Is Bariatric Surgery for You?

Perhaps you’ve heard about stomach-stapling operations or gastric bypass procedures for people who are very overweight. For some people with severe obesity, this type of surgery, known as bariatric surgery, can be an effective way to lose weight. However, it’s important to know what is involved before deciding whether it’s an option for you.

People who are very obese may have a hard time losing weight through diet, exercise and other traditional methods. Bariatric surgery can help by limiting the amount of food that can be eaten or changing how food is digested and absorbed.

Operations that reduce food intake do this by making the stomach smaller. Gastric banding is an example of this type of operation. In this procedure, part of the stomach is closed off with a hollow band that can be inflated with a salt solution. The band can be tightened or loosened by increasing or decreasing the amount of the solution in the band.

Only a small pouch about the size of an egg is left to hold food. After this procedure, a person can eat just about an ounce of soft food at a time. This gradually increases to about ½ cup to 1 cup.

A procedure known as gastric bypass limits food intake and hinders the digestion and absorption of nutrients. Normally, partially digested food passes from the stomach into the upper part of the small intestine. There, food is further digested and nutrients are absorbed. A gastric bypass reroutes the intestinal plumbing so that food passes directly from the stomach into a lower part of the small intestine. Weight loss occurs because fewer nutrients and calories are absorbed.

What Happens Afterward?

After gastric banding, you must consume only very small amounts of liquids for a period of about three weeks. Then you may add pureed and regular foods to your diet gradually. You’ll find it necessary to make some lifelong changes to your eating habits. Because your stomach is so small, you’ll need to eat five or six small meals a day. Eventually you can have three meals a day. You must chew your food well and eat it slowly, and you may sip liquids between meals.

After a gastric bypass, it’s crucial to take nutritional supplements. Otherwise, vitamin and mineral deficiencies can develop, leading to anemia, osteoporosis and other problems. Eating a healthy diet and getting regular exercise are still important, too.

Measuring the Results

Most people with gastric banding lose a lot of weight the first year. But they may later regain some of it. In fact, only one in five people manage to keep the weight off after 10 years.

People with a gastric bypass usually lose substantial weight during the first two years. After 10 years, it’s not uncommon for patients to have lost and kept off 60 to 70 percent of their excess pounds. However, it is possible for patients to regain weight after gastric bypass.

Qualifications for Surgery

There are risks and potential complications with bariatric surgery. You must fully commit to changing your eating habits for the rest of your life. And many employer health plans do not include bariatric surgery in their benefits.

Each facility's program may have slightly different qualifications or conditions, but in general to qualify for bariatric surgery, you must have:

• A body mass index (BMI) of 40 or more
• OR A BMI between 35 and 39.9 plus a serious health problem, such as high blood pressure, heart disease, type 2 diabetes or severe sleep apnea
• AND Proof that attempts to control your weight with a health care provider–supervised weight-loss program that includes documented monthly weigh-ins have not been effective

For people who have not been successful in losing weight through diet, exercise and changes in eating behaviors, bariatric surgery may be an option. To better understand the benefits and risks, talk with your health care provider.

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Patient's Frequently Asked Questions See a list of common questions about bariatric surgery

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