The Basics
Research has shown that, in many cases, underlying causes of obesity are genetic, environmental, and social. Studies have demonstrated that, once the problem is established, efforts such as dieting and exercise programs have a limited ability to provide effective long-term relief. The yo-yo diet phenomenon describes patients who lose weight with a diet and regain it back plus more after a few months.
The weight-loss experts with Keck Medicine of USC’s Bariatric Surgery program understand the many factors that contribute to lasting weight loss. That’s why we offer surgical, nutritional, and social support to help our patients achieve long-term success.
It is calculated as a measure of a person’s weight in relation to their height. BMI allows health care professionals and patients to better understand health issues associated with a specific weight classification, such as obesity or morbid obesity.
- BMI 20-25: Ideal
- BMI 25-30: overweight
- BMI over 30: obesity
- BMI over 40: morbid obesity
With a little work and a good support system, it can be a life-changing step towards developing positive habits and taking charge of your health.
Bariatric surgery intended for people who have a body mass index (BMI) of 40 or greater. This condition is also called morbid obesity.
A person with a body mass index of 35 or greater and one or more co-morbid conditions such as high blood pressure, sleep apnea, or type 2 diabetes, may qualify for bariatric surgery.
Bariatric surgery is generally reserved for people who have not had success with other weight loss therapies such as diet, exercise, and medications.
Remember:
- Bariatric surgery is not cosmetic surgery.
- Bariatric surgery does not involve the removal of fat by suction or surgical removal.
- Bariatric surgery works alongside long-term lifestyle changes, including diet and exercise, which are key to long-term success.
- Shorter life expectancy
- Serious health consequences in the form of weight-related health problems (co-morbid conditions) such as Type 2 diabetes and heart disease
- A lower quality of life with fewer economic and social opportunities
- Sleeve gastrectomy: This is currently the most common bariatric procedure. It transforms the stomach into a banana shape. Patients lose weight because they eat smaller portions and feel less hungry.
- Gastric bypass: This prodcedure transforms the stomach into a smaller pouch and attaches it to a lower part of the intestine. Patients lose weight because they eat smaller portions and absorb less fat while feeling less hungry.
- Revisions: This procedure is for patients who have had previous weight loss surgery but are experiencing weight regain, too much weight loss, or any other complication. Revisions for past lap band surgeries are common.
Statistically, bariatric surgery results in:
- 92% reduction in mortality from type 2 diabetes
- 60% reduction on mortality from cancer, with the largest reductions seen in breast and colon cancers.
- 56% reduction in mortality from coronary artery disease
There is also a 40% overall reduction in mortality after weight loss surgery.
More good news:
- More than 70% of patients who had sleeve or gastric bypass surgery experienced a complete resolution of type 2 diabetes symptoms. The rest had significant improvements.
- Patients who had bariatric surgery had lower insulin resistance and decreased risk for metabolic syndrome, high blood pressure, and high amounts of fats in the blood.
- 4% of patients who had gastric bypass surgery experienced complete resolution of high blood pressure. Sleeve gastrectomy achieved similar results.
- 95% of patients who had gastric bypass surgery showed improved cholesterol health. Sleeve gastrectomy achieved similar results.
- 6% of patients who had gastric bypass surgery experienced complete resolution of sleep apnea. Sleeve gastrectomy achieved similar results.
- 98% of patients who had gastric bypass surgery experienced complete resolution of acid reflux/GERD. Sleeve gastrectomy achieved similar results.
- 47% of patients who had gastric bypass surgery experienced Improvement of depression symptoms. Sleeve gastrectomy achieved similar results
- 41% of patients who had gastric bypass surgery experienced complete resolution of osteoarthritis. Sleeve gastrectomy achieved similar results.
- 44% of patients who had gastric bypass surgery experienced complete resolution of stress urinary incontinence. Sleeve gastrectomy achieved similar results.
