Bariatric surgery

[Kit]

Bariatric (weight-loss) surgery alters the stomach, intestine, or both to produce weight loss.

In the United States, about 160,000 people have bariatric surgery each year. This number accounts for almost two thirds of the total number of bariatric procedures done worldwide. These procedures result in substantial weight loss. People may lose half or even more of their excess weight and as much as 80 to 160 pounds. Weight loss is rapid at first and then slows gradually over a period of about 1 to 2 years. Weight loss is often maintained for years. The loss greatly reduces the severity and risk of weight-related medical problems (such as sleep apnea and diabetes). It improves mood, self-esteem, body image, activity level, and the ability to work and interact with other people.

When obesity is severe—for example, if body mass index (BMI) is 40 or higher—surgery is the treatment of choice. Surgery is also appropriate when people with a BMI 35 or higher have serious weight-related health problems, such as diabetes, high blood pressure, sleep apnea, or heart failure. Bariatric surgery should also be considered for people with a BMI of 30 to 34.9 with type 2 diabetes who have poor glycemic control even after appropriate lifestyle changes and drug treatment.

To qualify for surgery, people also need to do the following:

• Understand the risks and effects of bariatric surgery
• Be motivated to follow the changes in diet and lifestyle required after surgery
• Have tried other methods of losing weight
• Be physically and mentally able to undergo surgery

Usually, age alone is not a factor when bariatric surgery is being considered. In people under 18, bariatric surgery has had good short-term results. However, experience with this surgery in this age group is limited. Many people over 65 have had a bariatric procedure, but results have been mixed, and the risk of complications may be higher. However, in this age group, other factors, such as whether a person has other disorders or can function well, may be more important than age.

Surgery is not appropriate if people

• Have a psychiatric disorder that is not under control (such as major depression)
• Abuse drugs or alcohol
• Have cancer that is not in remission or another life-threatening disorder

[Julene]

an operation that makes the stomach smaller so that less food can be eaten and digested