Bariatric Treatment - 7 Steps To Know If Treatment Is Right For You
Reviewed by:John Rabkin, MD
Bariatric treatment could drastically improve the health, happiness, and lifespan for the over 18 million Americans who currently qualify… could you or someone you love be one of them?
To find out if weight loss surgery is the right decision, review the information below, and click each section for more information.
01Causes of Obesity
- 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.
See our Cause and Effect of Obesity section for more about what’s led to your obesity and what impacts it has.
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…
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.
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
Enter your height and weight below to determine whether you might qualify for bariatric treatment (BMI of 35 or higher)…
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.
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
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.
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.
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…
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.
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…
1. What is/was your weight/BMI when you made the decision?
2. What were the deciding factors for you (i.e. health problems, self-image, obesity discrimination, etc.)?
3. What was the biggest hurdle you faced in deciding to move forward? How did you overcome it?
4. Did you try other treatments/diets first?
5. Anything else that was an important consideration.
Bariatric Treatment Decision-Making Process of Other Visitors*
Click below to see contributions from other visitors…
This isn't the usual story about recovery, but it's certainly one worth mentioning. After returning from New Orleans from the Obesity Help Event, I was getting a ride from the…
My Bariatric Treatment Decision & Outcomes*
I was tired of being overweight, working like a dog in the gym, gaining more and more weight, then if I could not spend 2 hours in the gym, gaining…
Support on different levels will make a positive impact on your weight loss surgery journey!*
I am a resource junkie! I believe in having support on different levels at different times. I don't have just one type of support in my weight loss journey, I…
Genetics, Pre-Diabetes and Arthritis Made Me Decide*
My name is Elizabeth and I am at my highest weight: 237.8. I was never an overweight child or teen, but after I got on birth control pills at the…
Do autoimmune diseases disqualify me from weight loss surgery?*
I have both Celiac's and Sjogren's disease. Does this disqualify me from weight loss surgery? I maintain a gluten-free diet and I take Evoxac for the Sjogren's.
Weight Loss Surgery for Morbidly Obese Patient That Does Not Overeat*
I am morbidly obese, but I have no appetite and hardly eat anything. How would this surgery help me? At 5ft tall I am 255 lbs. I had a very…
Dual bariatric surgery and hiatal hernia fix performed at the same time*
Has anyone had experience with dual bariatric surgery and hiatal hernia fix performed at the same time? I am considering either gastric bypass or gastric sleeve surgery along with large…
Seeking conversion from lap band to gastric bypass*
I had the lap band placed 4 yrs ago. I'm a female, 50 yrs old. I'm 5'7" and weighed 274 lbs. pre-band. I got down to 185 lbs about 1…
Lap Band Surgery to Enable Me to Go Back to Work*
My decision to have lap band surgery was ultimately to loose weight and enable me to go back to work. I have some fairly severe back issues and with the…
Weight Loss Surgery is a Lifestyle Change NOT a Diet*
I have struggled with obesity since my teenage years and all of my adulthood. My mother, father, grandparents, aunts, and uncles ALL struggle with obesity on BOTH sides of my…
Gastric Bypass Surgery: The Most Important Decision of My Life Made in 15 Minutes*
In December of 2001 I was watching Good Morning America and saw Carnie Wilson talk about gastric bypass for the first time in my life. A few minutes later a…
Choosing Between Surgery or a Lifetime of Diets*
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…
No More Fighting This Life-Long Affliction: Why I'm Moving Forward with Weight Loss Surgery*
Like others I too have had lifelong experience with the efforts, successes and, for lack of a better word, failures to lose weight and maintain a healthy and attractive body.…
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…
All I Want*
Today I was thinking about my mother and my grandmother. My grandmother died as a result of diabetes, and I was about 17 or 18 when my mother developed diabetes.…
My Crazy Lap Band Journey That Ended in Its Removal*
My name is Julie, and I have been overweight all my life. I started gaining weight at the age of 5. So, I was an overweight child, a fat teen…
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.…
My Reasons for Lap Band Surgery*
My name is Mindy. I was not one of those people who decided to have WLS ( weight loss surgery ) because I had been over weight all my life.In…
Strike A Pose (take photographs) BEFORE Weight Loss Surgery*
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 overweight…
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…
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…
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…
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…
Obese From the Heart: A fat psychiatrist discloses*
Obese from the Heart is an easy read and is written by Dr. Sara Stein. She is amazing and has a gift of explaining exactly what it feels like when…
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…
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…
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…
04Find a Top Weight Loss Surgeon
- Ask for a free insurance check/ cost quote/ attend a seminar/ webinar
- Schedule a phone or in-person consultation (both often free)
Search the weight loss surgeon directory below to find a top surgeon by country and region:
SEARCH BY LOCATION
SEARCH BY REGION
United States, Canada & Mexico
Australia, United Kingdom & International
References for Bariatric Treatment
- For the Media – JAMA and Archives.Study Examines Outcomes of Gastric Bypass Surgery in Morbidly Obese and
Superobese Patients. April 2009. Available at: http://pubs.ama-assn.org/media/2009a/0420.dtl. Accessed August 10,2009.
