Talking With Your Doctor About Weight Loss Surgery
Weight loss surgery, also known as bariatric surgery, can treat obesity when medical weight loss programs have failed. It may also reverse type 2 diabetes and high cholesterol, which ultimately reduces the risk of heart disease. Experts define successful weight loss surgery as a losing 50% of your excess weight five years after surgery.
Your doctor can tailor your treatment plan to your specific circumstances. But individualized care starts with a conversation. Here are topics to bring up with your doctor that will help him or her decide the best course of treatment—for you.
Whether or not weight loss surgery is right for you depends on:
- Your body mass index (BMI)
- Your general health and weight-related health conditions
- Your personal motivation
- Your age
- Your history of weight loss
Your BMI measures your body fat using both your weight and height. A normal BMI is between 18.5 and 24.9. You may be a candidate for weight loss surgery if your BMI is greater than 40.
If your BMI is greater than 35 and you have serious weight-related health problems, you may also be a candidate. Weight-related health problems include high blood pressure, high cholesterol, severe sleep apnea, type 2 diabetes, heart disease, and liver disease.
Your doctor will ask you about weight loss programs you have tried, such as long-term dieting, exercise, and medications. Most weight loss surgery programs won’t accept you until you have tried these nonsurgical measures.
There are two main categories of weight loss surgery:
Restrictive procedures reduce the size of the stomach. This limits the amount of food you can eat. Restrictive procedures include adjustable gastric banding, stomach stapling, and combination banding/stapling.
Malabsorptive/restrictive procedures—gastric bypass—alter the normal digestive process. These procedures reduce the size of the stomach and attach it directly to the middle of the small intestine. This diverts food past most or all of the first section of the small intestine—the duodenum—where the body absorbs most calories.
Ask your doctor why he or she thinks a certain treatment is right for you. Ask about the side effects to expect, recovery time, expected weight loss, and changes to your daily life. Having a plan may help you feel better.
As with any surgery, weight loss surgery has risks and potential complications. General risks of surgery include problems related to the anesthesia, bleeding, blood clots, infection, and even death.
Complications specific to weight loss surgery include leaks of digestive juices, problems with the restrictive device, problems with the stomach opening, gallstones, and malnutrition. Ask your doctor about your specific risks. Find out how to prevent and treat them if they occur.
Weight loss surgery does not always lead to long-term weight loss. You can expect to regain some of the weight you lost as your body adjusts. Ask your doctor what kind of support is available to help you minimize this and deal with it when it occurs.
Finding out what to expect after weight loss surgery can help you and your loved ones prepare. Your recovery and the time you spend in the hospital will depend on your surgery choices. Ask your doctor about the specifics. You should also discuss your diet after surgery because it will change drastically. You will need to be very careful about what and how much you eat. Your doctor can tell you what to expect.
Other topics to talk about with your doctor include your activity goals, what medicines you need and how to take them, the need for any daily supplements/vitamins, and how often you will need follow-up visits with your doctor and dietitian.
If you lose a significant amount of weight, you will probably have loose skin. This can cause problems with daily activities, such as bathing and getting dressed. Loose skin folds are also susceptible to friction, irritation and infection. Ask your doctor about managing this.
Many people find it helpful to talk with someone else who has gone through weight loss surgery. Your doctor can help you connect with people who are willing to discuss their experience. Ideally, you should talk to people who had their surgery months and years ago. Ask your doctor about support groups and therapists who can help after surgery.
A second opinion can give you options you hadn’t considered or it can reinforce your current decision. It can increase your confidence in your decision so you don’t question yourself later. A good doctor understands the value of a second opinion and should encourage you to get one. Some insurance companies even require them. Your doctor can refer you to another bariatric surgeon to discuss your weight loss surgery options.