It’s the mom who never lost the weight from her pregnancies. The 55-year-old who needs a knee replacement, but her physician can’t safely approve it because of her weight. The mom-to-be who’s desperate to have a baby but is struggling due to weight-related complications. The woman whose doctor keeps saying that her heart disease, diabetes, or sleep apnea would improve if she lost weight.
What do these women have in common? More than you would think. Each could potentially be a candidate for weight loss surgery, said Dr. Renee Hilton, a bariatric surgeon at the Augusta University Health Center for Obesity & Metabolism.
“People always picture ‘My 600-Pound Life’ when you talk about weight loss surgery,” said Hilton. “But truly, the average bariatric surgery candidate is a woman in her 40s, around 5 feet 2 inches tall, who weighs around 215 pounds.”
In other words, even if you are just 100 pounds overweight, you could be eligible. According to the American Society for Metabolic and Bariatric Surgery, qualifications are:
- Anyone with a BMI over 40.
- Anyone with a BMI over 35 who also has a medical condition such as type II diabetes, hypertension, sleep apnea or other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders or heart disease.
- Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.
As a woman, Dr. Hilton knows the weight loss struggle only too well. She falls into the “busy professional” category, where much of her free time is dedicated back to work and being on call. “As women, we tend to not only be professionals, but also moms, wives, caretakers, cleaners, cooks—or whatever other titles and obligations we have—and we always seem to put ourselves last, and that includes our health,” said Hilton, who is also the only female bariatric surgeon in the region. “What we talk about at our center is regaining control of your life and being a healthier you, being able to play with your kids and spend more quality time as a family. Losing weight is just the bonus.”
Is surgery right for me?
There are plenty of misconceptions still out there about weight loss surgery, said Hilton.
Many—both men and women—don’t want to consider surgery except as a last resort. “But it’s far better for people to elect for bariatric surgery when they are less obese and haven’t developed serious conditions,” said Hilton.
This ties into another misconception, which is that surgery is a quick fix. It’s not—it’s part of an entire lifestyle change, which is far easier to make at 100 pounds overweight rather than 500 pounds. “As a center of excellence, we have a full team available to help patients achieve a successful outcome. This includes registered dietitians who counsel patients on nutrition and healthy eating; nurse practitioners who provide long-term follow-up to ensure patients are meeting weight loss goals; a physical therapist to help with exercise; a coordinator who guides the patients through the process; and a psychiatrist who helps anyone struggling with depression, emotional eating, or eating disorders,” said Hilton.
Just as it takes time to gain weight, it takes time to lose it, even when it’s accomplished through surgery. At AU Health, the process starts with viewing an online seminar and enrolling for a new patient visit, which includes a group introductory class as well as a one-on-one visit with a bariatric surgeon. Over the next three to six months, a candidate meets monthly with a nutritionist to discuss diet and exercise and also meets with a psychiatrist to ensure he or she understands the commitment involved. “Candidates will also typically start losing weight before surgery as they start adopting healthy habits,” said Hilton.
After surgery, the patient is on a special diet for about two weeks before progressing to a regular diet. Follow-up visits happen at 2 weeks, 3 months, 6 months, and then at one year after surgery—then annually for at least five years. The patient can then decide to continue their annual follow up with our AU team or with their primary care provider.
So for anyone who thinks that bariatric surgery is for those who are “too lazy” to do the work of losing weight, think again. “The surgery takes a strong commitment,” said Hilton. “Look at all the celebrities who have recently come forward to talk about having bariatric surgery…they have the financial means to hire a personal trainer and chef, and they still could not lose weight on their own. It’s tough. Their statement is pretty powerful and helps demonstrate that obesity is a medical condition, just like cancer, diabetes, or high blood pressure—and it needs to be treated in the same way.”