When is Weight Loss Surgery less risky than doing nothing?

Determining whether it’s the right time to have weight-loss surgery requires the consideration of several factors. Typically, a person who is one-hundred, or more, pounds over their ideal weight and has tried various lifestyle adjustments in order to lose the weight, namely employing exercise and proper nutrition, is considered to be a candidate for bariatric surgery.

It is, however, difficult to determine at what point you are losing the battle and the risk of surgery is greater than the risk of continuing with your current diet regimen. It is key to consider both the risks of both longstanding obesity and those of medical intervention and choose the option that has fewer inherent risks and provide a higher quality of life.

First, let’s have a look at the exhaustive list of health risks associated with having weight-loss surgery according to Mayo Clinic. Keep in mind that most of the risks associated with these surgical procedures are common to most any kind of surgery, and that the longer-term risks are most often associated with a failure to follow the post-surgical dietary guidelines prescribed by the patients’ surgeons and nutritionists, a lifestyle commitment whose importance is emphasized prior to electing for surgery.

As with any major surgery, gastric bypass and other weight-loss surgeries pose potential health risks, both in the short term and long term.

Risks associated with the surgical procedure can include:

·       Excessive bleeding

·       Infection

·       Adverse reactions to anesthesia

·       Blood clots

·       Lung or breathing problems

·       Leaks in your gastrointestinal system

·       Death (rare)

Longer term risks and complications of weight-loss surgery vary depending on the type of surgery. They can include:

·       Bowel obstruction

·       Dumping syndrome, causing diarrhea, nausea or vomiting

·       Gallstones

·       Hernias

·       Low blood sugar (hypoglycemia)

·       Malnutrition

·       Stomach perforation

·       Ulcers

·       Vomiting

·       Death (rare)

While many of these potential complications are due to the patient’s cooperation in terms of diet and lifestyle, they also depend on the experience and skill of the operating surgeon. You should always find out how many surgeries a doctor has performed, and maybe interview a couple of his or her former patients before advancing to the operating room.

Second, let’s examine some of the many health risks associated with obesity (>30 BMI) and morbid obesity (>40 BMI) according to Mayo Clinic:

If you're obese, you're more likely to develop a number of potentially serious health problems, including:

·       High triglycerides and low high-density lipoprotein (HDL) cholesterol

·       Type 2 diabetes

·       High blood pressure

·       Metabolic syndrome — a combination of high blood sugar, high blood pressure, high triglycerides and low HDL cholesterol

·       Heart disease

·       Stroke

·       Cancer, including cancer of the uterus, cervix, endometrium, ovaries, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate

·       Breathing disorders, including sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts

·       Gallbladder disease

·       Gynecologic problems, such as infertility and irregular periods

·       Erectile dysfunction and sexual health issues

·       Nonalcoholic fatty liver disease, a condition in which fat builds up in the liver and can cause inflammation or scarring

·       Osteoarthritis

·       Skin conditions, including poor wound healing

Quality of life

When you're obese, your overall quality of life may be lower, too. You may not be able to do things you'd normally enjoy as easily as you'd like, such as participating in enjoyable activities. You may avoid public places. Obese people may even encounter discrimination.

Other weight-related issues that may affect your quality of life include:

·       Depression

·       Disability

·       Sexual problems

·       Shame and guilt

·       Social isolation

·       Lower work achievement

As you may surmise, the side effects of being chronically obese are vast and severely affect peoples' quality of life. Some of the more complicated conditions have been medically proven to be reversed 

through bariatric weight-loss surgeries including diabetes, hypertension, high cholesterol and sleep apnea. This being the case, people need to realize that every month that goes by without doing something to reverse this condition is another month of letting these risk factors settle in more fully as likely outcomes rather than mere possibilities.

I require that patients do everything they can in terms of adjusting their lives to include healthy habits prior to going the surgical route. For many people, this just doesn’t work after even the most painstaking efforts. I suppose I could summarize my outlook as this:

Weight loss surgery is only justifiable when the risk to do nothing is greater than the risk to have surgery. At that point, however, it seems not only justifiable but crucial.

Sources:

http://www.mayoclinic.org/tests-procedures/bariatric-surgery/basics/risks/prc-20019138

http://www.mayoclinic.org/diseases-conditions/obesity/basics/complications/con-20014834