Surgical weight loss procedures have been in development since the 1950’s. The procedures that are done today are the refined and carefully honed products of these earlier procedures. When comparing weight loss results from surgical procedures with those due to diet and exercise the results are clear and very compelling. If you have a BMI of 30 or more you will have a better weight loss and more sustained weight loss with surgery than compared to any dietary or medical weight loss method. The amount of weight loss varies depending on the procedure as well as patient compliance. In general, the weight loss associated with the gastric bypass (RYGB), sleeve gastrectomy, and the duodenal switch are similar with 70-80% of excess weight loss. The weight loss with the lap-band is somewhat less with about 50% of excess weight loss. The average bariatric surgery patient maintains about 50-65% of their excess weight loss longterm.
In addition to more substantial and sustainable weight loss, bariatric surgery has a more favorable impact on the improvement or resolution of obesity-related co-morbidities than do dietary or medical weight loss methods. In the case of type II diabetes, patients with a BMI greater than 30 will likely experience a 20-35% excess weight loss and will also lower fasting blood glucose and have a greater likelihood of diabetes remission. This promotes mean normal blood sugars and consequently discontinuation of medications for treatment of diabetes. The gastric bypass and duodenal switch have the highest diabetes remission rates at about 85%. Given the insidious nature of diabetes and the potential complications that greatly diminish quality of life this is great news!
Patients with high blood pressure or elevated cholesterol with a BMI greater than 30 with the same 20-35% excess weight loss will also see higher remission rates with bariatric surgery. Again, very compelling data given the difficulty of managing hypertension and its side effects longterm.
Finally, quality of life is greatly improved with bariatric surgery for the morbidly obese patient. In addition, life expectancy is favorably impacted with bariatric surgery compared to dietary or medical weight loss treatment.
In summary, if you have a BMI of 26-30 weight loss achieved through diet and lifestyle changes is your best initial option. But if your BMI is greater than 35 with major medical co-morbities (diabetes, high blood pressure, obstructive sleep apnea, high cholesterol) or your BMI is greater than 40 without any co-morbitities, surgery is your best option for substantial and sustainable weight loss as well as remission of major medical conditions. The data are definitive and very compelling. Bariatric surgery is highly effective for the morbidly obese patient who has struggled with achieving long-term weight loss over the years.
We can help you to accomplish your weight loss needs. Please call the Colorado Bariatric Surgery Institute (303-861-4505) to schedule your consultation and begin losing the weight and improving your health. It’s time to begin enjoying life!
Thomas Brown, MD
Colorado Bariatric Surgery Institute