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Am I the right candidate for Bariatric surgery? Who is it for?

9 March

Am I the right candidate for bariatric surgery? This is the first question you may have if you are planning this treatment option for losing weight. In this article, we will answer that very question. Bariatric surgery is not for everyone because every obese person is not a candidate for this type of surgery. All obese people do not have the same mindset and same body chemistry. Bariatric surgery is the treatment option for obese people who want to get rid of extra body weight who are diagnosed to have either hormone leptin resistance or insulin resistance. First, you must take a bariatric surgeon’s opinion after getting checked completely, try all other methods of losing weight, and if you fail to lose weight by using other weight loss methods, then you must plan for bariatric surgery. The surgery will give long-lasting results only if you agree to manage lifestyle changes throughout life. You have to show commitment and compliance with the lifestyle changes like eating on time, sleeping on time, drinking water 3 liters per day, walking 5km in 45 minutes daily to get long-lasting results after the surgery. Many people believe that it is an easy method and will make them healthy and thin without doing any effort but it is not true. But, they have to adapt to a new lifestyle, thinking, and a new way of living. There are proper guidelines given by the national institute of health that should be considered before choosing a patient for weight loss surgery.

Guidelines given for choosing the right candidate for bariatric surgery include the following:

  • People who fail to lose weight by following proper diet and exercise plan after six or more
    months
  • Morbidly obese people with BMI > 32.5
  • People who are severely obese with BMI between 35 to 40 with comorbidities.
  • People who have a BMI of >40
  • Are committed to changing their eating habits
  • People who do not drink alcohol habitually or use other drugs
  • People who understand the results of the bariatric surgery properly
  • People have good mental health and are free from any emotional or psychological problems that may contraindicate with bariatric surgery
  • Understand the risks associated with the surgery

Besides the above guidelines, the doctor will also ask you to undergo a screening process to identify if
you are the right candidate for bariatric surgery or not. The doctor will perform a proper evaluation of
any case before suggesting bariatric surgery.

Evaluation includes the following things:

Nutrition and weight history of the patient
Diet plays an important role in gaining weight. Bad eating habits adopted during childhood and other
eating habits of the patient due to personal reasons can cause more body weight. the doctor will take
the weight history of the patient because it will help the doctor to find out at what stage the patient
becomes obese and what factors lead to the change in weight. The patient should be committed to
changing his/her bad eating habits because bariatric surgery can also give the best results if the person
is committed to maintaining the changed lifestyle after the surgery.

The medical condition of the patient
Doctors often determine the general medical condition of the patient after any surgery. Thus, the doctor
will evaluate the patient for any risks. In most cases, the risks are minimum and when they outweigh
the benefits the risks become acceptable. This means that people suffering from chronic diseases are
the best candidates for bariatric surgery because losing weight will also help to improve the functions
of other body organs.

The psychological condition of the patient
Bariatric surgery is recommended for patients who suffer from any kind of psychological problems as
long as their logical understanding prevails with family support. A person suffering from acute
psychological issues cannot be the right candidate for this surgery.

Age
Age is another important factor that is used for choosing the right candidate for bariatric surgery. It is
not recommended for people below 18 years and above 65 years. people above 65 years may suffer
from other health problems which will make them unsuitable for the surgery but surgery will be offered
for those who are medically fit as an option.

Screening of the patients before bariatric surgery
The screening will be done before surgery to choose the right candidate. Screening includes the
following:

Psychological screening
Bariatric surgery will change the lifestyle of an individual and also their eating habits. Therefore,
psychological screening is important before bariatric surgery. During the screening, the surgeon will
educate you on the behavioral changes that can help in achieving good results and the psychological
changes that may occur after surgery. The doctor will give complete information on how to stay
committed and motivated after the surgery. If a person is ready to accept the changes that will occur
after the surgery then he/she will be a suitable candidate for the surgery.

Medical and surgical screening
Medical and surgical screening before bariatric surgery is important to determine if you are healthy for
surgery or not. The surgeon will recommend certain tests to rule out a medical problem or the cause of
obesity. Tests also help to determine if you are suffering from other diseases such as heart diseases,
diabetes, hypertension, sleep apnea, or vascular diseases. The tests recommended before bariatric
surgery include chest X-ray, complete blood count, abdominal ultrasound, ECG, liver function tests,
renal function tests, thyroid function tests, lipid profile, many metabolic hormones, etc. Medical
clearance from different doctors is an important step for choosing the right candidate for bariatric
surgery. A person who is free from any medical problems can be the right candidate for bariatric
surgery.

After the proper screening, the doctor will choose the candidate for the right type of bariatric surgery. The mindset of the person plays an important role in getting the best results of the surgery. If you believe that you can eat whatever you like after bariatric surgery, then you are not the right candidate. People must understand that bariatric surgery is the last treatment option for them to lose weight after trying all other methods. If they are not committed to changing their habits and maintaining a good lifestyle
then bariatric surgery is not the right option for them.

Dr. Krishnamohan. Y

Clinical Director, Department of Minimal Access, Metabolic. Bariatric & GI surgery
MBBS, MS, FAIS, FMIS, FIAGES, FICS (USA)
CARE Hospitals, Banjara Hills, Hyderabad

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