When assessing the safety of bariatric surgery, a patient should consider if the risks of living with obesity far outweigh the risks of surgery.
With so many Americans living with obesity, pre-existing conditions arise from obesity that put their health in danger. Obesity mortality increases by 30% for every 5 kg/m2 above 25 kg/m2 BMI (body mass index). A BMI of 40+ decreases life expectancy by 8-10 years. From heart disease, hypertension, type II diabetes, to sleep apnea, lung failure, kidney failure, obesity causes many cases of premature death. Bariatric surgery can be the solution for not only improving your quality of life, but also extended your life expectancy.
Bariatric surgery today such as Gastric bypass or VSG (vertical sleeve gastrectomy) uses a small, thin laparoscope with a tiny camera to conduct surgery, making the patient’s surgery minimally invasive. Thus, providing an improved recovery time and increased level of safety by reducing scarring and post-op pain. Morbidly obese people have a BMI of 40+, with such extra weight comes many limitations on lifestyle activities. Patients may worry about the complication risks involved. With such risks, do come great benefits, especially when those risks are considered far less than living with the risks of long-term obesity.
Benefits of Bariatric Surgery
According to the Cleveland Clinic, less than 5% of people attempting to lose weight on their own keep it off for five years or greater. The majority of people trying to lose weight on their own gain back the weight they lost within a year. Benefits of bariatric surgery include, but are not limited to:
- Improved physique/physical appearance, especially with the popular Gastric sleeve surgery, see Gastric sleeve before and after
- long-term weight loss
- Improved heart health
- Relieves joint pain
- Improved fertility
- Decreased risk of depression and other mental health conditions
- Increased remission of type II diabetes
- Alleviates other pre-existing conditions (e.g., asthma, gastroesophageal reflux disease/GERD, hypertension, sleep apnea, etc.)
Types of Bariatric surgery
Bariatric surgery started in 1954 with the jejunoileal bypass. Then went on to develop into the Gastric bypass procedure in 1977, which showed much success and became a favorable surgery of choice in the 1980s. Gastric band came out in the late 1970s as non-adjustable, which had complications, so the improved adjustable gastric band was marketed in 1985. Decreased complications and improved weight loss were noted. Biliopancreatic diversion and biliopancreatic diversion with duodenal switch or BPD/DS was developed in 1987.
In 1993, LAGB (laparoscopically placed adjustable gastric band) or Lap Band emerged as a minimally invasive improved option to combat complications and gained approval in 2001. Laparoscopic sleeve gastrectomy (LSG or VSG or Gastric sleeve) emerged in 1999 and gained popularity. VSG is the most popular bariatric surgery in the US today since 2016
Dangers of Bariatric Surgery
No surgery comes without risks. The following are common risks associated with bariatric surgery, but not limited to:
- Procedures can be non-reversible.
- Weight loss quantity cannot be guaranteed. Research suggests 15-35% of patients fail to reach their weight loss goals post-surgery.
- Complications can arise such as sepsis (deadly infection spread throughout bloodstream after surgery). According to the University of Michigan, serious complications occur at a rate of less than 5%.
- Other risks can include the development of malnutrition, ulcers, or death.
- Patients are required to maintain a special diet after surgery.
Bariatric Surgery Research
Successful bariatric surgery has developed over the years to better define postoperative outcomes.
| Study Journal/ Organization | Year | Finding |
| Annals of Surgery | 2007 | A national registry study of various bariatric surgical patient clinical results post-op concluded the short-term mortality rates after bariatric surgery occur less than 0.5 %. |
| BMC Endocrine Disorders | 2020 | For patients with a median BMI of 48 kg/m2, excess body weight loss obtained by patients before bariatric surgery was only on average 7% from diet/exercise. Gastric bypass was performed on 87% of patients and a Gastric sleeve was done on 13% of patients. Furthermore, 80% of patients experienced weight loss of 50% or more following one year of bariatric surgery, indicating a successful surgical outcome. |
| PCORI | 2020 | Gastric bypass patients experienced a 26% total weight loss reduction, while Gastric sleeve patients experienced a 19% total weight loss reduction, and Lap band patients experienced a 12% total weight loss reduction at 5 years post-operation. |
Final thoughts on Bariatric surgery
The benefits of bariatric surgery by far outweigh the risks when considering pro-longed patient health. From understanding your personal health situation, to researching your healthcare needs, bariatric surgery can be a helpful tool. On a personal level, we must consider if bariatric surgery will benefit our body, our mind, our lifestyle, our family, our goals, our future, and if the answer is yes, then it just may be the right choice for you!