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Weight Loss Surgery: What You Should Know


More and more people who are morbidly obese and cannot lose the weight and keep it off are turning to weight loss surgery. We pretty much all know that being obese has serious health risks, such as heart disease, diabetes, stroke, arthritis and many other conditions. It can also make people feel tired all the time and embarrassed to go out in public. Some obese people have difficulty with job performance. There’s no doubt about it, being so overweight can put up a lot of roadblocks in your life. It’s easy to understand why surgery has become an appealing option for so many people.

How the operation works
Weight loss surgery, also called bariatric surgery, changes the digestive process. There are basically two kinds of operations. In one, parts of the stomach are closed off to make it smaller. These are called “restrictive” operations. In the other type of surgery, the stomach is made smaller and parts of the small intestine are closed off as well. These procedures, known as “malabsorptive operations,” not only limit the amount of food you can eat, but they also ensure that the intestines cannot absorb all of the calories and nutrients you do eat.

After recovering from the surgery, people are typically able to eat about one half of a cup to one cup of food at a time—for the rest of their lives.

Who’s a candidate for the surgery?
The American Society for Bariatric Surgery states that the operation should be offered to patients who are “morbidly obese, well informed, motivated and acceptable operative risks.” 

In other words, you’re a good candidate if you:

  • Understand the procedure and the effects it will have on your life
  • Have been unsuccessful in attempts to lose weight in more traditional ways
  • Understand that having the surgery will be life-altering, especially in the way you’ll have to think of your food
  • Understand there can be serious side effects and sometimes failure of the procedure to work at all
  • Are willing to take part in medical follow-up appointments throughout your life
  • Are committed to losing weight and maintaining a healthy lifestyle

People are considered to be morbidly obese if their BMI, or body mass index, is 40 or more. That’s about 100 pounds overweight (or more) for a man, and 80 pounds for a woman. But many surgeons will also consider performing the operation on people who are not morbidly obese if those people have other physical problems—severe sleep apnea, severe diabetes, obesity-related cardiomyopathy (a weak, inflamed, poorly functioning heart), difficulty moving, difficulty performing a job, etc.

Possible complications after surgery
The two most serious complications after bariatric surgery are blood clots in the lungs, respiratory failure and leaks of stomach juices into the abdominal cavity.

In addition, people who have weight loss surgery are at risk for the following conditions:

Dumping syndrome, which causes nausea, weakness, sweating, faintness and sometimes diarrhea after eating if food moves too quickly through the digestive tract.

Follow-up procedures are necessary in about 20 percent of cases to correct hernias or broken staple lines.

Nutritional deficiencies are also common. Food “bypasses” sections of the small intestine, so your body doesn’t absorb all the nutrients and calories you eat. About 30 percent of people who have the surgery experience anemia, osteoporosis and metabolic bone disease. It’s important to take supplements such as iron, calcium, vitamin B-12 and folic acid. 

Gallstones (clumps of cholesterol and other matter that form in the gall bladder) are an increased risk during periods of rapid weight loss. It can be helpful to take bile salt supplements to help prevent gallstones.

Be sure to read this month’s article about KJ and Mike, who had gastric bypass surgery about two years ago. We talked with them last year, and wanted to know how things are going one year later.

American Society for Bariatric Surgeons; National Institutes of Health
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