It might seem unnecessary to lose body fat before having bariatric surgery. After all, you are considering weight loss surgery because you need to lower your BMI (body mass index) for your health, but you are likely struggling to lose weight.
However, there are several very important reasons why it is usually necessary to lower your BMI before bariatric surgery. In this article, we will explain what bariatric surgery is, the different types of bariatric surgery, and any risks involved with weight loss surgery.
We will also explain why your doctor might tell you that you should lose weight before surgery, what could happen if you don’t, and some helpful tips for how to lower your BMI.
What is Bariatric Surgery?
Bariatric surgery is a medical procedure that changes your digestive system to help you eat less and feel full faster. Bariatric surgery is designed to help people who are severely overweight or obese lose body fat and improve overall health and quality of life.
When diet and exercise alone aren’t enough, bariatric surgery is often the only option for some people to successfully achieve and maintain a healthier weight. Doctors frequently recommend bariatric surgery for people who have serious health issues related to obesity, such as type 2 diabetes, high blood pressure, or sleep apnea.
While bariatric surgery is extremely effective, it is important to note that it isn’t a quick fix for obesity. Many people mistakenly believe that bariatric surgery alone will solve their weight problems. Weight loss surgery can play a significant role, but patients must adopt a healthy lifestyle both before and after surgery. Maintaining a healthy diet and staying active after surgery is essential for long-term success.
The decision to have bariatric surgery should only be made after careful consideration and consultation with a qualified bariatric surgeon to ensure eligibility and determine if weight loss surgery is the right choice for your specific situation.
Types of Bariatric Surgery
Bariatric surgery has evolved significantly over time, with various techniques and procedures developed to address different levels of obesity and weight-related health conditions.
These days, there are several types of bariatric surgery and techniques to choose from. Each type of bariatric surgery addresses different needs and conditions and comes with its own benefits and potential risks.
Here’s a look at some of the most common types and techniques of bariatric surgery:
RNY Gastric Bypass
Roux-en-Y Gastric Bypass, or RNY Gastric Bypass, most commonly called Gastric Bypass, is one of the most common and well-known types of bariatric surgery.
The procedure involves creating a small pouch from the top portion of the stomach and connecting it directly to the small intestine. This reduces the stomach’s capacity and the intestine’s absorption area, helping you eat less and absorb fewer calories.
Gastric Bypass is the bariatric surgery method typically suggested for those needing more substantial weight loss and people with severe obesity, especially those with a body mass index (BMI) of 40 or higher or a BMI of 35 or higher with obesity-related health issues such as type 2 diabetes, high blood pressure, or severe sleep apnea.
This method is also common for patients with severe gastroesophageal reflux disease (GERD) since Gastric Bypass can improve reflux symptoms.
Vertical Sleeve Gastrectomy
In a sleeve gastrectomy, a significant part of the stomach is removed, leaving only a sleeve-shaped section. This smaller stomach holds less food and produces fewer hunger hormones, helping you feel full more quickly and eat less.
The sleeve gastrectomy procedure is less invasive than Gastric Bypass and has gained popularity due to its effectiveness with lower risk. It’s a good option for people who are severely overweight and have not been able to lower their BMI through diet, exercise, or medication and prefer a less complex procedure with a lower risk of complications.
While sleeve gastrectomy is effective for many, it might not be the best option for everyone. If you have severe acid reflux or need a more aggressive weight loss approach, your bariatric surgeon might suggest gastric Bypass since it is shown to lead to more significant weight loss and be more effective in resolving obesity-related conditions such as type 2 diabetes.
A qualified bariatric surgeon will always suggest the weight loss surgery that is best for your unique circumstance.
Revisional Bariatric Surgery
Revisional surgery offers a second chance at achieving weight loss goals by resolving any problems or failures from a previous bariatric surgery.
Hence its name (revisional), this type of surgery involves repairing or modifying a previous weight loss procedure to improve outcomes. Due to it being a much more complex and complicated surgery, revisional bariatric surgery is more invasive and often carries more risk.
Revisional bariatric surgery is only for people who have already had a bariatric procedure but did not achieve the desired results, regained weight, or are experiencing complications from a previous weight loss surgery.
One common type of revisional bariatric surgery is gastric band removal. Also referred to as lap band removal, this advanced surgery involves removing the adjustable silicone band placed in gastric band surgery, to reverse the effects of the initial surgery. This type of revision surgery should only be performed with the expertise of a qualified bariatric surgeon.
You can significantly lessen your chance of needing revisional bariatric surgery if you choose the surgery method suggested by your bariatric surgeon, lower your BMI before surgery, follow all post-op guidelines, and adhere to a healthy lifestyle following surgery to prevent weight regain.
