October 30, 2023

For many, weight loss is not as simple as exercising more and eating less.

Morbid obesity is a disease that has silently affected more than a third of our nation in the last two decades. Surgery aimed at producing weight loss has been around for nearly 70 years. The procedures have evolved over time into what we refer to today as bariatric surgery or weight-loss surgery.

Recently, bariatric surgery has been shown to be superior in numerous clinical trials at producing weight loss and helping to control the diseases associated with obesity, including type 2 diabetes, high blood pressure, high cholesterol, sleep apnea and numerous other chronic health conditions.

The procedures are aimed at decreasing the amount of food you eat, decreasing the calories you absorb and impacting hunger. The procedures are currently approved for those individuals with a body mass index (BMI, a way of comparing an individual’s health risk based on both height and weight) of 40 and above, or BMI of 35 with one or more obesity-related health problem.

Weight-loss surgery is very effective helping some people lose 50 to 75 percent of excess body weight, producing great control of health conditions and improving quality of life. There are several myths associated with surgery; here they are with the facts.

Myth No. 1: Weight-loss surgery is the “easy way out.”

Fact: Most individuals believe the answer to obesity is to exercise more and eat less. However, large clinical studies tell us that diet and exercise alone rarely lead to meaningful weight loss in individuals suffering from morbid obesity.

The road to surgery is usually not a quick (or easy) one; the preoperative process involves an evaluation with the surgeon, dietitian and psychologist, and medical clearance to ensure surgery is safe. Once a patient proceeds with weight-loss surgery, he or she will attend frequent clinic appointments to help maintain certain diet and lifestyle changes needed for maximal success.

Myth No. 2: Weight-loss surgery is a dangerous procedure.

Fact: Weight-loss surgery has been shown to safely produce significant and sustained weight loss, decreasing the death rate due to obesity-related diseases by up to 89 percent. Although individual risk will vary, advances in surgical technique have decreased hospital stays and lowered the risk of death within the 30 days following weight-loss surgery to 0.13 percent, or approximately one out of 1,000 patients. This rate is noticeably less than most other operations, including hip-replacement surgery and gallbladder removal.

No. 3: Most people regain their weight back after surgery.

Fact: Although it is not uncommon to see a weight regain of 5 to 10 percent in the two years after surgery, most patients maintain weight loss equal to or greater than 50 percent of excess body weight long term, compared to 95 percent of individuals who gain their weight back after conventional weight-loss methods.

No. 4: Weight-loss surgeries create serious health problems caused by vitamin & mineral deficiencies.

Some weight-loss surgeries may lead to vitamin and mineral deficiencies caused by reduced nutrient intake or reduced absorption from the intestine. However, most of these deficiencies are avoided by regular use of oral vitamin and mineral supplements. Health problems related to vitamin deficiencies are rare in patients who follow the recommended guidelines.

This story was written by Dr. Matthew Spann, a fellowship-trained surgeon specializing in minimally invasive bariatric surgery at Vanderbilt Center for Surgical Weight Loss.

Need support to help you lose weight?

The Vanderbilt Surgical Weight Loss program offers advanced care to help you lose weight and improve your overall health. If you’ve been unable to reach a healthy weight with nutritional and lifestyle improvements alone, surgery might be a better and safer option for achieving your weight loss goals. Vanderbilt’s team will work with you to develop a personalized care plan combining surgery, nutrition, exercise and psychological support.

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