The Many Health Benefits of Bariatric Surgery

Obesity is quickly becoming a worldwide health crisis.

One recent study suggests that it may soon surpass world hunger as a leading catalyst for serious medical conditions globally. In the U.S. today, more than 1 in 3 adults are obese, compared to about 1 in 7 in 1980. The rise in obesity and resulting health problems threatens to reverse the steadily increasing lifespan that Americans have been experiencing in recent decades.   

Although these numbers can be alarming, there is an effective health intervention that can help reverse these trends: bariatric surgery, a procedure to change the size and position of a patient’s stomach and small intestines. Benefits of this minimally invasive surgery can extend well beyond weight loss for obese patients—including near-immediate resolution of several chronic conditions, a reduced need for medications, improved quality of life and increased longevity.

Why It Works, When Diets Fail

Over time, most obese patients have lost weight repeatedly. The pounds can continually return as the body reacts to weight loss by dramatically lowering the patient’s metabolic rate. But this setback doesn’t occur with bariatric surgery.

In fact, with bariatric surgery techniques in use today, we see significant metabolic improvements in our patients, often before any post-surgical weight loss occurs. For instance, there appear to be immediate changes in how the gut signals satiety and hunger to the brain. Other hormonal changes improve how the body metabolizes carbohydrates and fat. Even changes in gut bacteria following bariatric surgery may play a beneficial role.

What’s clear is that bariatric surgery can deliver significant positive health benefits to the body, beyond weight loss alone.

Potential Health Benefits

Here are some common obesity-related conditions that improve with bariatric surgery:

• Type 2 Diabetes: Resolved

Over 80% of obese patients experience complete remission of their type 2 diabetes immediately following bariatric surgery.

That means patients actually leave the hospital with normalized blood glucose and no longer need medication to control it. As a result, they also have a much lower risk of life-threatening damage to the heart and blood vessels from ongoing diabetes. I’ve seen a number of great outcomes for patients here at MedStar Washington Hospital Center.

A five-year research study known as the STAMPEDE trial showed that these dramatic benefits can’t be achieved with diabetes medication alone. When researchers compared obese patients taking intensive medication to control their diabetes with those who also underwent bariatric surgery, only the surgical patients were able to maintain glucose control without medications. They also experienced unmatched improvement in their blood lipid levels and their reported quality of life.

• Hypertension & High Cholesterol: Reduced

Bariatric surgery also offers important cardiovascular health benefits. Between 52% and 92% of obese patients quickly return to healthy blood pressure levels following surgery, depending on how long they’ve had hypertension and how many medications they’ve been taking. Some leave the hospital no longer requiring blood pressure-lowering medicines. Others are able to decrease to a single medication and improve control from there as they lose excess weight.

In addition, patients reduce their overall risk for cardiovascular disease, especially heart attacks and strokes, by 82% following surgery. Some of this is related to the weight loss, and some to metabolic and other changes in the body post-surgery.

For about 63% of obese patients, cholesterol levels return to normal following bariatric surgery as well. (Success rates for resolving this condition are a little lower than for others, primarily because it’s not always weight-related. If your high cholesterol levels are a family trait, you may have a genetic predisposition that bariatric surgery won’t reverse.)

• Obstructive Sleep Apnea: Cured

Nearly 90% of obese patients suffer from this serious sleep disorder, which involves the occasional collapse of throat tissue during sleep, temporarily cutting off breathing. Untreated, sleep apnea increases your risk for a multitude of health problems—from hypertension and heart rhythm irregularities to heart attacks and stroke. While CPAP machines can be a highly effective treatment, they can be inconvenient and difficult to use regularly and reap the full benefit.

With bariatric surgery, 80% to 85% of patients experience complete remission of their sleep apnea in the first few months as they lose weight. Many patients find they no longer need the CPAP machine to maintain normal breathing at night.

• Nonalcoholic Fatty Liver Disease (NAFLD): Resolved

As obesity has increased, so have cases of this chronic liver condition, characterized by too much fat stored in the liver cells. About one in four adults in the U.S. has this form of liver disease today, which is often silent and can lead to inflammation, scarring and even liver failure, similar to damage caused by alcohol abuse.

About 90% of NAFLD cases resolve with bariatric surgery. As a result, we’re seeing more obese patients being referred to us by liver specialists, who recognize the benefits of bariatric surgery for preventing liver failure in these patients.

• Polycystic Ovarian Syndrome (PCOS) Symptoms: Improved

This hormonal imbalance and metabolic problem affects about one in ten women of childbearing age. One risk factor is obesity. Belly fat tends to be very metabolically active, affecting your body’s insulin and producing extra testosterone that can affect the ovaries and trigger the irregular menstrual cycles we see with PCOS.

After bariatric surgery, our patients typically have a 100% resolution of most PCOS symptoms and a 79% resolution of the excessive facial and body hair (hirsutism) that typically comes with it.

• More Benefits

By their two-week follow-up appointment after bariatric surgery, most of my patients have lost 10 to 20 pounds. Besides the immediate health benefits, weight-related headaches, reflux and urinary incontinence go away very quickly as well following surgery.

Quality of life increases dramatically for my patients, as social stigma about their weight goes away and they can more comfortably enjoy travel, work opportunities and physical activities with loved ones.

Within 12 to 18 months, most of my patients have lost 75% of their excess weight and 90 to 95% of bariatric surgery patients maintain that weight loss long-term. This enables a wide range of benefits, from healthier pregnancies, to safer organ transplants and joint replacement surgeries, to the possibility of aging with less disease and dementia.

Perhaps most importantly, statistics show that treated patients typically enjoy more years of life as well, with an 89% lower risk of death within five years of their bariatric surgery. Truly life changing.

How to Begin

In 2013, the American Medical Association categorized obesity as a treatable disease, rather than a lifestyle choice. That announcement, along with the well-documented safety and effectiveness of bariatric surgery, has prompted more health insurers (private and government) to cover the procedure in recent years.

Coverage is still mostly reserved for people whose obesity is severe (a body mass index of 40 or more) or who have a BMI of 35–39 along with a weight-related health condition, like Type 2 diabetes. But it is hoped that bariatric surgery will soon be covered more broadly, as many more people could benefit from it before their health problems become advanced.

If you’re considering surgery, be careful to choose a highly experienced medical center and team. At MedStar Washington Hospital Center, our program is recognized as a Comprehensive Center with the highest level of accreditations from the American Society for Metabolic and Bariatric Surgery. Our connected, multi-disciplinary care team works with you before, during and after your surgery to ensure your care and well-being.

Attend our free online information session, a great way to ask questions and learn more. Then, schedule an appointment to get information about potential insurance coverage and to meet with a bariatric surgeon who can review options with you. Today, most of these visits can be done via telehealth.

Don’t wait to learn more about bariatric surgery. Earlier treatment can bring you a healthier, happier and longer life.