Medically Reviewed by:John Rabkin, MD, FACSBoard Certified Bariatric Surgeon
Bariatric treatment could drastically improve the health, happiness, and lifespan for over 18 million Americans who currently qualify. Could you or someone you love be one of them?
Read below to find out if weight loss surgery is the right decision for you.
TABLE OF CONTENTS
Click on any of the topics below to jump directly to that section
- Food Addiction
- Availability & marketing of hyperpalatable foods
- Diet & lifestyle
According to the Centers for Disease Control, one out of every three people are considered obese in the United States, with over 18 million people qualifying as “morbidly obese”.
“Obesity is NOT your fault.”
And despite the uneducated viewpoints and offensive weight discrimination that run rampant, obese people are NOT lazy, are NOT ignorant and DO NOT lack willpower. In short, obesity is not your fault.
The confluence of several factors has led to the rise of obesity across the country and the rest of the developed world. They include…
- Obesity and genetics: hunger-inducing hormones along with the weight our bodies naturally “want” to be, also known as the Metabolic Set Point Theory
- Food addiction: When the need for food leads someone to desire and pursue it over other reasonable considerations such as personal health, family, friends, work, or strong personal desires like appearance or avoiding obesity related health issues like diabetes. Click here to take the Food Addiction Quiz to find out if you may be addicted to food.
- The prevalence and marketing of unhealthy and hyperpalatable food choices
- Our demanding, time-strained lifestyle
- Our choices (intentionally last on the list)
Long story short, we have millions of years of evolution working against us – driving us to crave foods that can act against our health in large amounts. We have a constant bombardment of negative influences. And many of us have a packed and exhausting life that makes finding time to eat healthy and exercise seem nearly impossible.
Bariatric treatment is not for everyone and does carry risks. But with the factors above pulling so hard in the opposite direction, surgery may be the only way to significantly improve your long-term physical and mental health.
- 7 questions to find out if surgery is right for you
You’re here, which says that you’re sick and tired of the effects that obesity can have.
- Obesity health problems
- Food Addiction
- Out of breath quickly
- Obesity discrimination
- Relationship problems
- Poor self-image
- Failed diet and exercise programs
Bariatric surgery will most likely eliminate or improve each of these. But before we learn together whether surgery is right for you, it is important to understand that bariatric surgery is not for everyone. Even if you fit the profile below, surgery should always be the treatment of last resort.
If you and your bariatric doctors decide that it makes sense to move forward, be prepared to do a LOT of work both before surgery and for the rest of your life. Bariatric surgery should be thought of as one of the most effective tools available, but in order to succeed you must be ready to completely change your life.
Ready to figure this out? Okay, let’s get started…
Have you thoroughly explored other treatments for obesity, including diet and exercise plans?
If you’re convinced that further attempts at losing weight on your own will be unsuccessful, professional help could be the answer. A study published in the Journal of the American Medical Association found that most patients are more open to losing weight under a doctor’s supervision (1).
In addition, many insurance companies require that you have gone through a medically supervised weight loss program before they will agree to pay for bariatric surgery.
Are you severely obese (BMI 35+)?
According to the National Institutes of Health guidelines, you could be a good candidate for bariatric treatment if one of the following applies…
- You have a body mass index (BMI) of 40 or more ("morbidly obese" or "super obese"), or
- Your BMI is between 35 and 39.9 ("severely obese") and you have a serious obesity-related health problem
Continue to check in with us on the body mass index (BMI) requirements for weight loss surgery. Due to all of the positive health effects, there is a strong push underway to drop the bariatric treatment minimum BMI requirement to 30.
Subscribe for free to The Bariatric Surgery Blog for updates.
How do you plan to pay for bariatric treatment?
Making sure you can afford Bariatric surgery is another major consideration when thinking about weight loss surgery.
If you have insurance, there are many obstacles to overcome before your surgery will be approved. If you don’t have insurance, you’ll either need to use your savings, borrow the money, or use some other way to finance your surgery.
We have the following pages dedicated to the significant questions you will probably need to answer when it comes to paying for weight loss surgery, including…
- For any questions having to do with the expenses associated with bariatric surgery visit our Cost of bariatric surgery page.
- Our page on Bariatric surgery insurance, including how to determine whether you’re covered and ways you may be able to get coverage added to your plan.
- Also, if you have questions about paying for weight loss surgery without insurance, we have a great resource called Financing bariatric surgery and the 7 options you should consider
Do your expectations of life after weight loss surgery match reality?
You should work with your bariatric doctors and their team to set realistic post-surgery goals. You should also gain a solid understanding of the changes you’ll experience during life after weight loss surgery.
