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Weight loss surgery to treat obesity is often misconstrued as a “last resort” for patients who have given up on taking care of themselves. But it’s quite the opposite.
To put the bariatric surgery journey in perspective: If you experience knee pain or develop a heart condition, your doctor likely will prescribe medicine or another form of non-operative treatment, such as lifestyle changes. Surgery might be the next step if pain and symptoms persist—and most people would consider a procedure necessary to achieve better health and quality of life.
Like osteoarthritis or heart failure, obesity is a disease that sometimes requires surgical treatment. When non-operative weight management methods, such as diet and exercise, are ineffective, bariatric surgery can be a necessary step toward better health. It’s not a last resort; it’s a tool within a larger process to reduce excess weight, which is linked to chronic disease.
Bariatric surgery is personalized to each patient and may become an option earlier in certain cases. But no matter when the surgery occurs, it will always require hard work and dedication—before and after the operation—to sustain results.
Bariatric surgery is a permanent operation, though some patients need revisional procedures over time. Depending on the type of bariatric surgery that’s best for you, the surgeon will either remove a portion of the stomach or revise the bowel so a portion of the stomach is no longer accessible. With less room to hold food, you’ll feel fuller after eating, leading to long-term calorie restriction and weight loss.
To be eligible, you must be physically healthy enough to undergo the operation and mentally prepared to make lifelong behavior changes.
Planning for bariatric surgery.
The assessment process leading up to bariatric surgery usually takes six to nine months. We don’t take any shortcuts; our program is an American Society for Metabolic and Bariatric Surgery Center of Excellence and fully accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.
First, we’ll evaluate your eligibility for surgery based on other weight loss methods you’ve tried and your overall health. For example:
- If you have a body mass index (BMI) over 40 and are experiencing joint pain or fatigue but you don’t have a chronic disease and haven’t tried to lose weight through exercise and calorie restriction, we’re going to recommend you try non-surgical techniques first.
- If you have not had success with other weight loss methods and have a chronic disease associated with obesity, such as diabetes, sleep apnea, or hypertension, bariatric surgery is a logical next step.
Many insurers cover bariatric surgery based on criteria for surgical weight loss set by the National Institutes of Health:
- BMI of 40 or more
- BMI of 35 or more with a serious health problem associated with obesity
- BMI of 30 or more with type 2 diabetes that is difficult to control with medical treatments and lifestyle changes
Without coverage, the procedure costs several thousand dollars. Talk with your provider about your options.
Once you’re approved for surgery, we’ll introduce you to our pre-operative nutrition program, where you will:
- Attend nutrition classes to learn about the lifestyle modifications required for long-term weight loss and management, such as decreasing portion sizes and eating more plant-based and fewer processed foods.
- Adopt these new behaviors for a few months before surgery to demonstrate your ability to make healthy choices a regular part of your routine.
- Meet with patients who have had bariatric surgery to hear firsthand experiences and develop a support network.
Before surgery, all patients meet with our registered dieticians, who share health and weight loss strategies that will set them up for success before and after bariatric surgery.
We also often perform an upper endoscopy to examine the esophagus, stomach, and small intestine using a thin, lighted tube. This exam helps to confirm there are no abnormalities we need to treat before surgery, such as ulcers or a common infection known as H. Pylori, which can cause ulcers and inflammation.
Patients with chronic diseases must also receive clearance for surgery from their other care providers. A major operation puts extra stress on your organs, and we want to avoid causing further harm to ones that are already weakened by an existing disease.
Related reading: 6 Frequently Asked Questions About Bariatric Surgery
Life after bariatric surgery.
Depending on your overall health and weight loss goals, you’ll likely have one of three types of surgery:
- Sleeve gastrectomy, which reduces the stomach to roughly 25% of its original size and decreases the level of hormones that signal hunger to the body
- Gastric bypass, which creates a small stomach pouch, bypassing some of the intestine to limit food and nutrients
- Adjustable gastric banding, which places a band around the upper part of the stomach to limit food intake – this procedure is not performed at all MedStar Health locations
Our surgeons are experienced in advanced minimally invasive and robotic surgical procedures, resulting in a shorter hospital stay, less pain, and faster recovery.
Following surgery, you’ll stay in the hospital one or two nights. Your diet will be drastically different for the first month to give your digestive system time to adjust. It will likely include:
- Clear liquids only for the first 24 hours
- Thicker liquids, such as protein smoothies, for the next couple weeks
- Soft foods, such as applesauce, for about two weeks after that
You’ll come back to see us for a standard post-operative check-in after two weeks. We’ll remind you that this surgery is just one tool to help with weight loss; you now have commit to the core tenants of a healthy lifestyle, including making nutritious food choices.
We’ll follow up again after six weeks, then every three months through one year—and annually after that. Once you’ve had a bariatric procedure with us, we’re here to support your health journey for the rest of your life.
The majority of weight loss occurs within the first six to 12 months after surgery—you can expect to lose between 60 and 80% of your excess body weight. You might also face challenges during this time, such as falling into old eating habits that can lead to weight gain. Regularly connecting with us ensures we can provide timely support resources to help keep you on track.
Benefits beyond measure.
In addition to weight loss, bariatric surgery can prevent, reduce, and resolve chronic conditions related to obesity, such as diabetes, high cholesterol, sleep apnea, hypertension, and liver disease. Many patients can stop taking blood pressure medications or insulin and start exercising and engaging more with their families.
While improved quality of life isn’t something we can measure, it’s usually what brings patients the most joy after bariatric surgery. Patients often tell us their surgery helped them connect more with their kids and grandkids—they can participate in activities without feeling fatigued or self-conscious.
Nothing brings bariatric surgeons more satisfaction than happy, healthy patients. We are always excited to help people along their weight loss journey, and our clinic is a no-judgment zone.
Related reading: Experiencing Post-quarantine Weight Gain? Why You Should Consider Bariatric Surgery
Stifling the stigma around bariatric surgery.
Too often, patients who would benefit from bariatric surgery don’t pursue it out of fear of what others will think. I understand that stigma continues to surround weight loss surgery and that obesity bias has made engaging with healthcare systems difficult for some people.
But obesity is a disease that can—and should—be treated. And calorie restriction and exercise alone simply don’t work for everyone.
Bariatric surgery is just one more tool in the disease management toolbox. It’s not a quick fix, and it doesn’t mean giving up. Getting bariatric surgery means you’re committing to improving your health through conscious decision-making every day, and we’re here to help you every step of the way.
