Yara Zakharia, Esq.
More than 33% of the American adult population is currently obese or overweight, and between 5 and 10 million individuals in this country are considered dangerously overweight. Obesity costs the U.S. more than $30 billion a year and comprises more than 5% of all health care expenditures.
The National Institutes of Health define obesity as having 20% more body fat than one's ideal body weight, at which point health risks are foreseeable. Morbid obesity substantially augments the risk of at least one serious illness or health condition linked to obesity. Triggers are hereditary, social, and environmental in nature, although factors such as diseases and health conditions such as hypothyroidism, Type 2 diabetes, sleep apnea, and heart disease also play a role.
Individuals who have exhausted weight loss remedies such as a healthy dietary regimen and exercise may lower their health risks by availing themselves of bariatric surgery. Also referred to as obesity surgery, weight loss surgery, which is performed under general anesthesia at a local hospital, involves the surgical diminution of the stomach's volume to approximately 30 ml. Because the demand for obesity surgery exceeds the availability of qualified bariatric surgeons
, the average wait for an evaluation appointment is 4 to 8 months.
Am I Eligible?
To be eligible for weight loss surgery, prospective patients must be at least 18 years of age and have a minimum body mass index of 40 or a BMI of at least 35 if also accompanied by a serious illness such as a respiratory disease or diabetes. This type of surgery is intended for females with a surplus weight of at least 80 pounds and males who are at least 100 pounds obese.
Prior to obesity surgery, the following routine tests are usually conducted:
- Cardio evaluation
- Chemistry Panel
- Chest x-ray
- Complete Blood Count
- Gallbladder ultrasound
- Gastrointestinal assessment
- Glucose tolerance test
- Psychiatric evaluation
- Sleep study
The objective of these tests is to determine whether the prospective patient suffers from excessive blood fat levels, too much fluid in the tissues, breathing problems, or liver malfunction, among other health issues.
Weight loss surgeries fall under three major umbrellas:
- Malabsorptive procedures which decrease the quantity of intestine that is exposed to food so that the body takes in less calories
- Restrictive operations (most common), such as vertical banded gastroplasty and gastric banding, which reduce the size of the stomach so that less food is absorbed and food empties from the patient's stomach at a slower rate
- Hybrid operations (i.e. gastric bypass) which utilize both malabsorption and restriction
Obesity surgery is performed either via a gastric bypass or a gastric banding procedure:
This surgery, which aims at limiting the amount of food intake, involves the creation of a small stomach pouch by a series of staples and its connection to the small bowel. To effectuate malabsorption, a bypass of the duodenum and other areas of the small intestine are then constructed. Gastric bypass surgery enables individuals to lose weight much faster than with other methods. The average hospital stay ranges from 5 to 7 days for open gastric bypass patients and 2 to 3 days for laparoscopic gastric bypass patients.
Laparoscopic and open gastric bypass are two forms of abdominal cavity penetration. Gastric bypass surgery may be performed as either a laparoscopic or an open operation. The former involves the creation, in the abdominal wall, of several small incisions to allow for the utilization of surgical instruments and a small video camera. In an open gastric bypass procedure, on the other hand, only one incision is made for purposes of opening the abdomen.
The vast majority of gastric bypass operations are performed with a laparoscope, which is a video camera with a telescope attached to it. In a laparoscopic gastric bypass, a surgeon inserts gas into the patient's abdomen to expand it and utilizes a laparoscope to obtain a larger image of the patient's organs. Laparoscopic gastric bypass surgery is minimally-invasive and offers the advantage of a shorter hospital stay, faster recovery, reduced post-surgery discomfort, and less scarring.
This surgical technique involves the wrapping of a silicone strap around the upper stomach, thus creating a small pouch and a tight passage to the rest of the stomach. Gastric banding patients can expect a hospital stay of 1-2 days. This procedure is easier to reverse than gastric bypass surgery.
Weight Loss Surgery Risks
The likelihood of complications in bariatric surgery has decreased over the years. Some of the risks associated with bariatric surgery are bleeding, stomach obstruction, leaking of staples, respiratory complications, blood clots, hernias, and infections. Following surgery, patients will have to chew their meals repeatedly and eat small portions since the size of their stomach will have been reduced. For a few days after the procedure, patients will experience discomfort and have to follow a liquid diet until their body adjusts to the procedure.
Weight Loss Surgery Benefits
Benefits of obesity surgery include the following:
- Improvement of obesity-related health conditions
- Increased longevity
- Reversal of diseases such as sleep apnea, cardiopulmonary diseases, and type II diabetes
- Substantial long-term weight loss
Finding a Qualified Surgeon
When choosing a surgeon, prospective patients should inquire about his or her success rate and experience and ensure that they feel comfortable with him or her. Referrals may be obtained from family physicians, former patients, and online websites listing qualified bariatric surgeons.
Weight Loss Surgery Costs
The cost of weight loss surgeries can run anywhere from $20,000 to $50,000, with the average cost being $25,000. How much a patient will pay typically depends on location, the type of hospital or clinic performing the operation, and the surgeon. Many obesity surgery centers or surgeons offer payment plans. Insurance providers will generally cover part of the procedure, particularly if health risks are present.
[page updated December 2008]