Deciding on Bariatric Surgery

Is excess weight affecting your life and your health? Bariatric surgery (also called obesity surgery) may help you reach a healthier weight. This surgery alters your digestive system. For the surgery to be successful, you must change your diet and lifestyle. In most cases, the surgery is not reversible. So if you're considering surgery, learn all you can about it before you decide. Bariatric surgery also has a number of potential risks and complications that you need to discuss with your surgeon.

Qualifying for bariatric surgery typically involves a comprehensive evaluation by a health care team. This may include a surgeon, dietitian, psychologist, and other specialists. The specific criteria and requirements for bariatric surgery can vary depending on the health care institution, the type of surgery being considered, and your medical history.

Surgery is not for everyone. To qualify:

• You must have a BMI of 40 or more, or a BMI of 35 or more (see BMI box below) plus a serious obesity-related health problem, such as type 2 diabetes, high blood pressure, arthritis, or sleep apnea.
• Many programs require that you have attempted and failed to lose weight through nonsurgical methods, such as diet and exercise, over a specified period.
• You must be healthy enough to have surgery.
• For bariatric surgery you may undergo a psychological evaluation to assess your readiness for surgery and your ability to make the necessary lifestyle changes after surgery.

The goal of bariatric surgery is to help you lose half of your excess weight or more. This can improve or prevent health problems. This surgery is not done only for cosmetic reasons. Keep in mind that:

• Other weight-loss methods should be tried first. Lifestyle changes, behavioral modifications, and prescription medicines are initial choices. Surgery is only a choice if other methods don't work.
• Surgery is meant to be permanent. You will need to change how you eat for the rest of your life.
• You will also need to take certain multivitamins and mineral supplements daily for the rest of your life.
• You must commit to eating less and being more active after surgery. If you don't, you will not lose or keep off the weight over the long term.
• Most weight is lost steadily during the first year or two after surgery.
• Most likely, you won't lose all your excess weight. But you can reach a much healthier weight, and maintain it by following your doctor's advice for diet and exercise.

Obesity is measured by a formula called body mass index (BMI), which is based on your height and weight. A healthy BMI is about 18 to 25. A BMI of 30 or more signals obesity. A BMI of 35 or more is severe obesity. A BMI of 40 or more reflects morbid obesity. You can calculate your BMI at this CDC site:

https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html

• American Society for Metabolic and Bariatric Surgery
• National Heart, Lung, and Blood Institute Obesity Education Initiative