I have to visit with a dietitian and a psychologist at least once before surgery. I will also have to have a screen implanted in my artery prior to surgery to catch any blood clots that may form. That sounds like LOADS of fun. But the main hurdle is getting my weight at or below 500. Once that's done the rest is a walk in the park. Central park, at night, with a mugger chasing you, but a walk none the less.
Roux-en-Y is the surgery I will most likely be receiving.
Pros and Cons of Weight Loss Surgery
As a treatment for severe obesity, weight loss surgery's popularity is growing. When diet and exercise fail the more than 60 million Americans considered obese, surgery, for some, can literally be lifesaving.
But it isn't for everyone. While generally safe, bariatric weight loss surgery (also called simply weight loss surgery) has risks. And losing weight after bariatric surgery is far from automatic; it takes commitment to lifelong changes in eating patterns and lifestyle.
"Roux-en-Y" gastric bypass surgery -- where most of the stomach is bypassed and a small stomach pouch is made -- is the most commonly performed weight loss surgery today, accounting for about 80% of all weight loss surgery in the U.S.
According to the National Institutes of Health, weight loss surgery might be a choice for you if you meet the first or second of the following criteria and criteria three, four, and five:
Are You a Candidate for Weight Loss Surgery?
The following criteria may make you a candidate for weight loss surgery:
1. A body mass index (BMI) greater than 40.
For example, your BMI is greater than 40 if you are:
- Five feet six inches tall and weigh more than 248 pounds,
- Five feet nine inches tall and weigh more than 270 pounds, or
- Six feet tall and weigh more than 295 pounds.
You can calculate your body mass index using a BMI calculator on WebMD. In early 2011, however, the FDA approved the Lap-Band restrictive surgery for those with a BMI of 30 or higher who have at least one obesity-related condition, such as diabetes. The move made this particular procedure an option for more people.
2. Your BMI is greater than 35, and you have obesity-related health problems that may improve with weight loss.
Obstructive sleep apnea, severe arthritis, and diabetes are several conditions that may benefit from even a small weight loss. Weight loss surgery can dramatically reverse these health problems when caused by obesity.
3. You can demonstrate that traditional weight loss programs like diet and exercise haven't worked.
It's by far preferable to lose weight without surgery's risks. Weight loss surgery should be considered a last resort after traditional methods fail. Some centers may require you to show you have made serious efforts to lose weight.
4. You are ready to commit to permanent lifestyle changes after surgery.
Weight loss surgery is no quick fix. Ideally, surgery is only the beginning of a new healthy lifestyle.
5. You understand the risks and benefits of weight loss surgery.
As with any surgical procedure, it's essential to be well-informed before considering weight loss surgery -- knowing and accepting the risks as well as the benefits.
Benefits of Weight Loss Surgery
The primary benefit of weight loss surgery is easy to understand: weight loss!
- Gastric bypass surgery causes an average loss of 61% of excess weight.
- Gastric banding surgery causes slightly less -- an average of 47% of excess weight lost.
Improvements in general health are also common. Obesity-related medical conditions usually improve or even go away after weight loss surgery, including:
- Diabetes
- Severe arthritis
- Obstructive sleep apnea
- High blood pressure
About 95% of people report improved quality of life after weight loss surgery. Some studies also suggest people live longer after weight loss surgery, compared to equally obese people who do not have surgery.
Risks of Weight Loss Surgery
Weight loss surgery carries real risks. As many as 10% of people have complications afterward. Usually problems are only unpleasant or inconvenient, and might cause some pain and discomfort, or require additional surgeries, including:
- Nausea, vomiting, and diarrhea
- Wound infections
- Abdominal hernias
Serious complications do occur after weight loss surgery. Although rare -- happening about 3% of the time -- they can sometimes be life-threatening:
- Blood clot to the lungs (pulmonary embolism)
- Leaks in the new surgical gut connections
- Bleeding ulcers
- Heart attacks
About one in 400 people die from weight loss surgery complications in the first thirty days. The risk is higher for people over age 60. Having bariatric surgery at a center with very experienced surgeons reduces this risk.
Even after successful weight loss surgery, other problems are common:
- Gallstones, often requiring gallbladder removal
- Vitamin deficiencies or malnutrition, from poor absorption
- Excess skin, requiring surgical removal (body contouring)
After Weight Loss Surgery
Weight loss surgery should be the beginning of a new and healthy lifestyle. To make the most of the surgery and to maximize results, people need to:
- Break the binge habit
Nearly all severely obese people have unhealthy eating habits. A common problem is "binge eating." After weight loss surgery, eating large amounts of food at one sitting can make you sick. For many people, learning to eat small, frequent meals is a challenge.
- Eat healthy and take vitamins
Eating junk food or neglecting to take vitamin supplements can cause serious malnutrition after weight loss surgery. This can cause bone disease, loss of muscle tone, and low blood counts (anemia).
- Exercise
Keeping weight off is far easier when a person is active and exercises. In addition, exercise reduces rates of many diseases, including cancer and heart disease. To maintain weight loss in the long term, exercise is essential.
Such profound changes in lifestyle don't happen automatically or easily for most. Many weight loss surgery centers offer behavioral counseling programs to help people make the transition into their new and healthy lifestyle after surgery.
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