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Am I a Candidate for Bariatric Surgery?

The National Institute of Health (NIH) has set out criteria for bariatric surgery. It essentially recommends surgery in long standing obesity in patients who have failed medical weight loss measures and meet the following criteria:

  • BMI greater or equal to 35 and have one or more severe obesity-related health problems such as diabetes or sleep apnea among others.
  • BMI of 40 or greater with or without associated medical complications of obesity.

There are no absolute age restrictions. The upper age limit is guided more by the fitness of the patient rather than their actual age.

One has to be prepared to attend regular follow-up visits and make changes to diet and physical activity.


Contraindications
The following are some conditions where bariatric surgery may not be appropriate for you:

  • You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohn's disease.
  • You have severe heart or lung disease that makes you a poor candidate for surgery. You may however benefit from a smaller staged procedure.
  • You have some other disease that makes you a poor candidate for surgery.
  • You have a problem that could cause bleeding in the esophagus or stomach. This might include esophageal or gastric varices (a dilated vein). It might also be something such as congenital or acquired intestinal telangiectasia (dilation of a small blood vessel).
  • You have portal hypertension.
  • Your esophagus, stomach, or intestine is not normal (congenital or acquired). For instance poor esophageal motility.
  • You have or have experienced an intra-operative gastric injury, such as a gastric perforation at or near the location of the intended band placement.
  • You have liver cirrhosis.
  • You have chronic pancreatitis.
  • You are pregnant.
  • You are addicted to alcohol or drugs.
  • You have an infection anywhere in your body or one that could contaminate the surgical area.
  • You are on chronic, long-term steroid treatment.
  • You cannot or do not want to follow the dietary rules that come with this procedure.
  • You might be allergic to materials in the device.
  • You or someone in your family has an autoimmune connective tissue disease. That might be a disease such as systemic lupus erythematosus or scleroderma.

Your Motivation
While bariatric surgery is effective treatment for morbid obesity, good results require active participation by the patient. You must be committed to new eating and exercise habits for the rest of your life.

Weight Loss


Achieving successful and lasting weight loss after bariatric surgery is similar to a three-legged bar stool – where surgery, exercise and dietary adjustments form the three legs supporting weight loss. Surgery facilitates adoption of small dietary portions, while continued use of caloric liquids (drinks with calories) will sabotage weight loss. Surgically induced weight loss can help kick start a good exercise habit. Good weight bearing exercise such as walking will help the body retain muscle and bone mass while shedding fat.