Bariatric Surgery

Who is a candidate for bariatric surgery?

Eligible patients must meet the following criteria*:

• Failure of weight loss with non-surgical regimens
• Absence of uncontrolled endocrine/medical conditions
• BMI > 45 kg/m2
• BMI >35 kg/m2 with one or more medical conditions
• Absence of psychological instability
• Absence of drug or alcohol addiction

* Consensus Statement National Institutes of Health 1991

What are the options for surgical weight reduction?

Procedures are categorized as:

• restrictive (Lap-Band®, sleeve gastrectomy)
• restrictive and malabsorptive (gastric bypass)
• primarily malabsorptive (bilio-pancreatic diversion)

What are the most common risks of these operations?

• Lap-Band procedure:
  • Slippage of Band 5-10%
  • Erosion of Band 1-2%
• Gastric bypass procedure:
  • Ulcers 5%
  • Connection leaks 1-3%
  • Internal hernias 2%
• Lower extremity blood clots and pulmonary embolisms approx. 1% for both procedures.

What can the patient expect from the operation?

• Depending on the procedure performed - excess weight loss of 55-85%
• Resolution or improvement of diabetes in 80-90%
• Resolution or improvement of high blood pressure in 70-80%
• Resolution of acid reflux and sleep apnea in nearly 100%
• Significant improvements in fertility, arthritis, lower extremity swelling and overall quality of life

What are the 6 "rules" that must be followed for successful, long-term weight loss after surgery?

• Avoid high carbohydrate and high fat content foods
• Avoid eating and drinking together, and soft, pureed or liquid food choices
• Eat 3 meals per day with no snacking between meals
• Eat slowly and chew every bite thoroughly
• Regular exercise regimen
• Follow-up with regular appointments