There are many positive side effects patients should expect after weight loss surgery. It is important to remember that results will vary from patient to patient and that adopting a healthy lifestyle will significantly improve weight loss surgery patient outcomes.
Almost every patient achieves a substantially lower weight for life after bariatric surgery. Surgical weight loss is dramatically greater than any medication or non-surgical program. If all types of bariatric surgery are lumped together, in the long run, about two-thirds of patients will keep off more than half of their excess weight, meaning that they will be 70–150 pounds lighter than they started.
Lower weight leads to resolution or improvement of many medical problems. On average, patients experience dramatically better health after surgery than they had before – this is the core outcome of bariatric surgery.
Weight loss after bariatric surgery
Our goal is to help each patient lose a lot of weight, and to maintain the lower weight with better health for the rest of their life.
Ideal body weight is not a proper goal for a person who is currently considering bariatric surgery. This is because the body of a morbidly obese person takes on a lot of extra structure to support the excess weight and the body is not able to shed all that structure in a healthy way. In other words, patients who go from a BMI of 48 to a BMI of 24 are medically too skinny; they have low energy, feel weak, look ill and are probably not at the optimal weight for health. Most patients are at their ‘best’ weight at a BMI of 26-29.
Are all of our patients going to get that low weight level? Unfortunately not – only about 35 percent of our patients will get to this best weight.
This brings us to the second point: the key goal of bariatric surgery is to make a patient healthier. Sometimes surgery is worthwhile to bring diabetes under control, or to allow better heart function or better lung function, even if a patient only loses 30 pounds.
There will be a lot of variation in weight loss results after bariatric surgery, so it is necessary to talk to your healthcare team about some factors causing greater and lesser weight loss after bariatric surgery:
- Which procedure is done
- Starting weight – heavier patients tend to lose more pounds, but they are not as likely to get below a BMI of 30
- Age of patient – younger patients tend to lose more
- Diabetes – diabetics tend to lose less
- Overall health and ability to exercise – more active patients lose more
- Compliance with diet and exercise plans following surgery
- Family support and other support systems
Most people know someone who had a bariatric surgical procedure years ago, lost a lot of weight, and then gained it all back. There is no getting around the fact that some patients do regain substantial weight after bariatric surgery. Searching into the causes of weight regain almost always turns up one of these factors behind the problem:
- The person underwent an older surgical procedure that is prone to long term weight regain. The most common example is the vertical banded gastroplasty which was done very commonly in the 1980s and early 90s.
- The person has stopped visiting the surgical program to follow up. There needs to be an understanding that obesity is a lifetime disease that requires lifetime management and support. Normal people need reminders of the proper diet and activity patterns, as well as support in sticking with the life changes that keep these patterns in place.
Of the bariatric procedures that are currently most commonly performed, adjustable gastric banding appears most likely to be associated with long term weight regain.