Which patients should be offered bariatric surgery?

Which Patients Should be Offered Bariatric surgery?

Which patients should be offered bariatric surgery?

The first-line management of obesity should include a multi-disciplinary evaluation with nutritional and medical counseling, according to the patient’s need, in collaboration with an experienced consultant and surgical team. Many of our global surgeons suggest that adjustable gastric banding not be offered due to unacceptable complications and long-term failure. Some bariatric specialists recommend that single-anastomosis gastric bypass not be routinely offered, due to long-term complications in comparison with standard Roux-en-Y gastric bypass (Level 4, Grade D).13 • Different surgical options exist (e.g., sleeve gastrectomy, gastric bypass, and duodenal switch), with different levels of effectiveness. We recommend patients considering bariatric surgery schedule a teleconsultation and have an extensive discussion with the surgical team before deciding which surgical option seems to be the best for them.  All surgeries have some adverse effects and potential risks and require lifelong management to follow-up, mineral and vitamin supplementation, and behavioral changes. well as behavioral modifications and increased physical activity. Post-surgery we highly recommend our remote monitoring service to maintain good vitals that can be measured when returning home.

Ideal Bariatric Candidates

Patients with a BMI between 35 and 40 kg/m² with at least one major obesity-related disease (e.g., T2DM, obesity-related cardiac disease, sleep apnea), or patients with a BMI ≥ 40 kg/m² with or without associated diseases, are potential surgical candidates. In addition, bariatric surgery may be offered to patients with obesity (BMI ≥ 30 kg/m²) and significant obesity-associated disease(s), when psychological and behavioral interventions and medical management are insufficient to achieve optimal weight loss and control of comorbidities.

All potential bariatric patients are carefully evaluated by a bariatric surgeon once a second opinion or firmquote is completed. Following consultation, your bariatric surgeon may educate you regarding the risks, benefits, and alternatives to bariatric surgery. Patients should also understand the need for lifelong medical surveillance to prevent and correct potential long-term nutritional deficiencies after surgery. Contraindications for bariatric surgery include recent substance abuse (alcohol, drugs), non-stable psychiatric conditions (i.e., changes in psychiatric medications in the last six months), a diagnosis of cancer, or an expected life expectancy of fewer than five years.

Even though an age limit of 60 years is considered in the NIH recommendations, multiple studies have assessed the risks and benefits of bariatric surgery in the elderly. These are summarized in a systematic review that identified 26 articles encompassing 8149 patients.18 Pooled 30-day mortality was 0.01% and the overall complication rate was 14.7%. At the one-year follow-up, mean excess weight loss was 53.8%, diabetes resolution was 54.5%, hypertension resolution was 42.5% and lipid disorder resolution was 41.2%. The authors conclude that outcomes and complication rates of bariatric surgery in patients older than 60 years are comparable to those in a younger population, independent of the type of procedure performed.

Patients should not be denied bariatric surgery because of their age alone.

Next Steps

If you are considering bariatric surgery and would like to arrange a teleconsultation, or request a quote we would be pleased to support you with this and help you on your path to health and wellness. You can also review bariatric price guides here.


Great Choices – Bariatric Diet Foods

Losing weight and keeping it off is about more than making immediate sacrifices. Expert after expert has weighed in to say that it takes a full lifestyle change that you can stick with to lose weight permanently. Having said that, if you think losing weight means having a little less chocolate cake or only one bag of Cheetos after dinner, you’re going to need a drastic change to your eating plan. That means eating what you may consider being bariatric diet foods. These don’t need to be extreme, processed meals. In fact, the more natural you can get, the better. No matter what, though, you’re probably going to need to get used to what you perceive as a blander menu. However, there are some things you can do to make your sacrifice bearable.


Most spices are free of calories and can be used liberally to make dramatic changes in the flavor of your bariatric diet foods. If you think your meal is a bit too bland to stomach, the right spices can make all the difference in the world. Look around and you won’t have a hard time finding out which spices go well with which dishes. Of course, experimenting is part of the fun. Don’t feel locked into one certain spice just because some famous chef recommends it. Your goal is to lose weight, not impress a dinner party. Find ways to make your meals that will help you stick to the plan.

Incorporate Fruit

It has become a cliché, but fruit really is nature’s candy. While those striving for low carb solutions might need to limit their intake of fruit, other dieters will find several places in their meal plan for enjoying some sweet, nutritious choices. Some fruits are higher in calories than others, of course, so you’ll still need to be cautious. Your body might function better on 300 calories worth of strawberries than 300 calories worth of candy, but either choice can go to the waistline if you go over your energy needs.

Go Artificial

Some weight loss experts advise taking it easy on artificial sweeteners, and there are some studies that have linked high usage to some undesirable outcomes. Most of the hard science surrounding these claims is lacking, however. What isn’t lacking is the data on how bad processed sugar is for your body. Cut it out at any cost, and replacing it with high fructose corn syrup is not a viable choice. If you are having a hard time enjoying your bariatric diet foods, add some Equal or Splenda and see if it makes it easier.