WHAT IS WEIGHT LOSS SURGERY?
Weight loss surgery, also know as bariatric surgery, is a major surgical procedure created to allow for people to lose a significant amount of weight quickly and safely. Further, the goal of every bariatric procedure is to improve or eliminate the diseases associated with morbid obesity. There are two forms of bariatric surgery – restrictive and malabsorptive. In restrictive procedures, the primary receptacle for food, the stomach, is restricted or physically made smaller in order to reduce the amount of food that can be ingested at one sitting. Malabsorptive bariatric surgery involves re-routing the small intestine in order to reduce the usable surface area of the small intestine, restricting caloric absorption and leading to weight loss. Some procedures such as the gastric bypass and duodenal switch are combination procedures that use both restriction and malabsorption to reduce weight.
Who is a Candidate for Bariatric Surgery?
Weight loss surgery is meant for people who are more than 75 pounds overweight (with a Body Mass Index of 40 or greater) and who have not been able to sustain weight loss with other forms of weight management programs including diet, exercise, medication and physician supervised weight loss.
While those with a BMI of over 40 can qualify for surgery without obesity related diseases, those with a BMI of 35-39.9 can also qualify if they have one or more co-morbid conditions. Patients considering the Lap-Band® can qualify for that procedure with a BMI of as low as 30 with obesity related diseases.
Ultimately bariatric surgery is a disease resolution tool and most surgeons and insurance companies will evaluate a patient’s need for the surgery – called medical necessity. This, along with surgical risk, will be the deciding factor as to whether a patient is suited to bariatric surgery to manage their weight problems.
The difference between laparoscopic / minimally invasive surgery and open surgery:
Open surgery is rarely performed in the bariatric world today. Only in cases of need, such as when there is excessive scar tissue in the surgical area, does it need to be used. Open surgery involves the creation of a long single incision that opens the abdomen to plain view so a surgeon can place his hands into the abdomen.. Laparoscopic, or minimally invasive, surgery allows the surgeon to access the abdominal cavity using only a few small incisions in the abdomen. By using a fiber-optic camera and specially made long-handled medical devices, the same procedure can be performed without the major trauma to the abdominal muscle.
Compared to open surgery, minimally invasive surgery offers:
- A shorter hospital stay
- Faster recovery
- Less pain and blood loss
- Less abdominal trauma
- Less scarring
Is Bariatric Surgery Effective?
Study after study has shown the effectiveness of bariatric surgery. In particular, a review of more than 22,000 bariatric surgery patients showed that these procedures can in fact help improve or eliminate many co-morbid conditions. For example, the study showed:
- Improvement in or complete resolution of conditions including type 2 diabetes, hypertension, and sleep apnea.
- 60% reduction of excess weight.
What are the Risks?
Mortality Rates (Risk of Death) According to the 2004 ASMBS Consensus Statement:
|Gastric banding||0.1%||1 out of every 1,000 people|
|Gastric bypass||0.5%||1 out of every 200 people|
|Hip fracture repair||3.3 to 8.2%10,11||6 out of every 200 people|
Insurance: Bariatric surgery is within reach for many prospective patients because it is often covered by their health insurance plan including Medicare and Medicaid.
Those who do not have a health insurance policy and wish to have the procedure will have to self-pay. Since few people can pay for the full procedure up front, it may be worth considering financing the procedure. Some options include:
- Medical Loans: Most bariatric practices will be able to refer you to a third-party medical financing company. Please review the terms of the loan very carefully.
- Home Equity Loans Borrowing against the value of your home is another option to finance surgery. Again, ensure you fully understand the terms of your loan.