In general, here’s what to expect:
On the positive side:
- Depending on the type of bariatric surgery you choose, the typical patient can expect to lose anywhere from 25% to 80%+ of their excess weight. As a guideline, your initial goal should be to get your body mass index below 30 (to figure out how many pounds getting to a BMI of 30 will equal for you, see our How to Calculate BMI page.A BMI of 25 is possible, but 30 should be the real target as that’s where many of the obesity-related health conditions begin to show significant improvement. (By the way, your body doesn’t want you too thin. Moderately overweight people actually live longer than those at “normal” weight (2).
“Moderately overweight people actually live longer than those at ‘normal’ weight.”
- Your obesity health issues will go away entirely or be greatly improved. For example, a study by the Cleveland Clinic showed that 83% of type II diabetes patients (study did not include gastric balloon patients) had complete resolution of the disease after bariatric surgery.
- Pregnancy after weight loss surgery will also be much safer than it would be if you didn’t have the surgery. In many cases, the surgery completely cures weight related infertility.
On the challenging side:
- As we’ll discuss further down the page, this will not be an easy process. Your new bariatric diet and weight loss surgery exercise program will require a lifelong commitment.
- You won’t see bariatric treatment results overnight. Your lowest weight typically will not be reached until 1 to 3 years out.
- Once you reach your low point, you are likely to experience some weight gain after bariatric surgery
- While bariatric treatment has become much safer over the last several years – the mortality rate is only 0.135%, while the mortality rate for all national hospital stays is 2.04% – you should still review and understand the possible bariatric surgery risks and bariatric surgery complications.
- Relationships with family and friends may change. (more on this further down the page)
- Unhealthy food cravings may or may not go away after surgery (malabsorptive surgeries tend to reduce food cravings more than purely restrictive procedures). If you give into the cravings, you will reduce your chances for hitting your goal weight and increase the risk of complications.
As mentioned above, bariatric treatment may be the best tool to make you happier and healthier, but that’s all it is… a tool. You will be the key to making it successful.
See our Life After Weight Loss Surgery page for more information about the changes to expect in each area of your life.
Does your doctor agree that bariatric treatment is a good option?
Bariatric Surgery Source is your eyes and ears for bariatric treatment-related research and updates, but you should always follow the advice of your doctors when determining what’s best.
In addition to the NIH and insurance company guidelines mentioned above, your doctor may have their own requirements. For example, your doctor may insist that you…
- Can move around well. Being bed-ridden or confined to a wheelchair will increase the chance of blood clot symptoms and complications following surgery.
- Have a BMI below 50 or lose 10% of your weight before surgery. The higher your BMI, the higher your risk for complications. However, many surgeons don’t require any weight loss prior to approving surgery.
- Be under a certain age, as the risk of complications may increase as you get older. If you are over 50, your doctor will most likely require cardiac clearance before approving surgery.
- Be old enough so that your growth plates have fused. Teen weight loss surgery may or may not be appropriate. Surgery will not be an option for children until their growth plates fuse, but even afterwards there are several factors to consider.
- Do not suffer from certain medical conditions
- Do not take certain medications that could increase your bariatric surgery risks.
If your doctor says no, don’t be too quick to give up, especially if you are confident that this is right for you.
First, ask if there’s another bariatric treatment that they consider to be safe.
If the answer is still no, ask if they know of another doctor who may be willing to consider you and your particular situation for surgery. Some bariatric doctors specialize in higher-risk patients.
Will your family and friends be supportive of your bariatric treatment?
Making sure you have a good support network before and after surgery has been shown in several studies to help you heal faster and to increase the likelihood that you will keep the weight off over the long term (3).
Be sure to communicate with your friends and family as much as possible about your wishes and goals, and also your worries and insecurities. This will help them understand your choice and get them on board with making sure you have the most successful experience possible.
“Will there be feelings of jealousy from your partner or your friends…?”
You’ll need help from family, friends, and dedicated groups such as in-person weight loss surgery support groups or online weight loss support groups in order to be successful. It is difficult to understate the importance of this support.
For example, will your family be willing to grocery shop differently to keep the wrong foods out of the house? Will they consider your new diet limitations when ordering at a restaurant to help keep temptation away? These choices can make or break your new lifestyle.
Will there be feelings of jealousy from your partner or your friends if you start to attract new or different types of attention when out in public?
Is your family willing to exercise with you to help keep you on track?
Even if your family is already supportive, they need to be educated to understand why your new habits are so important. Sit down with them and review the relative information on our site, especially the following pages.
Are you willing to do whatever it takes to make your bariatric treatment successful?
Here’s an important exercise that will help you answer this question thoroughly and honestly.
Download and print our “Is Bariatric Surgery Really Right for Me?” document (by clicking the link). In it you will find a series of questions that require careful thought.
When responding to each question, be as honest and reflective as possible. This will be for your eyes only.
In addition to helping you be sure that this life-changing procedure is right for you, your responses will help you get more out of your bariatric doctor, dietitian and psychologist visits. Countless patients have also said that when post-bariatric surgery life gets tough, reviewing their responses to these questions has helped them get back on track.
