Given the rate of obesity in the United States and the potential outcomes, many Americans are now considering bariatric surgery. Of the many types of bariatric surgery options: gastric bypass, gastric band, gastric sleeve, duodenal switch, how does one select the best bariatric surgery for oneself?
Let’s start with a few startling facts to put the need for obesity surgery into perspective. Sixty-six percent of all adults in the United States are overweight or obese. The rate of obesity has doubled for adults and tripled for children over the last twenty years. Heart disease, high blood pressure, and diabetes are all outcomes of being overweight. Seven out of every 10 deaths in the United States are the result of chronic diseases. In 2005, 78% of people over 55 years old had at least one chronic disease. In addition to chronic diseases, obesity can also contribute to depression, stroke, arthritis, and cancer.
Determining the Best Bariatric Surgery
Before you select which is the best bariatric surgery for you, here are some questions to ask yourself:
What is your goal? How much weight do you wish to lose? Your body mass index must be above 40 for gastric bypass and gastric sleeve, while the duodenal switch is generally indicated for patients that meet the higher end of the threshold for severe obesity. If you body mass index is between 35 and 40, you may still be considered for these bariatric surgeries if you have a chronic health problem. However, if your body mass index is 30 then you may qualify for the gastric band surgery.
Do you have other medical conditions? Although too numerous to list in this article, there are some health conditions that will exclude you from certain types of bariatric procedures, thus narrowing your options. So be sure to discuss your complete medical history with your bariatric surgeon. Some health problems can complicate even the best bariatric surgery, such as blood clots and nutritional deficiencies.
How much weight loss do you need to achieve? On average, the duodenal switch yields the greatest weight loss and the gastric band yields the least. What is your perspective on permanently changing your anatomy? The gastric band is the only reversible bariatric surgery.
How motivated are you? The best bariatric surgery often depends not so much on the procedure that you select but rather on you ability to make the required lifestyle changes. Permanent programs of diet and exercise will be required as well as a regiment of vitamins and supplements, which varies between the types of bariatric surgery. Generally-speaking, the gastric band requires the least supplementation and the duodenal switch requiring the most. Are you prepared for long-term dedication?
Here are some general considerations: What other methods have you tried to lose weight? Have you tried diet and exercise and not been successful? Have you tried these methods a number of times? Approval for any bariatric surgery is in part dependent on this criteria.
Are you in good emotional health? Certain psychological conditions can compromise the benefits of the so-called best bariatric surgery. For example, a person suffering from depression may be asked to address his or her condition prior to having bariatric surgery. Alcohol abuse also can be problematic. Read “Passing the Bariatric Psych Evaluation.”
Does your health care insurance cover bariatric surgery? If so, which types of bariatric surgery are covered? What is the criteria for insurance approval? Weight-loss surgery can be expensive, and your insurance carrier will want you meet certain criteria for each of the specific types of bariatric surgery.
You may wish to read My Bariatric Life’s overviews on each of the bariatric surgery types:
Gastric Band Surgery Facts
Gastric Sleeve Surgery Facts
Gastric Bypass Surgery Facts
Duodenal Switch Surgery Facts
Finding the Help You Need for Bariatric Surgery
There are things you need to do when you search for a bariatric surgeon. The first thing is to exercise some patience and find a good bariatric surgery program, whether that be within a bariatric center of excellence or a private bariatric surgery practice. Chances are you are anxious to begin, but your situation is probably not a emergency. Read “Choosing the Right Bariatric Surgeon.”
A good bariatric surgery program will give information about the different options for weight-loss surgery, as well as which is the best bariatric surgery for you. They’ll also make direct conversation about pre- and post-surgery support programs of diet and exercise and lifestyle changes to support permanent weight loss.
Know your bariatric surgeon’s medical credentials, training, and certifications. Ask the surgeon about his/her level of bariatric surgery experience and level of success and complications with each type of surgery that you are considering. You will want a bariatric surgeon who is well-experienced in the type of bariatric surgery that you will undergo.
Inquire about the level of support you will receive post-weight-loss surgery. Does the bariatric surgeon’s program have support groups, a nutritionist, or a physical therapist? A bit of help after your weight-loss surgery can stretch a long way in ensuring coping skills after weight-loss.
Explore your bariatric surgery options and do some homework. Have consultations with two or more bariatric surgeons and their support staff to determine what is the best bariatric surgery for you. Connect with bariatric patients at support groups and online communities such as BariatricPal and ThinnerTimes. Keep in mind, however, that the best bariatric surgery for someone else may not be the best bariatric surgery for you.
In the end, when all of your research and interviews have been done, pair your findings with common sense and good old gut instinct, and you will have found the best bariatric surgery to meet your weight loss goals and lifestyle behaviors.
Living larger than ever,
My Bariatric Life
Photo: Dr. Vishal Mehta