Weighing Weight-Loss Surgery: Not the Solution for Everyone

Considering surgery to help you lose the excess pounds? It certainly can be an effective option, but it isn't for everyone. Weighing all of your options and the pros and cons of surgery can help you make a decision that you will be happy with for years to come.

Following the recommended guidelines for weight-loss surgery is the first step in determining if you should have this procedure. But you should also be sure to take into account recent research to figure out if this procedure is a wise choice.

Weight loss surgery comes in several types, but all of them alter the gastrointestinal tract in some way to limit the amount of food, and therefore calories, that can get absorbed by the body. The two broad categories include restrictive procedures that shrink the size of the stomach so you cannot eat as much, and malabsorptive procedures that prevent the body from taking up the calories you eat.

Regardless of the type of procedure you would like, first you have to qualify for surgery. The Agency for Healthcare Research and Quality (AHRQ) has recommended several guidelines for those considering weight-loss surgery.

First, a patient should have a body mass index (BMI) over 40. BMI is a calculation that takes into account one's height and weight. Those with a BMI between 18.5 and 25 are considered to be of normal weight. A person with a BMI between 25 and 30 is considered to be overweight, and a person with a BMI over 30 is considered to be obese. Someone with a BMI over 40 would be morbidly obese.

Next, a person may qualify for obesity surgery if he or she has a BMI over 35 and other serious conditions related to obesity. This may include diabetes, heart disease and other conditions that are made worse by excess weight.

Last, a patient should be able to show that other weight-loss efforts, especially diet and exercise, have not worked.

But beyond these recommended guidelines, new research is showing that weight-loss surgery should also be limited in regard to age.

In a study published in the Archives of Surgery, researchers found that patients over the age of 65 had far more complication after weight-loss surgery than younger patients. Additionally, these patients also experienced far less overall weight loss after the procedure.

"Giving that these operations may not be as effective in elderly persons and that there are high rates of [death and complications] for older patients, limiting bariatric procedures to those younger than 65 years may be appropriate," said Dr. Edward Livingston, lead study author from the University of Texas Southwestern Medical Center.

In addition to age, men, people with electrolyte disorders and those with congestive heart failure each had a greater risk of dying from the surgery or its complications, said Livingston. Patients with diabetes, depression or pulmonary disease also had increased risk of side effects and longer hospital stays.

No matter your risk, Livingston recommends that anyone considering weight-loss surgery should look for a surgeon with a lot of experience, preferably one who works in a larger hospital. That way, you can speak with various surgeons about the different types of weight-loss surgery and get various opinions about which could be the best option for you. "Don't be afraid to shop around," says Livingston.

Additionally, if you have other conditions that will make your surgery more risky, a larger hospital will likely be better prepared to handle any complications that may arise. Ultimately, be careful about making the decision to undergo weight-loss surgery.

"For patients who are elderly or are at high risk for complications, the benefits may not be worth the consequences," says Livingston.

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