- Pennington Biomedical Research Center. Weight loss surgery extends lifespan. August 2007. Available at: http://www.pbrc.edu/News/News_Story.asp?id=73. Accessed: August 12, 2009.
- Groessl, Kaplan, Barrett-Connor, Ganiats. Obese older adults tend to have lower quality of life than normal or overweight individuals. Am J Prev Med 2004;26(2):126-9 (AHRQ grant HS09170)
- Cleveland Clinic Journal of Medicine. Risks and benefits of bariatric surgery:
Current evidence. November 2006. Available at: http://www.ccjm.org/content/73/11/993.full.pdf+html?sid=3e4e601f-6d3a-4175-
98af-d04e64e1409b. Accessed August 8, 2009.
- Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, MacLean LD. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg.
2004 Sep;240(3):416-23; discussion 423-4.
- National Safety Council. Report on Injuries in America Highlights from Injury Facts, 2009 Edition. Available at:
statistics/Pages/HighlightsFromInjuryFacts.aspx. Accessed: August13, 2009.
- DukeHealth.org. Duke Medicine News and Communications. Large-Scale Analysis Finds Bariatric Surgery Relatively Safe. Available at: http://www.dukehealth.org/HealthLibrary/
News/large_scale_analysis_finds_bariatric_surgery_relatively_safe. Accessed: August 10, 2009.
- University of Wisconsin School of Medicine and Public Health. 30-day Surgical Mortality Rate (All Major Cardiac Surgery Procedures). December 2007. Available at:
http://www.uwhealth.org/qualityreports/surgicalmortality/14489. Accessed: October 31, 2009.
- E. Logue, K. Sutton, D. Jarjoura and W. Smucker Department of Family Practice, Summa Health System, Akron, OH. Obesity management in primary care: assessment of readiness to change among 284
family practice patients. Jour Am Board of Fam Medicine. Vol 13, Issue 3 164-171, 2000.
- Mary Anne McCaffree, MD, Chair. The clinical utility of measuring body mass index and waist circumference in the diagnosis and management of adult overweight and
obesity. June 2008. Available at: http://www.ama-assn.org/ama1/pub/upload/mm/
38/a08csaphreports.pdf. Accessed: August 15, 2009.
- American Heart Association Task Force on Practice Guidelines. ACC/AHA Guideline Update for Perioperative Cardiovascular Evaluation for Noncardiac Surgery. February 2002. Available at:
http://www.circ.ahajournals.org/cgi/content/full/105/10/1257. Accessed: August 11, 2009.
- LeMont D, Moorehead, MK, Parish, MS, Reto, CS, Ritz SJ. American Society of Metabolic and Bariatric Surgery. SUGGESTIONS FOR THE PRE-SURGICAL PSYCHOLOGICAL ASSESSMENT OF BARIATRIC
SURGERY CANDIDATES. October 2004. Available at: http://www.asbs.org/html/pdf/PsychPreSurgicalAssessment.pdf. Accessed: August 12, 2009.