Surgical Weight Loss

Surgery is a treatment option suitable for some persons with obesity.  You and your doctor must work together to determine if you would benefit from obesity surgery, which is a major operation that can change your life in many ways. 

Outline of Topics Discussed Background & Risks Qualifications for Surgery Patient Profile Effects of Surgery Other Surgeries

You must know about the risks and benefits of the surgery and the commitment you will have to make to lifestyle change and life-long follow-up with your medical team.¹  You must also take into account the health risks of being severely obese, and the health benefits you can gain from losing excess weight. 

This fact sheet is intended to help you better understand obesity surgery and does not take the place of medical advice from your doctor.

Obesity Background and Health Risks

Being obese or severely obese puts you at a higher risk for developing or worsening many serious medical conditions.  There are more than 30 obesity-related medical conditions that can damage your quality of life and cause early death.  Some obesity-related medical conditions include arthritis, several cancers, carpal tunnel syndrome, cardiovascular disease, gallbladder disease, gout, hypertension, infertility, liver disease, low back pain, obstetric and gynecologic complications, sleep apnea, stroke, type 2 diabetes, and urinary stress incontinence.

Obesity is commonly measured by using the Body Mass Index (BMI). You can find out what your BMI is simply by knowing your height and weight and using a BMI chart (see Table 1) or BMI calculator.

Table 1 - BMI CHART

To use this chart: Find your height in the left column.  Move across that row toward the right to find your approximate weight.  Then follow the weight column up to find your BMI in the bar at the top.

You are considered obese if you have a BMI of 30 or more.²  The number of adult Americans (age 20 or older) who are obese has increased significantly in less than 20 years - from 15% to 26%.  Severe obesity is defined as having a BMI of 40 or more.³  Approximately 2.9% of US adults (age 20 or older) today are severely obese.

Weight loss is recommended for persons with obesity or severe obesity.  Losing excess weight can improve your health by lowering risks from obesity-related medical conditions.  Methods of weight loss include dietary therapy, increased physical activity, behavior therapy, drug therapy, surgery or a combination of therapies. Surgery is a well-established method of long-term weight control for persons with severe obesity.  Several studies have reported patient weight loss of 60% of excess weight after five years.³

The benefits of obesity surgery appear to outweigh the risks.²  Each person’s medical situation is different, however, and you should discuss with your doctor whether the benefits of obesity surgery outweigh the risks in your specific case.⁴

Is Obesity Surgery for You?

You may qualify for obesity surgery:

• If you are severely obese (BMI of 40 or more) or have a BMI of 35 to 39.9 with serious medical conditions (such as high blood cholesterol and triglycerides, hypertension, sleep apnea, type 2 diabetes and other serious cardiopulmonary disorders).
• If you have tried other methods of weight loss (changes in eating, behavior, increased physical activity and/or drug therapy) and are still severely obese.
• If you are unable to physically perform routine daily activities (work-related and family functions) and your quality of life is seriously impaired due to the severity of your obesity.
• If you understand the procedure, risks of surgery and effects after surgery.
• If you are motivated to making a lifelong behavioral commitment that includes well-balanced eating and physical activity habits which are needed to achieve the best results.

Patient Profile

• The International Bariatric Surgery Registry (IBSR) has put together a database with information on 14,641 people who have had obesity surgery.⁵  The patients had the following characteristics:
• Average Weight at Time of Operation: 279.4 pounds (+/- 60.3*)
• Average BMI at Time of Operation: 46 (+/- 8.3*)
• A BMI between 35 and 39.9: 19.7%
• A BMI of 40 or more: 76.1%

*add (+) or subtract (-) the number in parenthesis from the average number to find a range.

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Effects of Surgery

Obesity surgery helps you lose weight by changing the way your body digests and absorbs food.  Your body digests food to break down what you eat into small pieces of nutrients (carbohydrates, proteins, fats, vitamins and minerals).  When the pieces are small enough, the cells of your body absorb the nutrients to give you energy to live.

Digestion and absorption begin in the stomach, continue through the small intestine and end in the large intestine, which digests and absorbs what it can and eliminates the rest as waste.  Obesity surgery involves making changes to the stomach and/or small intestine.

The Stomach - is made smaller in size with surgery.  A section of your stomach is removed or closed which limits the amount of food it can hold and causes you to feel full.  This is called food intake restriction.^{6, 7}

Learn more about Restrictive Surgery Here!

The Small Intestine - is where most of digestion and absorption take place.  It has three parts: the duodenum (upper part connected to the stomach), the jejunum (middle part) and the ileum (lower part connected to the large intestine).  Surgery shortens the length of the small intestine and/or changes where it connects to the stomach. This limits the amount of food that is completely digested or absorbed and is called malabsorption.^{6, 7}

Through food intake restriction, malabsorption or both,  you can lose weight since less food either goes into your stomach or stays in your small intestine long enough to be digested and absorbed.

Learn more about Combined Restriction and Malabsorption Surgeries Here