What Is Bariatric Surgery, Really?

Bariatric surgery has developed an inaccurate reputation as the “last resort” for those needing to lose weight. With that being said, the reputation is well-deserved as the term weight loss surgery is, rather unfortunately, used interchangeably with bariatric surgery. And while a bariatric procedure’s most obvious effect is weight loss, the true benefits lie in the improvement or resolution of obesity related diseases such as high cholesterol, high blood pressure, type-2 diabetes and sleep apnea.

As we learn more about the effects of bariatric surgery on the body, it has become clear that benefits of these procedures extend far beyond the realm of weight loss alone. Recent studies have started to shed light on the gastric bypass procedure and consequent drastic improvement in type-2 diabetes even before the patient has lost a significant amount of weight. Seeing that type-2 diabetes has become one the most serious societal health challenges in the United States – and a small but growing proportion of diabetics do not have a BMI of 35 or over – this development is very important for the future of bariatric surgery.

As a result, we will likely see additional research on this topic and the possibility of the gastric bypass being appropriate for a wider cross-section of patients that are experiencing morbid obesity. This research is key to changing the conversation with many primary care doctors, insurance companies and even patients themselves that have pre-conceived notions.

The current trend, and it is a good one, is to rebrand weight loss surgery as metabolic surgery. This name change, while seemingly insignificant, is reflective of the benefits outside of weight loss alone. After all, metabolic syndrome represents a collection of diseases (many of which are related to excess weight) that affect those that are overweight, but not obese, as well as those of normal weight. And metabolic disease is not only causing a huge financial toll on the patient and our health system, but more importantly it limits patients’ abilities (often significantly) to perform activities that enrich their lives.

Ultimately, new light must be shed on metabolic surgery, promoting the understanding that improvements in techniques and devices have made surgery safer and more effective than ever. And when comparing the risks of surgery to many of the risks of poorly or uncontrolled metabolic disease, the choice is often clear. Further, we need to recognize that weight analysis, in the form of BMI, may not be the best indicator of the need for surgery. Rather a holistic approach to the patient’s general health should be taken into account when considering their candidacy.

We will keep you posted on the latest developments on these exciting possibilities in metabolic surgery. And we encourage you to contact our office with any questions you may have.