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Why Do People Need to Lose Weight Before Bariatric Surgery?

a person indoors
a person indoors

When you think of weight loss, you’re likely thinking of starting a healthy exercise regime, eating right, and maintaining a healthy lifestyle. But for some people, none of these tweaks and changes will be effective—which may make them candidates for weight loss surgery.

Some weight loss surgery (like liposuction and noninvasive fat reduction treatments) can be cosmetic. But we’re focusing here on the type of surgery people with health conditions like obesity may need—bariatric surgery.

What is Obesity?

Remember, obesity is not just significant weight gain. According to research, The National Institutes of Health declared obesity a disease in 1998. The American Obesity Society announced it as one in 2008, and The American Medical Association voted to recognize it as a disease in 2013. 

According to the World Health Organization (WHO), obesity is an epidemic in the U.S. As the CDC notes, over one-third of adults in the U.S. are obese, with the number continuing to rise—more than two in five adults has obesity.

And as data from the National Health and Nutrition Examination Survey found, in the U.S. alone, one in every 11 American adults has severe obesity. To find out more about the condition and the research surrounding it, check out our article on obesity.

Not everyone with obesity who has trouble losing weight is a candidate for bariatric surgery, but for those who are, this weight loss surgery can help with overall wellbeing. Read on to find out more.

Weight Loss Surgery isn’t a Miracle Cure for Obesity

No weight loss surgery can be a miracle cure for conditions like obesity. Instead, it’s a tool that can help people at risk of more severe complications if they don’t lose weight achieve and maintain long-term weight loss.

But for the surgery to be successful, patients need to be committed to making lifestyle changes and taking an active role in their own care. 

Interestingly, one of the most important things patients can do is lose weight before the surgery. But before we get into that, let’s learn a little more about the surgery itself.

What is Bariatric Surgery?

A surgeon in the operating room

Bariatric surgery is a weight-loss surgery performed on people with conditions like obesity. The surgery works by restricting the amount of food that the stomach can hold or causing malabsorption of nutrients in the intestines.

Bariatric surgery is typically only performed on people who have a body mass index (BMI) of 40 or higher or who have a BMI of 35 or higher and other obesity-related health problems.

The surgery is usually only performed after other weight-loss methods, such as diet and exercise, have failed.

The Types of Bariatric Surgery

Depending on what you need and what health conditions you have, your doctor may recommend different types of bariatric surgery.

There are two main types of weight-loss surgery: restrictive and malabsorptive.

  • The most common type of bariatric surgery is a malabsorptive procedure called gastric bypass surgery, which involves creating a small pouch at the top of the stomach and reconnecting the small intestine to this pouch. It allows food to bypass a large portion of the stomach and small intestine, reducing the number of calories and nutrients absorbed.
  • Another type of bariatric surgery is a restrictive type called gastric banding, which involves placing a band around the stomach to create a smaller pouch.
  • A gastric sleeve or vertical sleeve gastrectomy also involves removing a large portion of the stomach.

Although bariatric surgery can be an effective way to lose weight and improve health for people who are obese, it’s a major decision.

Even if you’re a candidate for bariatric surgery, it’s essential to meet with a qualified bariatric surgeon to discuss your options before opting for the procedure. Each type of surgery has its risks and benefits, so it is important to talk to your surgeon about which procedure is right for you.

In addition to meeting with your surgeon, you will also need to meet with a nutritionist to develop a healthy eating plan post-surgery. It is also important to commit to making lifestyle changes such as regular exercise.

Who is a Good Candidate for Bariatric Surgery?

Another thing to note is that while bariatric surgery can be an effective way to lose weight, it's not right for everyone.

Bariatric surgery is usually only recommended for people who suffer from morbid obesity and have been unable to lose weight through diet and exercise. These patients are typically at a higher risk of or already experiencing various health problems, including but not limited to:

  • High Blood Pressure
  • Non-alcoholic Fatty Liver Disease
  • Heart Disease
  • Type 2 Diabetes
  • Certain Cancers

While there are exceptions, most people need to lose at least 10 percent of their body weight before undergoing bariatric surgery.

There are several reasons for this requirement:

  • First of all, patients who are overweight are more likely to experience complications during surgery.
  • Second, excess weight makes it more difficult for surgeons to access the stomach and intestines.
  • Finally, people who are overweight often have more significant amounts of visceral fat, increasing the risk of surgical complications.

So people must meet the weight requirements before undergoing bariatric surgery.

Is Weight-loss Surgery A Good Option For You?

