Your Decision

The decision about whether to undergo obesity surgery is fairly complex and most importantly, very personal. You must understand that weight-loss surgery is a major undertaking, and though most patients enjoy an improvement in obesity-related health conditions and self-esteem after successful surgery, these results should not be the overriding motivation for having the procedure.

Deciding to undergo a bariatric surgical procedure will change your life in a dramatic and permanent way, so there’s no such thing as too much careful consideration. Even if you are interested in having surgery, your goals should be to live better, healthier and longer.

For all these reasons, you should make the decision to have weight-loss surgery only after careful consideration and consultation with an experienced bariatric surgeon or a knowledgeable family physician. A qualified surgeon should answer your questions clearly and explain the exact details of the procedure, the extent of the recovery period and the reality of the follow-up care that will be required. As part of routine evaluation for weight-loss surgery, they may require you to consult with a dietitian/nutritionist and a psychiatrist/therapist. This is to help establish a clear understanding of the post-operative changes in behavior that are essential for long-term success.

It is important to remember that there are no ironclad guarantees in any kind of medicine or surgery. There can be unexpected outcomes in even the simplest procedures. What can be said, however, is that weight-loss surgery will only succeed when the patient makes a lifelong commitment. Some of the challenges facing a person after weight-loss surgery can be unexpected. Lifestyle changes can strain relationships within families and between married couples. To help patients achieve their goals and deal with the changes surgery and weight-loss can bring, most bariatric surgeons offer follow-up care that includes support groups, dieticians and other forms of continuing education.

Ultimately, the decision to have the procedure is up to you. After having heard all the information, you must decide if the benefits outweigh the side effects and potential complications. Remember, this surgery is only a tool. Your ultimate success depends on strict adherence to the recommended dietary, exercise and lifestyle changes.

The following are considerations that help determine whether or not a patient should have gastric bypass surgery.

• Weight
  Surgery is only offered when a patient is so heavy that they meet the medical definition of morbid obesity and have failed dietary and medical management of this problem. For patients who do not meet these criteria, the risk of surgery outweighs the expected health benefits of the weight-loss. Bariatric surgery should never be done solely for cosmetic reasons. Unlike other centers in the country, we currently do not offer bariatric surgery to someone who does not meet the weight criteria.
• Ability to comply with therapy
  You must be able to follow the advice of your surgeon, especially regarding dietary habits after surgery. Again, bariatric surgery is only a tool, a patient’s expectations are unrealistic if a patient depends on the procedure to "take care of the weight problem" in some magical way. Dietary habits that we recommend after bariatric surgery are simple and very effective if adhered to. Bariatric surgery is a powerful tool to achieve long-lasting weight-loss if used correctly.
• Complicated medical conditions
  Some people who are severely obese are extremely ill as a result of their obesity. In these individuals, the excess weight may have caused significant and permanent damage to one or more organ systems. The most commonly affected organs are the lungs (sleep apnea), the heart (congestive failure or coronary artery disease), the kidneys (damage from diabetes or high blood pressure), and bones and joints (damage from stress and arthritis). Medical problems like these increase the risk of any major surgical procedure including bariatric surgery, but they also strengthen the need for weight-loss. In other words, patients with these medical conditions require careful consideration, but do not necessarily require surgery. It is the sole decision of our surgeons to decide whether your risk of undergoing surgery outweighs your current medical risks – and then offer you gastric bypass surgery.
• Age
  Surgical candidates at the extremes of the age spectrum also require extra consideration to evaluate the appropriateness of surgery. UI Hospitals and Clinics generally does not offer this kind of surgery to patients who are older than 60 years of age or younger than 20 since they may be at a higher-than-average risk for this operation, and also because they may not completely benefit from its outcome. For example, older patients may not be physically active and will therefore not be able to comply with the exercise regimen after surgery. Similarly, on the younger side of the age spectrum, the concern is not medical risk but more a question of whether the individual can fully understand what they are getting into. Patients must demonstrate exceptional maturity and independent thought to be good candidates for a bariatric surgical procedure.