Is weight loss surgery right for you? Here’s what you need to know

If you carry more than a few extra pounds, weight-loss surgery could be a great way to improve your health, gain self-confidence and have more energy to do the things you love.

Weight-loss surgery (also known as bariatric surgery) makes your stomach smaller and/or changes the way the small intestine absorbs food.

This used to involve open surgery, with bigger incisions that took a while to recover from. Surgeons now use tiny cuts (laparoscopy) and special instruments. This approach has fewer risks and allows you to recover faster

But having bariatric surgery isn’t only about the operation. It involves many aspects of your daily choices — from how you eat and move to how you manage stress.

If you can commit to lifestyle changes, “the impact is phenomenal,” says Mark Eichler, MD, a bariatric surgeon at PeaceHealth Southwest Medical Center in Vancouver, Washington.

How effective is it? Most people lose at least a third of their extra weight after bariatric surgery. And some lose almost all of it. But the benefits go beyond the number on your scale.

“It is one of the few things where you can clearly surpass any medical treatment out there,” Dr. Eichler says. “And it can improve or cure the Big Four comorbidities: Diabetes, high blood pressure, cholesterol and sleep apnea.”

Research shows that bariatric surgery can help with many health concerns linked to carrying extra weight. For people who had weight loss surgery:

• More than 8 out of 10 no longer have to manage their diabetes.
• 9 out of 10 no longer have to treat their sleep apnea.
• More than 6 out of 10 no longer have to manage high blood pressure.

Are you a good candidate?

People who qualify usually have a certain weight to height ratio (BMI), certain health conditions, and have had a hard time losing weight in other ways.

Meeting those requirements may be more common than you realize. “Of the 15 million patients who meet the criteria, only about 1.4% actually get the procedure,” Dr. Eichler says. “It’s really underutilized.”

You could be a good candidate for bariatric surgery if:

• You're between 18 and 74 years old.
• Your body mass index (BMI) is 40 or higher.
• Your BMI is 35 or higher, and you have another health condition related to your weight, like diabetes or high blood pressure.
• You don't drink a lot of alcohol.
• You don't use nicotine or drugs, or you're willing to quit.
• You don't have untreated depression or other mental health conditions.
• You've tried to lose weight with your doctor's help but haven't succeeded.

It’s also important to consider whether you’re ready to make the lifestyle changes that go along with bariatric procedures. Here are a few of the habits required to make surgery work for the rest of your life:

• Eat smaller meals and more slowly.
• Stay active for 30 minutes or more per day.
• Avoid greasy and/or sugary foods.
• Limit alcohol.
• Take vitamins and supplements.
• Get a yearly checkup with your bariatric team.

If you’re willing to make these adjustments, surgery can be an excellent tool for long-term weight loss.

Next steps

If you think bariatric surgery is right for you, you can move forward by having a conversation with your primary care provider. To prepare for the discussion, ask yourself some questions:

• Will I be healthier in the future without weight loss surgery?
• Can I lose my extra weight on my own?
• How would my life be different if I were healthier?
• Which type of surgery might be best for me?
• What would it cost my health and my finances if I didn’t lose weight?
• How do I make time to prepare for the surgery and recovery?

Your PCP can see if you qualify for surgery and help you decide if it's the best option for you. They'll also let you know if you need a referral to get started.

Having surgery to lose weight is a big decision — and the reasons to consider it are different for each of us. As you sort through your options, this tool also can help you weigh the pros and cons.

“Another thing I’d stress is that if you are carrying a lot of extra weight, the chances that you will find long-term success with diet and exercise alone are about 3 to 5%,” Dr. Eichler says. But people who have bariatric surgery lose weight and keep it off for years.

Choosing a program

If you decide to have surgery, look for a bariatrics program that is accredited. This means that outside experts have made sure the program is doing all it can to provide safe, effective care.

PeaceHealth is accredited by the American College of Surgeons’ Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Blue Cross Blue Shield also recognizes our program as a Blue Distinction Center of Excellence for bariatric surgery.

Once you’ve chosen a program, you’ll meet with its team of specialists. This includes not just the surgeons who do the operations. You’ll also work with experts in diet, mental health and other specialties. They'll explain everything, help you get ready physically and mentally, and offer ongoing education and support.