate for surgery

• A mental healthcare provider, who can look at your emotional readiness for the surgery

• A dietitian, who will look to see if you are ready to make the needed dietary changes

• A primary healthcare provider, who can look at your general health and readiness for surgery

• A heart healthcare provider, who can make sure your heart is healthy for surgery

• A lung healthcare provider, who can make sure your lungs are healthy for surgery

All of these healthcare providers must agree that the surgery is safe for you.

Before your approval, you'll also need to:

• Lose some weight before your surgery, to prevent problems

• Stop smoking

• Work with healthcare providers to treat medical or emotional problems

Bariatric surgery is a big step. It's important to be committed to changing your eating habits and lifestyle for long-term success. Make sure you fully understand the risks and benefits of surgery. Ask for support from your partner, family, and friends.

You will need some exams and tests. These are to make sure you are healthy enough for the surgery and recovery. You may need tests such as:

• Blood tests. These are done to check for anemia, infection, hormone levels, and kidney function.

• Screening tests. These check for nutrient deficiencies.

• Chest X-ray. This is done to help make sure your heart and lungs are healthy.

• Echocardiogram. This is done if more information about your heart is needed.

• Electrocardiogram. This test looks at your heart rhythm.

• Pulmonary function tests. These are done to see if your lungs are healthy.

• Sleep study. This is done to check for sleep apnea.

It’s important to have a realistic weight-loss goal for your surgery. Many people don't lose all of their extra weight after surgery. You may lose one-half to two-thirds of your excess body weight. This depends on the type of surgery you have. Your healthcare provider can give you a more exact idea of what you can expect.

Losing this amount of weight may help any health conditions you have, even if you still have extra weight. You may be able to reduce or stop some of the medicines that you take, and have more energy and a better self-image. Having a realistic weight-loss goal can help keep you motivated. It can help keep you on track with your good eating habits. Your healthcare providers will give you a realistic idea of how much you can expect to lose after your surgery.