Should I have surgery for obesity?
Introduction
This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.
Key points in making your decision
If you are obese and lifestyle changes and taking medicines have not helped you lose enough weight, surgery may be an option. However, all weight loss surgeries have risks, and it is important for you and your health professional to discuss the risks and benefits and decide what is best for your situation. Consider the following when making your decision:
- Although guidelines vary, surgery is generally considered when your body mass index (BMI) is 40 or higher and you also have a life-threatening or disabling condition related to your weight. The following conditions may also be required, or are at least considered:
- You have been obese for at least 5 years.
- You do not abuse alcohol.
- You do not have untreated depression or another major psychiatric disorder.
- You are between 18 and 65 years of age.
- Depending on the type of surgery, most people lose from about 30% to 80% of their excess weight (the weight above what is considered healthy).
- Some of the weight lost may be regained.
- Some types of surgery may put you at risk for nutritional deficiencies.
- People who are obese have a higher risk of complications from surgery.
Medical Information
What is obesity?
Obesity is a complex disease in which having too much body fat puts you at risk for health problems. Obesity is measured by body mass index (BMI). A BMI of 30 or more is considered obese.
What are the risks of obesity?
Being obese increases your risk for many health problems, including heart disease, high blood pressure, type 2 diabetes, and joint problems. Losing even 5% to 10% of your body weight may help reduce your risk. This would mean, for example, losing 11.5 kg (25 lb) if you weigh 113.5 kg (250 lb) .1 Weight loss reduces blood pressure and cholesterol levels and helps reduce blood sugar levels in people who have type 2 diabetes.2
How is the surgery done?
Surgery for obesity can be done by making a large incision in the abdomen (an open procedure) or by making several small incisions and using small instruments and a camera to guide the surgery (laparoscopic method). Laparoscopic surgery for obesity reduces recovery time and postsurgery complications.3
For more information, see the topic Obesity.
Your Information
Your choices are:
- Have surgery.
- Do not have surgery and instead use medicine and lifestyle changes.
- Do not have surgery and make only lifestyle changes.
The decision about whether to have surgery takes into account your personal feelings and the medical facts.
Deciding about surgery for obesity General reasons to have surgery General reasons not to have surgery
- Depending on the type of surgery, you may lose from about 30% to 80% of your excess weight (the weight above what is considered healthy).
- You have a body mass index (BMI) of 40 or higher or a BMI of 35 or higher and a health problem, such as diabetes.
- You have tried diet, activity, and medicines and have lost little or no weight.
- Losing weight will reduce related health problems such as high blood pressure, type 2 diabetes, high cholesterol, coronary artery disease, and sleep apnea.
Are there other reasons that you might want to have surgery?
- You have an ongoing problem with alcohol.
- You have untreated depression or another major psychiatric disorder.
- You are younger than 18 or older than 65.
- Risks common to all surgery for weight loss include infection of the abdominal cavity, a blood clot in the lung (pulmonary embolism), gallstones, and nutritional deficiencies that can result in anemia or osteoporosis.1, 4
- There is a risk of death. Fewer than 3 in 200 (1.5%) die after surgery for weight loss.
- Surgery is expensive if your provincial health plan or private insurance does not cover it.
- You will have to make big changes in how you eat, including eating different foods than you are used to and having smaller portion sizes.
- Rapid weight loss may cause an excess of flabby skin, which may require more surgery to remove it.
Are there other reasons that you might not want have surgery?
These personal stories may help you make your decision.
Wise Health Decision
Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about having surgery for obesity. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
I have a body mass index (BMI) of 40 or higher or a BMI of 35 or higher and a life-threatening or disabling condition caused or made worse by my weight. Yes No Unsure I have tried diet, exercise, and medicine, and they have not worked. Yes No Unsure I am not depressed and do not abuse alcohol. Yes No Unsure I am between 18 and 65 years of age. Yes No Unsure I understand the risks of surgery for obesity. Yes No Unsure I have the finances and/or health plan coverage to pay for surgery. Yes No Unsure I believe that surgery can help me. Yes No Unsure I feel confident that I can make major diet changes after surgery. Yes No Unsure Use the following space to list any other important concerns you have about this decision.
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to have or not have surgery for obesity.
Check the box below that represents your overall impression about your decision.
Leaning toward having surgery
Leaning toward NOT having surgery
Return to the topic Obesity.
| Author: | Douglas Dana Caroline Rea, RN, BS, MS | Last Updated: July 27, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology & Metabolism David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism | |
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