Overview
According to the American Society for Metabolic and Bariatric Surgery (ASMBS), approximately 177,600 bariatric (weight loss) procedures were performed in the United States in 2006. Bariatric surgery can help morbidly obese individuals lose a significant amount of excess weight and keep it off long-term. Weight loss is aided by limiting intake, blocking calorie absorption, or both, depending on the type of procedure used.
Significance
According to the ASMBS, about 15 million (or one in 50) adult Americans are morbidly obese. Morbid obesity (more than 100 lb. of excess weight in men and 80 lb. of excess weight in women) is associated with more than 30 other diseases and conditions, including type 2 diabetes, high cholesterol, heart disease, sleep apnea, hypertension, asthma, cancer, joint problems and infertility. The direct and indirect costs of obesity-related illness are about $117 billion annually.
Types
Four bariatric surgery procedures are available to patients in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases. The adjustable gastric band is an inflatable band placed around the stomach that limits food intake. In the biliopancreatic diversion with duodenal switch procedure, a large portion of the stomach is removed and the digestive system is rerouted to block calories from being absorbed by the body. Gastric bypass, or “Roux-en-Y,” is a combination procedure that reduces the size of the stomach and bypasses a portion of the small intestine, thereby reducing intake and calorie absorption. The fourth procedure, the sleeve gastrectomy, involves removal of a large portion of the stomach, as in the first stage of the biliopancreatic diversion with duodenal switch. Although only limited three- to five-year data on this procedure is available, the ASMBS has accepted it as an approved surgery because it appears to reduce the risk of bariatric surgery in high-risk patients, either as a planned first stage surgery or as a stand-alone procedure. Whenever possible, procedures are performed using a laparoscope, or a tiny camera, through a small incision in the abdomen, although patients who are extremely obese may require an open incision in the abdomen.
Benefits
According to the ASMBS, bariatric surgery may be among the most effective treatments for many obesity-related diseases and conditions, including type 2 diabetes, depression, migraines, liver disease, polycystic ovary disease, degenerative joint disease, asthma, obstructive sleep apnea and hypertension. The percentage of excess weight loss varies with the type of procedure performed. Most patients lose half of their excess weight in the first six months after surgery. Weight loss usually stops within two years after the surgery.
Complications
Complications vary according to the procedure and the health of the patient. Complications may include pneumonia, blood clots, infection, gallstones, hernia, nausea, vomiting, diarrhea and nutritional deficiencies.
Warnings
According to the Mayo Clinic, bariatric surgery isn’t a magic fix for obesity. There is no guarantee that you will lose all of your excess weight or that you’ll keep it off. The postoperative eating and exercise regimen requires commitment, and is essential to long-term success.
Financial Matters
On average, bariatric surgery costs $20,000 to $25,000, according to the ASMBS. Many health insurance plans cover certain bariatric procedures if the surgery is considered medically necessary to correct an obesity-related illness.
About this Author
Marcy Brinkley’s articles about health care and legal issues have appeared in “Texas Health Law Reporter” and the “State Bar of Texas Health Law Section Report.” She holds a bachelor’s degree in nursing, a master’s degree in business administration and a Doctor of Jurisprudence.
