Weight Loss Surgery – Perspectives and Indications for Surgery

In the United States, sleeve gastrectomy or vertical longitudinal sleeve gastrectomy is the most commonly performed weight-loss surgery, followed by gastric bypass, adjustable gastric band, and duodenal switch. Sleeve Gastrectomy and other types of weight-loss surgery, collectively known as bariatric surgery, make surgical changes to your stomach and in some cases your intestines to limit how much food you can eat and in some cases nutrient absorption, leading to weight loss.

Like any major procedure, it has potential side effects. In addition, the long-term success of surgery depends on your ability to make changes to your lifestyle. When you want to be considered for sleeve surgery or other procedures, you must undergo an evaluation. 

At Texas Endosurgery Associates, under the expert guidance of Dr. Ricardo Bonnor, MD, FACS, FASMBS, we evaluate each patient to determine their suitability for weight loss surgery. Call (281) 579-5638 or complete a short inquiry form for further details.

Fellow of the American College of Surgeons FACS
ASMBS Ricardo Bonnor

Obesity

A body weight that exceeds the ideal range for age, gender, and height by 20% poses a significant health hazard. (1) Research recognizes that excess weight significantly reduces individuals’ quality of life, particularly by affecting overall health and hindering daily activities, leading to diminished well-being. Moreover, studies on this subject indicate that individuals with obesity not only face physical health repercussions but also encounter social stigmatization. (2)

Health conditions related to obesity can include type 2 diabetes, hypertension, sleep apnea, and joint problems, among others. These conditions can significantly impact a person’s overall health and well-being. While diet and exercise are the primary methods for weight management, they may not always be effective for individuals with severe obesity. In such cases, weight loss surgery, also known as bariatric surgery, can provide a viable solution.

Are You?

  • Well-informed about the surgical procedure and the effects of treatment?
  • Determined to lose weight and improve your health?
  • Aware of how your life may change after the operation (adjustment to the side effects of the operation, including the inability to eat large meals)?
  • Aware that you will need to avoid smoking, carbonated, or sugary drinks after the operation to avoid problems?
  • Aware of the potential for serious complications, dietary restrictions, and occasional failures?
  • Committed to medical follow-up and vitamin/mineral supplementation?

Body Mass Index

Determining who is a good candidate for weight loss surgery involves several important considerations. Firstly, doctors examine the individual’s body mass index (BMI). BMI is a measure of body fat based on height and weight. 

Generally, BMI values between 18.5 and 24.9 are considered within the normal weight range. A BMI of 25 to 29.9 indicates overweight, while a BMI of 30 or above is classified as obesity. Factors such as muscle mass, age, gender, and ethnicity can influence an individual’s BMI interpretation. Generally, those with a BMI of 40 or higher with or without health conditions, or a BMI of 30 or higher with underlying health conditions related to obesity may be eligible for weight loss surgery. (3)

Are you a candidate? Find out using our Quick Assessment!

Questions/Perspectives to Consider

  • Are you ready to commit to lifestyle changes?
  • What is your ideal body weight? How much will you need to lose to reach this?
  • Do you smoke? Do you drink alcohol in excess?
  • Are you extremely limited in activity? You must be able to perform exercise after surgery.
  • Are you currently in a social environment that is supportive of your goals?
  • Do you understand the operation and know the risks associated with bariatric surgery?
  • Are you willing and want to make the necessary lifestyle changes for a successful outcome?

Medical Conditions Preventing Weight Loss Surgery

Certain medical conditions may be absolutely or relatively contraindicated in weight loss surgery due to the potential risks involved. 

  • Pre-existing heart conditions: Individuals with severe heart disease or a history of heart attack may not be suitable candidates for weight loss surgery. The stress placed on the cardiovascular system during surgery can pose significant risks. (4)
  • Uncontrolled high blood pressure: Uncontrolled hypertension can increase the chances of complications during and after surgery. It is crucial to stabilize blood pressure levels before considering weight loss surgery.
  • Severe lung disease: Conditions such as severe chronic obstructive pulmonary disease (COPD) or pulmonary hypertension can make surgery risky due to compromised lung function.
  • Active cancer or recent history of cancer: Undergoing weight loss surgery during active cancer treatment is contraindicated. 
  • Chronic kidney disease: Impaired kidney function can affect the body’s ability to recover from surgery and may increase the risk of complications. This is a relative contraindication not absolute.
  • Uncontrolled diabetes: Poorly controlled diabetes can hinder the healing process and increase the risk of infections. It is essential to stabilize blood sugar levels before considering weight loss surgery. We require a hemoglobin A1C less than 8.0 prior to surgery.
  • Pregnancy or plans to become pregnant: Weight loss surgery is not recommended for individuals who are currently pregnant or planning to conceive within the next 18 months. Pregnancy places unique nutritional demands on the body.

Weight loss surgery is a tool that requires a lifelong commitment to dietary modifications, regular exercise, and ongoing medical follow-up. Patients must be willing to make these lifestyle changes to achieve sustainable weight loss.

Preparation for Long-Term Change

Beyond the immediate post-surgery period, long-term success hinges on adopting healthier habits for life. Patients must adhere to a nutrient-dense diet, emphasizing lean proteins and vegetables, while limiting refined sugars and fats. Regular physical activity becomes integral, promoting fitness and maintaining weight loss. 

Emotional well-being is also important, necessitating coping mechanisms and a supportive environment. Routine medical check-ups and ongoing monitoring ensure sustained progress. 

Cost of Weight Loss Surgery in Houston

At Texas Endosurgery Associates, Dr. Bonnor and his experienced team are dedicated to helping you achieve long-lasting results. Call (281) 579-5638 or contact us today!

Commonly Asked Questions (FAQ)

What dietary restrictions should I follow after weight loss surgery?

After weight loss surgery, it is crucial to adopt and maintain a healthy eating plan. This typically involves consuming smaller portions, choosing nutrient-dense foods, and avoiding high-calorie or sugary options.  

Is psychological support necessary after weight loss surgery?

Psychological support is highly beneficial after weight loss surgery. Significant weight loss can bring about emotional challenges and adjustments. Access to counseling or support groups can help navigate these changes and promote mental well-being throughout your weight loss journey.

How can I maintain my weight loss after surgery?

Maintaining weight loss requires ongoing commitment and dedication. It involves adhering to healthy eating habits, regular exercise, attending follow-up appointments, and monitoring your progress.

References

  1. Milena Gulinac, Dimitrina Miteva, Peshevska-Sekulovska M, et al. Long-term effectiveness, outcomes and complications of bariatric surgery. World Journal of Clinical Cases. 2023;11(19):4504-4512. doi:https://doi.org/10.12998/wjcc.v11.i19.4504 
  2. Soroceanu RP, Timofte DV, Danila R, et al. The Impact of Bariatric Surgery on Quality of Life in Patients with Obesity. Journal of Clinical Medicine. 2023;12(13):4225. doi:https://doi.org/10.3390/jcm12134225 
  3. Stahl JM, Malhotra S. Obesity Surgery Indications And Contraindications. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK513285/ 
  4. Stenberg E, Cao Y, Jernberg T, Näslund E. Safety of bariatric surgery in patients with previous acute coronary events or heart failure: nationwide cohort study. BJS Open. 2022;6(3):zrac083. doi:https://doi.org/10.1093/bjsopen/zrac083 
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