Across the United States, many of us carry a few extra pounds. But true obesity can take a severe toll on your health and your life. Modern bariatric surgery has shown success in safely reducing obesity and fighting related conditions.
That’s what drives Thomas Hirai, MD, a weight-loss surgeon at El Camino Health in Los Gatos, California. Dr. Hirai is fellowship trained in minimally invasive and bariatric surgery.
“When I came across these patients who’d had bariatric surgery, I could see them resolving their type 2 diabetes, heart disease and other related health problems,” he says. “That’s why I decided to do this. It can have such a strong impact not only on longevity but on quality of life.”
So how do you know whether bariatric surgery right for you? Here are a few things to consider.
Are You a Candidate?
The first factor is your body mass index (BMI) — an estimate of your body fat based on weight and height. You may benefit from bariatric surgery, and insurance, Medicare or Medicaid may cover it, if:
- Your BMI is 40 or more, or
- Your BMI is 35 or more, and you have at least one serious related health problem.
You’ll need to consult with a dietician and be cleared by a mental health professional to ensure you can make the needed lifestyle changes after surgery. You’ll probably need medical tests to make sure you’re healthy enough for the surgery. If you smoke, make quitting your first priority; most bariatric surgeons will not operate on tobacco users.
The Procedure: What to Expect
Most bariatric surgery today is laparoscopic, performed through small incisions using a camera for guidance. The most common procedures are sleeve gastrectomy and gastric bypass. Sleeve gastrectomy removes a large part of the stomach. Gastric bypass reduces the size of the stomach and bypasses part of the small intestine, so you do not absorb all the calories from the food you eat. Both procedures should leave you feeling full faster.
“We go over the options and work with each patient to choose the most suitable operation,” says Dr. Hirai.
After surgery, you’ll spend one or two nights in the hospital. You’ll be up and around quickly, to speed recovery and help prevent complications. You’ll start with liquids only, and the team will work with you to add solid foods.
Lifestyle Change is Key
For long-term success, you’ll need to commit to taking the best care of yourself. That means eating healthy foods in the right amounts and staying active, as well as keeping follow-up appointments. Your surgeon will prescribe nutritional supplements and check your vitamin and mineral levels regularly. You’ll also need to avoid certain medicines, such as ibuprofen, which can increase the risk of stomach ulcers.
Taking the Next Step
You may want to start with your regular primary care doctor, then talk to a bariatric surgeon. Dr. Hirai does not require a physician referral for an appointment, but your insurance might.
“There’s no obligation or pressure, as your commitment is key to your success,” he says.