Losing weight is one of the most common New Year's resolutions. Going about it sounds straightforward enough: replace unhealthy with healthy foods, eat less, exercise more.

Easier said than done.

Currently, 30% of the U.S. population is considered overweight (BMI 25-30) and an additional 40% are considered obese (BMI>30). All in all, 70% of the population is either overweight and/or obese. Obesity has multiple deleterious effects on the body and, as a result, individuals may suffer from many obesity-related conditions. Conditions vary and may range from high blood pressure to diabetes, from physical joint pains to psychological and emotional disorders, from sleep apnea to cancer and even infertility.

Contrary to popular belief, most people with obesity have tried to lose weight. Many successfully, losing 20, 50, 100 pounds, to sadly regain it months later. They diet and exercise. Many attend weight loss camps or support groups, while other undergo hypnosis and biofeedback. They take supplements and medications.

When the odds of losing weight are stacked against you, then bariatric surgery may be the best alternative. 

What is bariatric surgery?

Bariatric or weight-loss surgery helps you lose weight by reducing the size of your stomach and, therefore, limiting how much you can or want to eat. There are various types of bariatric procedures, and they all have one thing in common: they require your participation in the weight loss process in order to succeed.

Bariatric surgery can help you lose a certain amount of weight—maybe the first 30-50 pounds comes off very quickly with minimal activity—but it won't eliminate all the weight you need to lose or guarantee that you keep it off. To make your surgery a success, you must change your eating habits and take your health seriously. You must dedicate yourself to achieving overall wellness through proper nutrition and exercise. If you don't, then you're likely to return to your presurgical weight.

Who are the candidates who qualify for bariatric surgery?

Bariatric surgery candidates must have:

• BMI of 35 to 39.9, with two or more comorbidities, such as diabetes, hypertension, sleep apnea or heart disease, a history of cancer, or joint pain
• BMI of 40 or more, with or without comorbidities
• Proven inability to lose weight
• Medical conditions that are due to obesity and or worsened by it
• Physical, psychological, social, or economic problems that could be significantly improved by weight loss
• Motivation and commitment

Candidates will not be considered for surgery if they meet any of the following exclusion criteria:

• Obesity related to a metabolic or endocrine disorder
• Untreated history of substance abuse or major psychiatric problem
• Surgery contraindications, meaning the surgery may be high-risk or life-threatening
• Women who are currently or attempting to become pregnant

What kinds of support do bariatric surgery patients need?

Doing these things alone can be tough. The most successful bariatric surgery patients are those who are not only determined to succeed, but also have essential support from:

• A healthy relationship with a partner
• Encouraging family members
• Committed friends
• Understanding colleagues
• Easy access to healthy food
• Willingness to exercise

Why is it important for weight-loss surgery patients to undergo nutrition counseling?

The success of any weight-loss surgery also depends on your participation in nutrition counseling. For at least two to three months before and several months after surgery, you will work with a team of individuals who will educate and instruct you on better eating habits. They will guide you on proper nutritional choices, portion control, and methods to avoid inappropriate foods. The education and understanding you achieve throughout this period will allow you to choose appropriate foods that are healthy for you.

Will I ever eat or enjoy food again?

There are many misconceptions about weight-loss surgery. One is that you'll never be able to enjoy delicious food or have ice cream again. Wrong! Instead, you'll be able to enjoy such items occasionally and in a more controlled manner. You'll think twice before indulging and develop a measured approach to eating. Completely removing such items eventually leads to failure. Our goal is to educate you to make the proper choices. Surgery is only a tool to help you succeed.  

Another myth is that bariatric surgery is easy or "a short-cut." It’s not! It takes a lot of courage to do this. Bariatric surgery gives you a second chance at living a healthy life. For those who undergo the process, they are investing in a better future, not only for themselves, but for their loved ones.

About the Author

James Bonheur, MD is Stamford Health's Director of Bariatric Surgery.