Severe obesity is defined as a body mass index (BMI) greater than or equal to 40 and may be treated with surgical intervention. In few cases where a patient’s BMI >/= 35 and presents with comorbid conditions they may be approved for surgical intervention as well.
When a patient has exhausted the usual methods of bodyweight reduction (i.e. diet, exercise, lifestyle change etc.) a physician may recommend weight loss surgery as an option. This option is typically last resort due to the life-long impact and permanency of the procedure. Of the clinically approved protocols the two most commonly performed are Banded Gastroplasty and Roux-en-Y Gastric Bypass. Both procedures help patients experience clinically significant weight loss.
Pros and Cons of bariatric surgery are important to consider for any patient. As with all surgical procedures there are short and long-term risks as well as modifications being made to the patient’s body. Here is a small table that outlines some pros and cons:
- Immediate and sustained weight loss
- Improvement in comorbid obesity-related conditions (hypertension, dyslipidemia etc.)
- Reduction in risks related to obesity
- Improved mortality
- Improvements to quality of life
- Improvements in psychological outook
- Initial failures to lose weight
- Risk of complications whether it be surgical, perioperative, nutritional and psychological
- Permanency of surgery
- Weight regain either short or long-term
- Initial costs, if elective and not covered
- Gastrointestinal complications with eating/digestion/regurgitation
Ultimately making the decision to undergo weight loss surgery is personal and all options need to be considered. Having open and honest dialogue with a board-certified physician can help patients navigate these major life-changing procedures. Always remember that having the surgery is just a component to effectively losing the weight long term. It’s important to stick to the recommended dietary program recommended the surgeon and/or registered dietitian, but also integrating beneficial lifestyle modifications.