Is Weight Loss Surgery for You?

Nutritional deficiencies. Patients who have weight-loss surgery may develop nutritional deficiencies such as anemia, osteoporosis and metabolic bone disease. These deficiencies can be avoided if vitamin and mineral intakes are maintained.

Complications. Some patients who have weight-loss operations require follow-up operations to correct complications. Complications can include abdominal hernias, infections, breakdown of the staple line (used to make the stomach smaller) and stretched stomach outlets (when the stomach returns to its normal size).

Gallstones. More than one-third of obese patients who have gastric surgery develop gallstones. Gallstones are clumps of cholesterol and other matter that form in the gallbladder. During rapid or substantial weight loss a person's risk of developing gallstones increases. They can be prevented with supplemental bile salts taken for the first six months after surgery.

Need to temporarily avoid pregnancy. Women of childbearing age should avoid pregnancy until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus.

Side effects. These include nausea, vomiting, bloating, diarrhea, excessive sweating, increased gas and dizziness.

Lifestyle changes. Patients with extensive bypasses of the normal digestive process require not only close monitoring, but also life-long diet and exercise modifications and vitamin and mineral supplementation.

 

Am I a Candidate?

If you have a body mass index (BMI) of 40 or more -- which is about 100 pounds overweight for men and about 80 pounds for women -- you are considered severely obese and therefore a candidate for surgery.

Surgery may also be an option for people with a BMI between 35 and 40 who suffer from obesity-related problems (for example, severe sleep apnea, obesity-related heart disease, or diabetes). For these people, the risk of death from not having the surgery is greater than the risks from the possible complications from undergoing the procedures.

Keep in mind that as in other treatments for obesity, results may vary. In many cases, patients are required to show proof that their attempts at dietary weight loss have been ineffective before surgery will be approved. A psychological evaluation may be required by doctors to determine your potential response to weight loss and change in body image. Most surgeons require patients to demonstrate serious motivation and a clear understanding of the extensive dietary, exercise and medical guidelines that must be followed for the remainder of their lives after having weight loss surgery. In addition, studies are performed to assess the health of your heart and hormonal systems. Nutritional counseling is also a must before and after surgery.

For patients who remain severely obese after non-surgical approaches to weight loss have failed, or for patients who have an obesity-related disease, surgery may be an appropriate treatment option. But for most patients, greater efforts toward weight control, such as changes in eating habits, lifestyle changes, and increasing physical activity, are more appropriate. The following questions may help you decide if weight loss surgery is right for you.

 

• Have you tried to lose weight through conventional methods of weight loss: group classes, one-on-one counseling, calorie controlled meal plans, food journals, exercise?
• Are you well informed about the surgical procedure and the effects of treatment?
• Are you determined to lose weight and improve your health?
• Are you aware of how your life may change after the operation (adjustment to the side effects of the surgery, including dramatically different eating habits)?
• Are you aware of the potential for serious complications from the procedure, the associated dietary restrictions, and the slight chance that the procedure will not help you lose weight?
• Are you committed to life-long medical follow-up?

SOURCES: Department of Nutrition Therapy at The Cleveland Clinic. National Institute of Diabetes and Digestive and Kidney Disease