Being on the bariatric surgery division really changes your perspective on obesity and ways to combat it. Currently, the indications for bariatric surgery are a BMI > 40, BMI > 35 w/ comorbidities (such as hypertension, diabetes, asthma, etc), and BMI > 30 w/ intractable diabetes and/or metabolic syndrome. In addition, bariatric surgery is indicated for those who have failed all conventional methods of weight loss. The process for being approved for bariatric surgery is intense. Patients need to demonstrate that are motivated to make significant changes to their lifestyle post surgery. Therefore, patients undergo psychological assessment as well as extensive nutritional counseling.
Currently, there are three major surgical options for weight loss surgery: Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy and gastric banding. Gastric banding has fallen out favor and really I’ve only seen RYGB and sleeve gastrectomies in the OR. Patients tend to do really well after these operations. Both the RYGB and the sleeve are done laparoscopically. Since the operation is minimally invasive, patients tend to heal quite quickly. In fact, most of the patients I saw went home the same day or one day after their operation.
In terms of outcome, both the RYGB and the sleeves have comparable outcomes. Both result in significant weight loss after 2 years. For RYGBs, the weight loss is maintained for ~10 years! Following up regularly with patients helps with ensuring weight loss as well as with preventing complications. I’ve interacted with a number of bariatric patients who have undergone these procedures, and most of them are very happy with the results!
