Surgical Treatment of Obesity - Bariatric Surgery - Gastric Bypass Surgery
I am considering a procedure for obesity, but what are the risks, and how much weight am I going to lose after surgery? Is it reversible?
Doctor Joshua’s Answer:
First, we need to assess whether you are a candidate for bariatric surgery. Generally, a Body mass index (BMI) greater than 40 is required before gastric bypass surgery is considered. However, if obesity is causing significant medical problems such as diabetes and heart disease, bariatric surgery may be considered even for those with a lower BMI.
Body Mass Index measures your weight in relation to your height. You can check your BMI using this Calculator. 18.5-24.9 is ideal, 25-29.9 is overweight, >30 obese, >40 morbidly obese.
Non-surgical treatment is first attempted. Bariatric surgery may be considered if nonsurgical treatment fails.
The main surgical procedures employed are gastric bypass and gastric banding.
A meta-analysis (a critical study of previous studies) was published in the Journal of the American Medical Association in 2004. You can view the summary here.
The study found that on an average, the patients lost 61-70% of their excess weight after surgery. This shows that bariatric surgery is a highly effective treatment.
The operative mortality (risk of death) was 0.1-0.5%, or 1 to 5 in 1,000 during the first 30 days following surgery. The risk of death was lowest in gastric banding, slightly higher for gastric bypass, and highest (>1%) for biliopancreatic diversion or duodenal switch. Please see the eMedicine article for other complications.
Diabetes, hyperlipidemia and sleep apnea were resolved or improved in >75% of patients.
In summary, bariatric surgery is a highly effective treatment for obesity, but the candidates for surgery must be carefully selected, the surgical and anesthesia teams must be experienced, and the patient must be fully informed of the risks of the procedure.
Good luck!
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