When it comes to weight-loss surgery, there is no one-size-fits-all solution. The best way to determine if weight-loss surgery is right for you is to work with a qualified healthcare provider to assess your individual needs.

They will consider several factors, including your current weight, health history, and body mass index (BMI).

If you are considering weight-loss surgery, it is essential to understand the risks and potential complications involved. These procedures are not without risks, and there is no guarantee of success. 

However, weight-loss surgery can be an effective tool for achieving long-term weight loss and improving overall health for many people. If you are considering weight-loss surgery, be sure to work with a healthcare provider who can help you decide whether or not this procedure is right for you.

Why Is Preoperative Weight Loss so Important for Bariatric Surgery?

A person measuring their waistline

Losing weight before bariatric surgery can have several benefits:

  • It can help reduce the size of your abdomen, making the surgery easier to perform.
  • It also reduces the risk of complications during and after surgery.
  • Losing weight can help patients recover more quickly from the procedure and improve the long-term success of the surgery.
  • And finally, patients who lose weight before surgery are more likely to keep the weight off in the long term.

So most surgeons will ask some patients to lose a certain amount of weight before they are considered for bariatric surgery. It may be as little as 10 percent of body weight and as much as 50 percent. In rare cases, it may be more than 50 percent. 

But regardless of the amount necessary, losing weight before bariatric surgery can make the procedure safer and more effective. So it’s essential to work with your doctor to develop a plan for pre-operative weight loss.


A Note on Insurance and Bariatric Surgery

Since it’s not a cosmetic weight loss surgery, does insurance cover bariatric surgery? Many insurance companies provide coverage for bariatric surgery, though each company has different requirements that you must meet before getting approval for this type of surgery.

Meeting these requirements can be difficult for many people, but it is important to remember that bariatric surgery is a serious procedure with potentially serious complications.

If you think you meet your insurance company's requirements for bariatric surgery, speak to your doctor to see if you are a good candidate for the procedure.

Changing Your Diet For Bariatric Surgery

Preparing vegetables in the kitchen

Since bariatric surgery for people who have not had a successful weight loss surgery through other means, how do you lose weight before the procedure?

Can a low-calorie diet help now if it hasn’t during previous weight loss journeys? The best way to find the answers to these questions is to consult with a healthcare professional before you decide to get the procedure.

In the meantime, here are some dietary tweaks that may help.

Before the Surgery

In preparation for your surgery, you'll need to change your diet to lose weight and get your body ready for surgery. Here are just a few:

  • Eat fewer calories. Cut back on high-calorie foods and drinks and eat smaller portions.
  • Avoid foods that are hard to digest, such as fried and sugary foods and high-fat or processed meats.
  • Protein helps heal wounds and supports the growth of new tissue. Try to aim for at least 1.2 grams of protein per kilogram of ideal body weight, or consider aiming for at least 20 to 30 grams of protein per meal. 
  • Drink plenty of fluids. Surgery can cause dehydration, so it's essential to stay well-hydrated before and after your procedure.
  • Since you have to limit caffeinated beverages such as coffee, tea, and soda for a short period after surgery, it’s helpful to cut back gradually to prepare yourself beforehand.

After the Surgery

When you undergo bariatric surgery, your stomach capacity reduces, and your intestine is re-routed to absorb fewer calories and nutrients from food.

So you may have to change your diet and lifestyle after surgery to make sure you are getting the right amount of nutrition while consuming fewer calories.

Changing your diet can be difficult, but it is crucial to make these changes for a successful outcome after bariatric surgery. Working with a dietitian can also help here.

Good Exercise Habits For Bariatric Surgery

One of the most important aspects of post-operative care is exercise. Regular exercise helps to speed up your metabolism, promote weight loss, and improve overall health.

Patients who have undergone bariatric surgery need to take special care when starting an exercise program. It is essential to consult with a doctor or physical therapist before beginning any new activity.

They can help create a safe and effective workout plan that meets each patient's individual needs. Additionally, it is important to start slowly and gradually increase the intensity of workouts as tolerated.

By following these guidelines, patients can safely and effectively improve overall health and wellbeing after bariatric surgery.

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Carlee Hayes, RDN, CD

Reviewed by: Carlee Hayes, RDN, CD

Carlee's training at Western Illinois University and an internship at the Memphis VA Hospital lead her to a career in outpatient counseling and bariatric nutrition therapy. In these positions, Carlee realized many of the disease states (upwards of 80%!) her patients experienced were actually preventable. She knew she had to dig deeper into preventative health and has since been passionate about helping people translate this complex glucose data into actionable changes anyone can implement into their everyday lives.

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