- 100% of patients who had gastric bypass surgery experienced complete resolution of menstrual dysfunction due to PCOS. Sleeve gastrectomy achieved similar results.
- 100% of patients who had gastric bypass surgery experienced complete resolution of menstrual dysfunction due to PCOS. Sleeve gastrectomy achieved similar results.
- 79% of patients who had gastric bypass surgery experienced complete resolution of excess hair due to PCOS. Sleeve gastrectomy achieved similar results.
- Patients who had bariatric surgery also experienced restored ovulation and fertility.
The Benefits
For people suffering from morbid obesity, bariatric surgery can be a powerful tool. For the surgery to be effective long term, the patient must be an active participant in getting healthier. Through lifestyle changes, such as regular exercise and a healthy food plan, many patients are able to make a long-term change for better health.
Results of five-year follow-up:
Treatment | Weight Loss Success (Percentage of Patients) |
---|---|
Diet and exercise* | 2 to 5 percent |
Medication** | 0 percent |
Bariatric surgery*** | 50 to 90 percent |
* Success measured as a loss of 10 percent of initial body weight.
** Weight loss is not maintained once treatment ends.
*** Success measured as a loss of 50 percent of excess body weight (equivalent to loss of approximately 20 to 25 percent of initial body weight).
Qualifying for bariatric surgery
Qualified patients have:
- BMI of 40 or greater OR
- A BMI of 35 or greater with one or more co-morbid conditions
Other common guidelines include:
- Understanding the risks of bariatric surgery
- Committing to dietary and other lifestyle changes as recommended by the surgeon
- Having a history of failed weight loss treatments
- Undergoing a complete examination, including medical tests
- At Keck Medicine, we also ask patients to attend or watch our bariatric surgery seminar to make sure they are aware of our full program and all their options
The best way to determine if you qualify for bariatric surgery is to make an appointment to discuss your options with one of our bariatric surgeons.
Because every insurance policy is unique, it’s important that you thoroughly understand your insurance provider’s Certificate of Coverage to know exactly what is and isn’t covered through your plan. Our administrative team can help you understand your policy’s level of coverage.
As you think about paying for surgery, it’s important to ask about hidden “program fees” or “supplemental fees.” These are common at some bariatric programs in Southern California. At Keck medicine of USC, we never charge hidden or supplemental fees. Our staff will fully explain your costs at the outset.
The qualification process includes a series of tests with your bariatric surgeon. You also will meet with a nutritionist, psychologist and other support staff members in sessions leading up to surgery. Each health care professional will help you prepare for the changes and challenges that lie ahead.
Success after surgery
Further thinking
Clinical evidence indicates that morbid obesity itself carries a greater risk of mortality than bariatric surgery. That said, any surgery carries an inherent risk.
The Bariatric Surgery program at Keck Medicine of USC has achieved an outstanding record for safety, including one of the lowest complication rates in the nation. Our emphasis on clinical excellence and patient safety have earned our program recognition as a Metabolic and Bariatric Surgery Accreditation Quality Improvement Program Accredited Comprehensive Center and as a Blue Distinction Center by Blue Shield and Blue Cross.
For more reading on the risks and benefits of bariatric surgery, visit https://asmbs.org/resources/metabolic-and-bariatric-surgery.
- Nausea or Vomiting
- Nutritional deficiencies if vitamins are not taken after a gastric bypass
- Dehydration
- Gallstones
- The need to avoid pregnancy for the first year
We take every precaution to prevent these complications. Should they arise, your support team will work with you to treat and resolve them.
- Share your concerns and fears with your surgeon.
- Attend a support group and speak with patients who likely share the same fears.
- Learn about the complication rates and mortality rates of surgery.
- Listen to bariatric surgery patients share their own fears and concerns.
- And remember, you’ll have a team of health care professionals dedicated to your best possible care.
- Remember that in the vast majority of cases, the sensation of discomfort disappears after a few days and a positive experience is the norm.