Choosing Bariatric Surgery and the Promise of Improved Health
Historically, bariatric surgery was considered the last leg of a weight-loss journey after diet, exercise, and other medically supervised programs have failed. However, weight-loss surgery has now gained increased consideration by the medical community as an effective and enduring option for weight loss in select individuals.
Bariatric surgery can restore a person’s dignity, independence, and, most importantly, their health and survival. Some people who have sustained weight loss may see a dramatic reversal of diabetes, heart disease, and other weight-related difficulties.
Reducing fat via bariatric surgery differs from that of liposuction, a surgical technique that removes excess fat under the skin, because bariatric surgery affects how food is digested. And it is this critical difference that appears to make bariatric surgery ideal for people with obesity-related health problems, such as high blood sugar, high cholesterol, and other critical metabolic irregularities.
Still, people considering surgical treatment for weight loss don’t always understand what factors play into a successful end result. The surgery may have complications, and successful surgical results depend on a patient’s willingness to adopt ongoing lifestyle changes, including following strict dietary and lifestyle guidelines.
- Will the bariatric program support you at every juncture of your weight-loss treatment?
- Are you ready for the emotional and medical challenges of major diet and lifestyle modifications?
- Do the surgeon and hospital have the unique qualifications required to perform bariatric surgery, and a track record of success based on volume and performance?
- Have you been offered the right procedure that best suits your individual health and lifestyle needs?
- Does the hospital have safeguards in place that prevent complications or intervene quickly should complications arise?
For the last seven years, Healthgrades has performed an exhaustive review of bariatric surgery in American hospitals. People considering weight-loss surgery can use this information to help decide where to go for weight-loss help.
What was uncovered in the Healthgrades 2012 Bariatric Surgery Trends in American Hospitals report is noteworthy. The quality and cost of bariatric programs varies significantly from hospital to hospital. Healthgrades also found that as a hospital’s volume increased, the number of complications decreased significantly.
Is Bariatric Surgery an Option?
Doctors use body mass index (BMI) to determine a person’s weight category. BMI is a measure that takes into account both a person’s weight and height. People with a BMI of 35 are considered a candidate for weight-loss surgery if they also have heart disease, type 2 diabetes, severe sleep apnea, and other weight-related health problems, including the ability to move around, earn a living, or run a household.
The morbidly obese (or those with a BMI of 40 or more) are candidates for weight-loss surgery regardless of their individual health problems, but may require some nonsurgical weight loss before undergoing bariatric surgery to be eligible for certain surgical programs.
People seeking weight-loss surgery should expect a comprehensive medical, surgical, nutritional, and psychological assessment before they are accepted as a candidate.
What People Considering Bariatric Surgery Need to Decide
People eligible for weight-loss surgery should consider which hospital and surgeon they should entrust, the most appropriate procedure, and the costs involved. The conversation about weight-loss surgery will likely begin with your primary care physician.
- Read an in-depth guide: How to Talk to Your Doctor About Weight-Loss Surgery
Choosing the Right Bariatric Program and Hospital
As with all surgical procedures, the surgical team’s expertise is critical. And where you go can have an enormous impact on the effectiveness, safety, and end result of the surgery.
Hospitals can undergo a rigorous evaluation by the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery to be accredited as a quality bariatric center. Among the many bariatric surgery standards, it requires that a hospital performs at least 125 surgeries and a surgeon performs 50 weight-loss surgeries per year. They also need to have an experienced bariatric treatment team that includes program coordinators, nurses, nutritionists, psychologists, and other supportive staff to help guide patients through pre- and post-surgical challenges and difficulties.
Other factors include a hospital’s track record for life-threatening or permanently disabling in-hospital complications, such as infection, wound complications, leaks from where the stomach was stapled or stitched, bowel blockage, excessive bleeding, accidental cuts, blood clots, and breathing problems. In some cases, additional surgery is required. The Healthgrades report found 6% of patients had an in-hospital complication. The in-hospital complication rate is the foundation for the Healthgrades star system that rates hospitals as being a 5-star (best) to 1-star (poor) for bariatric surgery.
Exploring the Surgical Approaches and Procedures
The two surgical approaches to weight-loss surgery are: laparoscopic, where surgical instruments are guided with cameras inserted through several small incisions; and open surgery, which requires one large incision of several inches in the abdomen.
Additionally, two types of procedures work in different ways to reduce the number of calories available to the body.
- Restrictive procedures involve reducing the size of the stomach to limit how much food a person can eat comfortably. Examples are adjustable gastric banding (Lap-Band® surgery, gastric band surgery), vertical banded gastroplasty, and vertical sleeve gastrectomy.
- Malabsorptive procedures reduce the amount of calories and nutrients the body can absorb by changing the path food takes down the gastrointestinal tract. Examples are Roux-en-Y gastric bypass, and biliopancreatic diversion with a duodenal switch.
The most common procedure is gastric bypass performed laparoscopically.
Paying for Bariatric Surgery
You’ll also want to know what your coverage options are, how much your insurance will pay, and what out-of-pocket costs you’ll incur. The Healthgrades report found a tremendous state-to-state variability in hospital charges. A state’s average charge ranged from $15,896 to $57,280 per patient.
More than 200 million consumers use Healthgrades websites to find, compare, select, and connect with a doctor or hospital, and use its comprehensive information about clinical outcomes, patient satisfaction, patient safety, and health conditions to make more informed healthcare decisions.