Separating fact from fiction of bariatric surgery

Weight loss surgery will be a life-changing and very likely a life-saving procedure for most choosing this method of weight loss. Losing weight for some may seem straightforward, but for others who have struggled with their weight for years, one option is bariatric surgery.  According to the American Society for Metabolic and Bariatric Surgery, approximately 24 million Americans are eligible for this surgery.  Surgeries for weight loss are usually performed in a hospital setting with the use of general anesthesia. Not everyone wanting to lose weight is a candidate for weight loss surgery as there certain criteria that must be met.  Qualifications for any bariatric surgery include:

·      Body Mass Index or BMI equal or greater than 40 or more than 100 pounds overweight 

·      BMI equal or greater than 35 and with at least two obesity-related co-morbidities such as type 2 diabetes, hypertension, sleep apnea, non-alcoholic liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease 

·      Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.

Making the decision to pursue bariatric surgery for weight loss must be thought out carefully.  There are many myths and misconceptions individuals have regarding this surgery.  To help sort through truth from fiction, here are 9 common myths often associated with this procedure:

1. Myth:  Bariatric surgery is a quick and easy fix for rapid weight loss

Reality:  This is not a miracle procedure.  Weight loss surgery is designed to assist morbidly obese to reach a healthier weight and lifestyle.  The surgery itself is simply a useful tool for weight loss but it is a procedure that requires a huge lifelong commitment.  By itself, bariatric surgery does not help someone lose weight and keep it off.  The patient must change eating and exercise habits – if they don’t, they are likely to regain the weight back over time.

2. Myth:  People who are obese are lazy

Reality:  Obesity is a disease and is not indicative of someone’s laziness or lack of willpower.  Most of them have tried numerous times over the years to lose weight and get healthy but have been unsuccessful.  Deciding to have weight loss surgery is a last resort but a viable option. 

3. Myth:  Bariatric surgery is dangerous

Reality:  All surgeries have risks such as complications and even death.  Over the years, bariatric surgery has advanced to where many are performed laparoscopically with mini-incisions resulting in faster healing, less pain, and less scarring.  If a person does not have bariatric surgery, they still face life-threatening conditions associated with obesity such as type 2 diabetes, hypertension, high cholesterol, and sleep apnea.

4. Myth:  Weight loss surgery will result in vitamin and mineral deficiencies

Reality:  Depending on the type of bariatric surgery will determine the extent of malabsorption they may cause and which nutrients may be affected.  Fortunately, nutrient deficiencies following surgery can be avoided with appropriate diet and the use of dietary supplements.  Most bariatric programs also require patients to have their vitamin and minerals checked on a regular basis following surgery. All patients are given detailed instructions on introducing solid food back into their diet to eventually where they are consuming a nutritionally balanced diet. 

5. Myth:  Most people who have bariatric surgery regain their weight

Reality:  It is true that as many as 50% of patients may regain a small amount of weight back (about 5%) two years or more following their surgery.  However, longitudinal studies find that most bariatric surgery patients maintain successful weight-loss long-term.  Successful weight loss is defined as weight loss equal to or greater than 50% of excess body weight.

6. Myth:  Surgery increases the risk of suicide

Reality:  Many people seeking bariatric surgery are more likely to suffer from depression or anxiety and to have lower self-esteem than someone who is of normal weight.  For this reason, bariatric programs require psychological evaluations prior to surgery and many have behavioral therapists available for patient consultations after surgery.  For many patients, having this surgery can result in a significant improvement in their psychosocial well-being. 

7. Myth: Weight loss surgery prevents you from regaining weight

Reality: Do not think of weight loss surgery as a magic bullet for weight loss. After surgery is done, every patient will need to adopt a change in lifestyle and diet in order to prevent weight regain.  It will be important to team up with a Registered Dietitian who can recommend adjustments with diet to help make the treatment successful.

8. Myth: Insurance does not cover weight loss surgery

Reality: Insurance coverage will vary from state to state but many companies now offer public and private options for weight loss surgery that is deemed “medically necessary.”  Many insurance companies may cover upwards of 80 percent of what is deemed “customary and usual” fees associated with the surgery. Medicare and Medicaid, in some states, will also offer coverage to certain approved individuals. 

9. Myth: A woman will be unable to have children after weight loss surgery

Reality: Even though it is strongly advisable not to become pregnant soon after weight loss surgery, a woman should still be able to have children after consulting with her doctor over the best time to do so.  Generally, it is advised to wait two years before trying to conceive.  This allows time for a woman’s weight to stabilize after the surgery and for better regulation of hormone changes and nutritional imbalances that can occur initially post-surgery.