Clinical studies show that, following surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. Patients may lose 30 to 50% of their excess weight in the first six months and 77% of excess weight as early as 12 months after surgery. Another study showed that patients can maintain a 50-60% loss of excess weight 10-14 years after surgery. Patients with higher initial BMIs tend to lose more total weight. Patients with lower initial BMIs will lose a greater percentage of their excess weight and will more likely come closer to their ideal body weight. Patients with Type 2 Diabetes tend to show less overall excess weight loss than patients without Type 2 Diabetes. The surgery has been found to be effective in improving and controlling many obesity-related health conditions. A 2000 study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved. For example, many patients with Type 2 Diabetes, while showing less overall excess weight loss, have demonstrated excellent resolution of their diabetic condition, to the point of having little or no need for continuing medication.
The actual weight a patient will lose after the procedure is dependent on several factors. These include:
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Patient's age
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Weight before surgery
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Overall condition of patient's health
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Surgical procedure
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Ability to exercise
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Commitment to maintaining dietary guidelines and other follow-up care
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Motivation of patient and cooperation of their family, friends and associates
In general, weight loss surgery success is defined as achieving loss of 50% or more of excess body weight and maintaining that level for at least five years. Clinical data will vary for each of the different procedures mentioned on this site. Results may also vary by surgeon. Ask your doctor for the clinical data stating their results of the procedure they are recommending.
Indication
Weight loss surgery is typically reserved for those individuals 100 pounds or more overweight (Body Mass Index [BMI] of 40 or higher) who have not responded to other less invasive therapies such as diet, exercise, medications, etc. In certain circumstances, less morbidly obese patients (with BMIs between 35 and 40) may be considered for surgery (patients with high-risk co-morbid conditions and obesity-induced physical problems that are interfering with quality of life).
Surgery should not be considered until you and your doctor have evaluated all other options. The proper approach to weight-loss surgery requires discussion and careful consideration of the following with your doctor:
- These procedures are in no way to be considered as cosmetic surgery.
- The surgery does not involve the removal of adipose tissue (fat) by suction or excision.
- A decision to elect surgical treatment requires an assessment of the risk and benefit to the patient and the meticulous performance of the appropriate surgical procedure.
- These weight loss surgical procedures (approved in the United States) are not reversible.
- The success of weight loss surgery is dependent upon long-term lifestyle changes in diet and exercise.
Complications and Risks
As with any surgery, there are operative and long-term complications and risks associated with weight loss surgical procedures that should be discussed with your doctor. Possible risks include, but are not limited to:
- Bleeding*
- Complications due to anesthesia and medications
- Deep vein thrombosis
- Dehiscence
- Infections
- Leaks from staple line breakdown
- Marginal ulcers
- Pulmonary problems
- Spleen injury*
- Stenosis
*Removal of the spleen is necessary in about 0.3% of patients to control operative bleeding. If surgery is performed laparoscopically and complications occur during the operation, your doctor may choose to perform open surgery.
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