Are you frustrated with your weight? Are you afraid that you will always be heavy? Do you feel like you have tried every diet and exercise program without any results? If the answer to those questions is "yes," then it might be time to consider the weight loss surgery option.
But before you head to the surgeon's office, there are a few things to think about. Bariatric surgery isn't for everyone. There are risks to weigh, financial considerations to mull over, and medical issues to take into account. Ask yourself these questions to begin the process of considering surgery.
What is my BMI? If you don't know your body mass index (BMI), you can use this online calculator to figure it out, or have it evaluated in your health care provider's office. Once you have your number, you can use it as a starting point to see if surgery might be right for you.
If your BMI is greater than 40, most medical organizations recommend that weight loss surgery could be a reasonable option if you are healthy enough to sustain the procedure. If your BMI is 35 or over, you may be a good candidate for surgery if you have at least one obesity-related medical condition. And if your BMI is over 30 and your health is also compromised by diabetes or metabolic syndrome you may want to speak to your physician about bariatric surgery.
"For many people, a BMI of 30 is a tipping point," says Dr. Ninh T. Nguyen, MD, the President-elect of the American Society for Metabolic and Bariatric Surgery (ASMBS). In an interview with About.com about preparing for bariatric surgery, he suggests that when people reach a body mass index of 30, they can reasonably consider bariatric surgery if other attempts at weight loss have failed.
- Do I have any weight-related medical conditions? Excess weight can cause or aggravate medical conditions such as diabetes, sleep apnea, high cholesterol, heart disease and high blood pressure. In some cases, these conditions may make you a good candidate for weight loss surgery. But in other cases, they may affect your ability to withstand the surgical procedure. Your physician will be able to tell you more about how your condition will affect the procedure.
- Have I tried other weight loss programs? Surgery may be a good option when other methods of weight loss have failed. Have you tried losing weight with diet and exercise? Some insurance companies will only cover the expense of the procedure if you have tried traditional methods of weight loss for at least six months.
- Am I ready to change my lifestyle? Weight loss surgery isn't a magic wand. If you choose to undergo surgery, you will still have to modify your diet and eating habits. Patients who have the greatest success with bariatric surgery adopt moderate eating and exercise habits to maintain their weight loss over a long period of time.
Dr. Nguyen says that the lifestyle changes after surgery can be the hardest part of the recovery process. As part of the preparation process, he counsels his patients about the importance of understanding the physical, emotional, social changes that may occur after surgery.
- Have I investigated the different types of surgery available in my area? There are several different procedures available for patients who choose weight loss surgery. Roux-en-Y gastric bypass (RYGB), laproscopic adjustable gastric banding (LAGB), and laproscopic sleeve gastrectomy are three common types of surgery. Each procedure has different risks and benefits. You should find out more about each procedure before choosing one.
- Will insurance cover my expense? Insurance coverage varies by provider. You'll want to investigate your coverage for the initial surgery and for any possible future surgeries before you invest too much time considering the surgery. According to one report, 25% of patients considering surgery were denied coverage three times before finally getting approval.
- Can I afford the initial surgery and any subsequent surgeries if they become necessary? If your insurance coverage does not pay for the surgery, or if it only pays for part of the procedure, are you ready to contribute the extra expense? Bariatric surgery costs an average of $11,500 to $26,000. A revision of the surgery, if necessary, can cost $5,000 to $10,000.
- Will I have continued access to medical care? Most surgeries require that you continue to see your doctor to monitor your health in the years following treatment. Your doctor will monitor your weight loss, but may also adjust medications if necessary, provide recommendations for vitamin and mineral supplementation, and possibly suggest adjustments to your surgery. Patients who have lap band surgery, for example, may need to have the size of the band adjusted to meet their weight loss needs.
Going under the knife is a big decision and a big commitment. Use these questions as a starting point for considering the weight loss surgery option. Once you know the answers, continue to get advice from reliable sources, such as your medical provider, a board-certified bariatric surgeon, and other people who have undergone the procedure.
Access to Care. Morbid Obesity & Metabolic and Bariatric Surgery Fact Sheet. American Society for Metabolic & Bariatric Surgery. Accessed: July 12, 2012. http://asmbs.org/
American Society for Metabolic & Bariatric Surgery. Accessed: July 12, 2012. http://asmbs.org/
Managing the Severely Obese Patient: An Integrated Approach. Allergan Lap Band System. Continued Medical Education Course. July, 2011
Metabolic and Bariatric Surgery Fact Sheet American Society for Metabolic & Bariatric Surgery. Accessed: July 12, 2012. http://asmbs.org/
Nguyen, Ninh T., MD, President-elect, American Society for Metabolic and Bariatric Surgery. Interview. July 16, 2012
Weight Control Information Network. Bariatric Surgery for Severe Obesity. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed: July 12, 2012. http://win.niddk.nih.gov/publications/gastric.htm