Fast Five Quiz: Weight Loss

Romesh Khardori, MD, PhD; Evelyn S. Marienberg, MD


November 08, 2022

Well-performed bariatric surgery, in carefully selected patients with a good multidisciplinary support team, has been shown to ameliorate morbidities associated with severe obesity. Bariatric surgery guidelines state that laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, laparoscopic Roux-en-Y gastric bypass, and laparoscopic biliopancreatic diversion without/with duodenal switch, or related procedures, should be considered as primary bariatric and metabolic procedures performed in patients requiring weight loss and/or amelioration of obesity-related complications.

Patients should be considered candidates for bariatric procedures if they have a BMI > 40 kg/m2 and/or > 45 kg above the age- and sex-defined ideal weight. For persons with BMIs of 35-40 kg/m2, at least one major comorbidity (eg, type 2 diabetes, hypertension, NAFLD or nonalcoholic steatohepatitis, obstructive sleep apnea, osteoarthritis of the knee or hip, urinary stress incontinence) must be present to justify these procedures. The presence of comorbidities is not a contraindication to bariatric surgical procedures; however, the patient's condition must be stabilized and adequately treated before surgery.

A recent meta-analysis showed 48.9% excess weight loss and 22.2% total weight loss at 20 years following bariatric surgery.

Tobacco use should ideally be discontinued for 1 year prior to bariatric procedures. At a minimum, guidelines recommend cessation at 6 weeks prior, particularly among those who smoke cigarettes.

Learn more about bariatric surgery.

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