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Bariatric Surgery: Losing Weight is Just the Start

By now, most everyone is familiar with the dramatic weight loss that can be achieved through weight loss (bariatric) surgery. If you haven’t experienced it with a friend or family member, you’ve probably seen celebrities who’ve lost an amazing amount of weight following bariatric surgery and seem to be quite happy about it.

But evidence suggests that losing weight, although significant, is only one of many benefits that weight loss surgery can deliver.

According to Dr. Scott Shikora, Director, Center for Metabolic Health and Bariatric Surgery at Brigham and Women’s Hospital, prospective patients should be educated about the significant related health benefits that bariatric surgery can provide, not just the weight loss. He explains that most of us are aware that bariatric surgery can lead to a trimmer body and a corresponding increase in self-esteem, but many of us don’t realize how many diseases may be effectively treated through weight loss surgery.

Shikora and his peers are thus trying to raise awareness about the breadth of weight loss surgery’s benefits. “The field is now more focused on the health benefits of weight loss surgery,” says Shikora. “We talk to patients about the health benefits first, and then we talk about how much weight they can expect to lose.”

Weight loss surgery has the demonstrated potential to dramatically improve a variety of health conditions, including heart disease, depression, asthma, infertility (in women), osteoarthritis, and gout. However, bariatric surgery is also believed to be particularly effective at treating metabolic conditions such as type 2 diabetes, high blood pressure, high cholesterol, fatty liver disease, and obstructive sleep apnea – and in some cases, such as type 2 diabetes, independent of weight loss.

“Gastric bypass, in particular, has been shown to be extraordinary in its ability to improve or even cure diabetes,” says Dr. Shikora. He explains that some 80 percent of patients with type 2 diabetes can expect to leave the hospital with normal blood sugars and be off all their medications within days of surgery.

Furthermore, studies have shown that obese patients who undergo bariatric surgery are less likely to die from a heart attack or stroke than those patients who undergo more conventional treatment for their weight condition.

“Quite simply,” says Shikora, “I’m convinced that, overall, qualified candidates who opt to have bariatric surgery end up living longer and having a better quality of life.”

Shikora, however, stresses that certain criteria must be met before surgery becomes part of the conversation. To qualify, a candidate must have a body mass index (BMI) of 40 or more, or a BMI between 35 and 40 and significant co-morbid conditions. In either case, patients must also show that they have tried other methods of losing weight and that they are ready to commit to long-term post-operative care and significant adjustments to their diet. For these patients, surgery is a recommended course of treatment.

Yet Shikora is aware that there are still people who believe that bariatric surgery is a shortcut because patients should simply work harder to eat less.  “What they’re failing to realize is that while bad eating habits certainly do play into this, it’s often genetics,” explains Shikora. “And people can’t beat their genes.”

– Chris P