Who Is A Candidate For Bariatric Surgery?

Air Date:
Heard On The Larry Meiller Show

Obesity is a huge problem in the United States. There are many approaches to lose weight, but for some people, the surgical option is the best. Larry Meiller finds out what bariatric surgery involves, who is a good candidate, and what it means for the rest of the patient’s life.

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  • Doctor Says Bariatric Surgery Isn't A Quick Fix

    Obesity is one of the most significant public health issues the U.S. has ever faced.

    According to the U.S. Centers for Disease Control & Prevention, more than one-third of American adults are obese, which that means that Americans are dying from otherwise preventable conditions like heart disease, stroke, and Type 2 diabetes.

    “It’s tremendous problem,”said Dr. Michael Garren, medical director of the University of Wisconsin Health Medical and Surgical Weight Management Program. Garren’s clinical specialties include minimally invasive bariatric surgery.

    “Not just as a surgeon, but as a physician, the majority of patient problem we see, in some way, shape or form, has some relationship to the obesity epidemic,” Garren explained.

    For people 20 or 30 pounds overweight, Garren said, diet and exercise are a great approach for losing a modest amount of weight and seeing the accompanying health benefits.

    Those aren’t the people that are candidates for bariatric surgery.

    “The people that I deal with are the people with what we call morbid obesity, or clinically severe obesity,” Garren said. “These are the people that are at least 100 pounds over their ideal body weight.”

    He said that these people suffer from multiple serious health consequences of their obesity, including high blood pressure, heart disease, diabetes and sleep apnea.

    “And really, a difficult quality of life,” he added.

    Traditional methods of weight loss — like diet and exercise — or even counseling and medications, aren’t effective with that group of people, Garren said. For this demographic, bariatric surgery can be a medical necessity. It’s what they can offer to those patients for them to “safely and durably lose a tremendous amount of weight,” he said.

    While there are several different types of bariatric surgery, Garren said that most of the procedures “alter the anatomy of the stomach to a degree, usually making it smaller, such that the person who had the surgery can only take in a very small amount of food at a given time.”

    Some of the procedures also regulate how much of that digested food can be absorbed as well. He summarized the process as “in essence, we severely limit the number of calories that are taken in.”

    While a quick fix to weight loss might sound appealing, there are strict limits on who can have bariatric surgery.

    “That’s very much wishful thinking,” Garren said.

    He added that he specifically tells his prospective patients that this is not the easy way to achieve significant weight loss.

    “In fact, I tell them that “if they look at it as the quick fix, that may in fact make them not a great candidate for bariatric surgery.”

    The National Institute of Health developed standards in 1991 that are still used to determine eligibility on the physical aspect. That is primarily the Body Mass Index (BMI), which looks at a person’s height–weight ratio. Garren said that a BMI of 40 or more, “or those with a BMI of greater than 35 with a major medical problem — diabetes, high blood pressure, heart disease, things like that — would be at least candidates for bariatric surgery.”

    It isn’t just the physical aspect that is assessed, however. Garren said that the patient “needs to be highly motivated to improve their health. This is not cosmetic surgery … This is a medical intervention for a severe medical problem.”

    Garren said that there is an element of desperation for his patients.

    “They’re desperate to improve their health, to improve their quality of life,” he said.

    In addition, they have thought for an average of two years about having bariatric surgery, “even before taking that step of coming to see me,” he said.

    The surgery isn’t the end of the process, Garren emphasized. In fact, it is more of a beginning, and motivation continues to be key, he said.

    “They need to be willing to make some fairly dramatic behavioral changes for the rest of their life in order to be successful with this,” he said

    “This is clearly not the easy way out,” Garren said.

    For more information on bariatric surgery, visit the UW Health Medical and Surgical Weight Management Program website.

Episode Credits

  • Larry Meiller Host
  • Judith Siers-Poisson Producer
  • Michael Garren Guest