When To Say Yes to Weight-Loss Surgery

You’ve dieted. You’ve exercised. You’ve made New Year’s resolutions, joined online support groups or followed weight-loss apps — yet you’re still overweight or obese. Is it time for bariatric surgery?

The answer might be yes.

Three Main Weight-Loss Options

In medical terms, people with a body mass index of 25 or more are overweight; 30 or higher BMI is obese. Your doctor will determine yours using a detailed formula.

If you want to lose weight, you have three major options:

• Diet and exercise. On your own or guided by a dietitian, at the gym or in your living room, you can choose the least invasive way to drop pounds. Eat less, drink fewer high-calorie beverages, and choose foods that are leaner and unprocessed. In addition, add exercise to your daily routine. The downside: For the diet-exercise combo to work, you need to commit to lifestyle changes for life. One study shows that most obese people who lose weight this way gain it back within four years.
• Medications. You can try a weight-loss medication. Many people choose one of the Glucagon-like peptide-1 receptor agonists. Doctors originally prescribed some only for patients with diabetes. Today, many people have found success by taking these pharmaceuticals to shed pounds — about 20 percent of their body weight. The drugs will curb your appetite, so you won’t feel hungry as often. The downsides: Unless you have Type 2 diabetes, insurance might not cover the prescription, or might cover it for a while and then stop. Out-of-pocket costs can be steep. And, you’ll likely need to take the medication for the rest of your life or the weight will return.
• Surgery. Weight-loss surgery, also called bariatric surgery, has been around for 70 years. It involves a specialist performing one of several types of operations that make you unable to eat large quantities at one time. Following psychological and dietary assessments, you’ll work with a surgeon to select the best type of bariatric surgery for your needs. Studies show that patients tend to lose 50 percent to 70 percent of their excess weight within three years, or 20 percent to 30 percent of their starting weight, although not all keep it all off. The downsides: All surgeries have inherent dangers. Also, you’ll need to eat only small quantities of foods in a single sitting for the rest of your life.

Stumped? Ask Yourself These Questions

As your own advocate, you alone will choose whether to keep your weight as it is or take one of three options to slim down. If you’re committed to weight loss, you’ll likely try the diet-exercise combo first, then choose one of the others.

If you’re leaning toward surgery, ask yourself these questions:

• Where do I want to be in one, five and 20 years?
• Do I feel like I failed at nonsurgical strategies?
• Am I really ready to change my lifestyle forever so I can keep off the weight I lose?
• Am I eligible for a bariatric procedure based on having multiple medical conditions, known as “comorbidities”?
• Do I know enough about the surgical options to choose the best one for me?
• What are potential short- and long-term complications, and will I be able to deal with them if they happen?
• Do I have a support system of family or friends?
• Will I be able to maintain a new diet that is high in lean proteins and low in carbohydrates?
• Can I afford the foods I will need, since proteins are more expensive than carbs?

If you answer yes to most of these questions, you are likely an appropriate candidate for bariatric surgery. Just know that, while effective, it is not a shortcut. You will still need to change your eating habits and exercise regularly. You will not magically become and stay thin.

How You’ll Benefit from Weight Loss

However you choose to lose large amounts of weight, you’ll improve your health and life in unexpected ways. It’s not just about shopping in popular stores and being judged less by strangers. It’s about health.

If your BMI returns to the “healthy” range of 18.5 to 24.9, your medical challenges might ease up. Sleep apnea, Type 2 diabetes and high blood pressure might disappear. Your arthritis might decrease, and the acid reflux too. Your libido may rev up. Joints may hurt less and liver issues might dissipate.

A thinner body, together with healthier eating habits and regular exercise, will help you in many ways beyond looks. Choose the method that’s best for you and change your life.