What are the Risks of Bariatric Surgery?
Bariatric surgery, like any major surgery, carries some risks. Understanding these risks and how lowering your BMI could help lessen your chance of complications can encourage you to reach a healthier weight before exploring weight loss surgery options.
Reading over these risks can seem scary. However, it is important to remember that for many, the health benefits of bariatric surgery typically far outweigh any potential risks, especially when dealing with severe obesity and related health conditions.
Here are some of risks of bariatric surgery to be aware of:
Infection
There is always a risk of infection at the incision sites if you have surgery. Your bariatric surgeon will take precautions to minimize this risk, and you will be guided on what to do at home following surgery to lessen your chance of developing an infection.
Bleeding
Some bleeding is expected during any surgery, but significant bleeding is rare.
Blood Clots
There’s a risk of blood clots forming in the legs (deep vein thrombosis) or lungs (pulmonary embolism). Preventive measures, like medication and moving around soon after surgery, will help reduce this risk.
Reactions to Anesthesia
While uncommon, some people may have adverse reactions to anesthesia. This can happen in any surgery. If you have a history of adverse reactions to anesthesia, make sure to inform your surgeon during your consultation.
Nutritional Deficiencies
After bariatric surgery, your body absorbs fewer nutrients. This can lead to deficiencies in vitamins and minerals. Taking prescribed supplements and following a balanced diet can prevent this.
Dumping Syndrome
Following weight loss surgery, some people experience “dumping syndrome,” where food moves too quickly from the stomach to the small intestine. This can cause nausea, vomiting, diarrhea, and dizziness. Should this occur, your surgeon can provide dietary recommendations and prescribe medications to help manage the symptoms effectively.
Gallstones
Rapid weight loss after surgery can increase the risk of gallstones. Should this occur, your doctor may prescribe medication to dissolve the gallstones or recommend surgery to remove the gallbladder.
Hernias
Incisional hernias can occur, where internal tissues push through the surgical site. While rare, if a hernia occurs, your surgeon may need to perform corrective surgery to repair it.
Weight Regain
While bariatric surgery is highly effective, some patients may regain weight. This usually only happens if old eating habits return or follow-up care isn’t maintained.
Emotional Changes
Adjusting to life after weight loss surgery can bring emotional challenges. We suggest joining support groups and counseling to help you navigate any emotional reactions to bariatric surgery.
8 Reasons Why It’s Important to Lower Your BMI Before Bariatric Surgery
Your body mass index (BMI) is a measurement that your doctor will calculate to help determine if your weight is healthy for your height. It’s different from just your weight on a scale because it considers both your weight and height together. Click here to learn more about BMI and to use our free BMI calculator.
Here are a few reasons why getting this number down before surgery is important:
1: Your BMI Could Impact Your Eligibility for Bariatric Surgery
Insurance companies have different requirements for covering bariatric surgery based on BMI, but most will consider a patient eligible and cover some or all costs if their BMI is 40 or higher. Some plans may also cover patients with a BMI between 35 and 40 if they have other health complications, such as high blood pressure, type 2 diabetes, or obstructive sleep apnea.
That said, having a higher BMI isn’t necessarily better. If your BMI is too high, some insurance companies and doctors require patients to participate in a medical weight management program for several months before surgery.
2: Fewer Issues with Anesthesia
The higher your BMI, the higher your risk for anesthetic-related complications. There are several reasons for this, one being the amount of anesthesia it might take to put you to sleep. Additionally, inserting a breathing tube is more difficult in obese patients.
Obesity also increases oxygen demand and can lead to lower blood oxygen levels and higher carbon dioxide levels if ventilation is impaired. Excess fat can also restrict chest movement, increasing the risk of pneumonia.
Steps can be taken before and during surgery to reduce anesthesia risk in obese individuals. However, it is best to lower your BMI as much as possible before surgery, including bariatric surgery.
3: Shorter Operating Time
Surgeries are shorter when you have a lower BMI. One reason goes back to anesthesia. The higher your body fat, the longer it might take for your anesthesiologist to find a suitable vein to administer anesthesia.
However, the main reason surgery time is longer in those with a higher BMI is because there is more fat around vital organs and structures. The more layers of skin and tissue you have, the longer it will take your surgeon to reach your organs.
Additionally, the higher your BMI is, the more likely you are to have cardiovascular and respiratory complications, which can prolong surgery times.
4: Lower Risk of Cardiovascular Problems
If you are obese, your heart has to work harder to supply your body with blood and oxygen. This added strain, combined with the effects of anesthesia during surgery, increases your risk of heart attack, chest pain (angina), stroke, and high blood pressure.
