Should You Consider Weight-Loss Surgery?

Having weight-loss surgery because of obesity is a major decision that will alter your life forever. It changes what and how much you can eat. You’ll have to swap your normal-size meals for small portions that you eat slowly, and you may have to give up some of your favorite foods.
But weight-loss surgery may be just what you need if you’re carrying around a significant amount of extra weight that you haven’t been able to lose through diet and exercise. With obesity rates in the United States soaring, many are choosing weight-loss surgery. The American Society for Metabolic and Bariatric Surgery estimated over 220,000 people in the United States had bariatric surgery in 2008 — more than double the number of just five years earlier.
It’s a big choice to make, and one that should take some time and contemplation.

Weight-Loss Surgery: Are You a Good Candidate?
There’s a misconception that anyone can decide to have weight-loss surgery, explains Margaret Furtado, RD, a clinical dietitian specialist at the Johns Hopkins Bayview Medical Center Bariatric Surgery Program in Baltimore. Bariatric surgery programs like the one at Johns Hopkins have a screening process to determine if this surgery is right for each patient.
Screening starts with evaluating your body mass index, or BMI, a calculation based on your weight in relation to your height. The minimum weight criteria is either:

• BMI of 40 or higher, with or without health problems
• BMI of 35 or higher with health problems such as diabetes, heart disease, or sleep apnea

Typically, men who have weight-loss surgery are 100 pounds or more overweight and women are 80 pounds or more overweight, according to the National Institutes of Health.
Weight-Loss Surgery: Have You Tried Diet and Exercise?
Insurance companies require that patients first try to lose weight by eating healthy foods, cutting portions, and exercising for at least six consecutive months. If that fails, they meet the criteria for weight-loss surgery. Most people attempt this by working with their primary physician or through classes at a medical center, Furtado says. But it can also be done through Weight Watchers, Jenny Craig, NutriSystem, or other weight-loss programs.
Other questions that need to be answered include:

• Do you have untreated emotional problems? Part of the screening involves meeting with a psychologist at the weight-loss surgery center to make sure you are not binge eating and don’t have untreated depression. If you’re experiencing a condition like binge eating, you may need cognitive-behavioral therapy before you can have the surgery, Furtado says.
• What are your expectations? When a patient tells Furtado that she wants weight-loss surgery in order to be a size 2 or to look like her personal trainer, she explains that those are unrealistic expectations and may be a sign that she’s not ready for the surgery. The same goes for patients who refuse to give up drinking soda or won’t quit smoking before the surgery. “It’s a red flag that they’re not ready,” Furtado says.

How do you know when you are ready? When you understand that weight-loss surgery is a tool to help you take control of your weight for the rest of your life and that the ultimate goal is to be healthy. “Some people think their life will be perfect,” Furtado says. The reality is, there’s work to be done after the surgery. You’ll still have to think about your diet, you’ll have to practice mindful eating, you’ll have to eat slowly, and you’ll have to listen to your body’s signals of feeling hungry and feeling full.
If you’re ready and you meet the criteria, you have the opportunity to see big-time results. The average patient loses 60 to 75 percent of excess weight during the first two years after surgery. Studies show that weight-loss surgery can resolve diabetes in 77 percent of patients and sleep apnea in 86 percent of patients. High blood pressure and high cholesterol can also be improved or resolved in many patients.
Weight-loss surgery can mean a whole new life for you, as long as your goals are realistic and centered on wellness.