Complete the questionnaire, then return here.
Now that you’ve completed the questionnaire and have a clearer or renewed understanding of your personal struggles with weight loss, it’s time to consider the changes that are required after weight loss surgery.
You will have to commit to the following FOR THE REST OF YOUR LIFE…
- Bariatric diet
- A new weight loss surgery exercise routine
- Bariatric vitamins
- Follow-up doctor visits (as a part of life after weight loss surgery)
So you don’t lose your spot on this page, the above links will open in a new window. Click on each and read through them to get an understanding of how they will affect your life.
Summary of Whether Bariatric Treatment is Right for You
Despite what many people think, bariatric treatment is not an “easy way out”. Complying with the many requirements can be very difficult, especially when you’re just getting used to the new routine. Plus, it can be tempting to slip back into your old habits as time goes on.
Do you still feel that bariatric weight loss surgery is right for you? If so, put your work from this section in a safe place for future reference and make your way through the next steps further down the page.
First, the next two sections are for feedback from you and from other visitors to this page.
If you are seriously considering surgery, have decided to move forward with it, or already had surgery in the past, please share your decision making process. It’ll really help other visitors, as many who visit this page are struggling with the same issues. In many cases you can be that expert people visiting our site are trying to find.
Also take time to review the contributions from other visitors… their experiences may help in your decision-making process.
If you want to skip those sections and jump straight to "Next Steps", click here.
- Patient experiences
- Ask the expert
Is Bariatric Treatment for You?*
Your thought process leading up to your decision to have bariatric treatment is extremely valuable to other visitors who are also considering it.
Please include any or all aspects of your decision, including…
- What is/was your weight/BMI when you made the decision?
- What were the deciding factors for you (i.e. health problems, self-image, obesity discrimination, etc.)?
- What was the biggest hurdle you faced in deciding to move forward? How did you overcome it?
- Did you try other treatments/diets first?
- Anything else that was an important consideration.
Questions From Other Visitors*
Click below to see contributions from other visitors to this page.
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I have been overweight my entire adult life. I'm not sure what I weighed when I was in school, but I know that I was wearing size 12 stone washed…Obesity - Is It a Disability?*
This will most likely be a controversial subject (I'm still struggling with indecision), but it's something I've been thinking about lately. On my recent trip to Disney World, it was…My Crazy Lap Band Journey That Ended in Its Removal*
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As important as all the research I did before having weight loss surgery was (I'm 'almost OCD', especially about researching surgery!), pouring over every bit of inspiration I could find…Can I Still Have Weight Loss Surgery If I Don't Meet the BMI Requirement?*
Most insurance companies require a BMI of at least 35 to approve weight loss surgery. My BMI is just over 34. Can I opt to have the surgery anyway if…Denied Bariatric Surgery Due to Previous Hospitalizations?*
I began researching weight loss surgery in March 2011 and went to my first informational meeting April 1, 2011. I decided that I wanted to go forward and have Roux-en-Y…Bariatric Surgery & MS or Other Neurological Conditions*
Is it safe to do the procedure with a patient who has a neurological condition such as MS (multiple sclerosis)? I am a 37 year old female who has been…Lap-Band Weight Loss (then, the band lost it's fill)*
I had my band placed Dec 2005. My last fill was Aug 2006. I started at 240#, and lost down to 120#. I was on cloud 9, and stayed at…My Bariatric Treatment Decision*
I have struggled with my weight since I was about 17 years old. 40 years later I have finally decided to take the plunge after trying numerous diets and attempting…The Emotional First Aid Kit by Cynthia L. Alexander, PsyD*
The Emotional First Aid Kit: A Practical Guide to Life After Bariatric Surgery is one of my all-time favorite books. I recommend this book to both pre and post op…Weight loss surgery can be your most important tool ever, but ONLY if it's used the right way*
In reading some of the stories here or talking to others on other boards, it appears as if there is the misconception that weight loss surgery frees us from healthy…Eat it Up!*
I have always viewed the choice to have weight loss surgery as a lifelong lifestyle change. For me this lifestyle change affects us not just physically but also mentally and…If hunger is not the reason you eat, then eating is not the solution.*
Does the following sound familiar: You're having a meal at someone else's house, and the hostess brings in the rich, high calorie dessert, one of your favourites, which looks wonderful.…Why I Chose to Have Weight Loss Surgery*
I have been obese since about the age of 11. I have only known a life of being heavy and all the life aspects that go along with that (not…Tips On Choosing the Right Weight Loss Surgeon & Surgery Center*
Having weight loss surgery is a huge decision and life changing event. Many times people ask me how did I know which program to join and what surgeon to perform…Fighting Weight by Khaliah Ali: Book Review*
Recently I read a book about one person’s experiences with the gastric band, and enjoyed it very much. It’s called Fighting Weight by Khaliah Ali, with the help of a…