Obesity also heightens your chances of developing deep vein thrombosis (DVT), a condition where blood clots form in the veins, potentially leading to a serious complication known as pulmonary embolism—a blood clot in the lungs.
5: Faster Healing
Excess fat puts extra pressure on the incisions your doctor makes, which reduces the amount of blood and oxygen the wound needs to heal properly.
Excess fatty tissue also increases the risk of infection. Preventing infections is crucial because they could lead to the need for antibiotics, additional surgeries, or a longer hospital stay.
6: Less Time in the Hospital
Bariatric surgery requires a hospital stay. However, you could be released much sooner if you lower your BMI before surgery. This is because you are more likely to have complications during and after surgery that require close monitoring.
7: Better Prepared for Post-Op Lifestyle Requirements
To sustain weight loss after surgery, you must commit to a healthy lifestyle. Incorporating healthy habits before bariatric surgery can prepare you well for continuing them afterward.
If you are already focusing on nutrition, exercising, and getting quality sleep to lower your BMI before surgery, you will have developed a habit, making adherence following surgery much easier!
8: Gives You Lower-Risk Options
Losing excess weight before bariatric surgery gives you more options. By lowering your BMI before surgery, you may qualify for other treatments that carry lower risks.
For instance, you might be eligible for a less invasive sleeve gastrectomy over gastric bypass surgery. Or, if you lose enough weight, you might not even need surgery and could instead explore a prescription weight-loss program involving one of many FDA-approved medications for obesity.
Helpful Tips to Lower Your BMI Before Bariatric Surgery
If you are considering weight loss surgery, chances are you’ve tried to lose weight and failed. Just because you’ve been unsuccessful in the past does not mean losing weight is impossible. Talk to your bariatric surgery team about what you’ve tried in the past so they can make new recommendations based on your previous weight loss attempts and health history.
For example, if you’ve tried keto, your doctor might suggest a more balanced approach that includes healthy carbohydrates. If you enjoy larger meals and are open to only eating during a specific “feeding window,” they might suggest intermittent fasting.
If your exercise routine has been limited, they may recommend increasing the duration and intensity of your walks or incorporating other enjoyable physical activities.
In addition to finding a diet and exercise regime that works for you, here are some additional steps you can take to lower your BMI and be better prepared for bariatric surgery.
Focus on Protein
Eat more protein-rich foods such as lean meats, fish, beans, Greek yogurt, and protein shakes. Protein helps you feel full longer and supports muscle strength during weight loss.
Cut or Limit Processed Sugar and Simple Carbs
Reduce your intake of sugary foods and drinks, including sodas and sweets. You should also minimize high-GI starchy foods like white pasta, white bread, pastries, muffins, and most cereals.
Stop Smoking
If you smoke, you should quit or reduce smoking, as smoking can hinder weight loss efforts and negatively affect surgical outcomes and healing.
Limit Alcohol
Alcohol is high in empty calories and impedes weight loss progress.
Practice Portion Control and Mindful Eating
Avoid going to buffets or places that offer “bottomless” foods. To avoid binge eating at home, the best approach is not to buy unhealthy foods that will tempt you to overeat.
Have a Support System
Surround yourself with physically active individuals to stay motivated and engaged in regular exercise.
Get Moving
Incorporate more movement into your daily routine by parking farther from your destination, taking the stairs instead of the elevator, and avoiding prolonged periods of sitting.
Get Quality Sleep
Sleep affects hormones that regulate hunger and appetite, such as leptin and ghrelin. When you aren’t getting enough quality sleep, these hormones can become imbalanced, leading to increased cravings for high-calorie foods.
Poor sleep can also increase cortisol levels, disrupt metabolism, and impact insulin sensitivity, making it harder for the body to regulate blood sugar levels and burn calories efficiently.
Take a Look at Your Medications
Talk to your doctor or surgical team about medications you are taking that may contribute to weight gain, and explore alternative options if possible.
Bariatric Surgery in Middle Tennessee
The Surgical Clinic in Middle Tennessee is a group of private practice surgeons representing various surgical specialties, including bariatrics. Our bariatrics clinic in Nashville, led by Dr. Patrick Davis, offers hope for those struggling with obesity by giving them a new lease on life.
If you are interested in learning more about bariatric surgery, visit our website to learn more about our practice, see our 5-star reviews, get to know our bariatrics surgeon, request a consult, and even calculate your BMI and find valuable weight loss resources.
We also suggest reading “Understanding Bariatric Surgery: A Comprehensive Guide to Your Weight Loss Journey.”