What is morbid obesity? 

     Morbid obesity or clinically severe obesity may be defined as being 100 pounds or more over your ideal weight or having a body mass index (BMI) of 40 or greater. Body mass index is a ratio that divides your weight in kilograms by the square of your height in meters. A BMI of 25 or more is considered overweight while 30 or more is obese.  Click here for a BMI calculator.

     Morbid obesity may lead to medical complications including high blood pressure, diabetes, sleep apnea, depression, gastroesophageal reflux (GERD), stroke and coronary heart disease.  People who are severely obese may experience more gallbladder disease, respiratory problems and osteoarthritis than those who are not.  

What treatments are available for obesity? 

We offer a comprehensive weight management program that stresses the importance of diet, physical activity and behavior modification techniques for weight loss and maintenance.  According to the National Institutes of Health, however, these treatments may not help morbidly obese patients achieve long-term weight loss goals.

     Weight loss (bariatric) surgery may be an option for patients who meet the NIH criteria for obesity and who have tried other weight loss methods but have not been able to achieve desired results.   

Those who meet NIH criteria for obesity have

a body mass index (BMI) of 40 or more,

or are at least 100 pounds over their ideal body weight,

or have a BMI of 35 or more with a life-threatening illness that may be improved with weight loss, such as sleep apnea, type 2 diabetes or heart disease.

     Surgical treatment of obesity may not only help control the diseases associated with obesity, but it may also help prevent the development of those same diseases if they are not already present. Many patients report an improved quality of life, better moods, increased self esteem and the ability to participate in more social activities.        

What is bariatric surgery?

     Bariatric surgery is not a cosmetic procedure like liposuction or a tummy tuck. Bariatric surgery helps patients lose weight by limiting the amount of food intake (restriction) and/or causing some of the food to be poorly digested and incompletely absorbed (malabsorption).            

     Today there are several surgical options for weight loss, but they do have risks. You and your surgeon must evaluate the procedures and decide which one is right for you. Results achieved by patients must be independently evaluated and managed. Actual weight loss will vary.            

     The Roux-en-Y Gastric Bypass, which is one method used by the Bariatric Surgical Weight Loss Center, creates a small pouch in the stomach so that less food can be eaten. The rest of the stomach is bypassed and no longer receives food. The procedure also bypasses a section of the small intestine so that the amount of calories absorbed is reduced.            

     The adjustable gastric banding system, another method used, places an adjustable band around the upper part of the stomach. The result is you take in less food.  

Who should be considered for bariatric surgery?

     To be accepted for weight loss surgery (such as gastric bypass surgery), you need to meet certain criteria.

In general, you should:

be between the ages of 16 and 65 years old;

be either 100 pounds or more overweight with a BMI of 40 or more OR with a BMI of 35 or more with co-morbidities;

have tried unsuccessfully to lose weight through various weight loss programs;

undergo a psychological evaluation and nutritional counseling to understand the dietary changes after surgery and to determine that you are emotionally healthy enough to understand the ramifications of your decision;

be willing and able to commit to long-term medical follow-up, as well as the rigorous, lifelong changes in eating, exercise and lifestyle habits that will be necessary to meet and maintain your weight loss and health goals after surgery.

What are the different surgical procedures?

Weight loss surgery involves one or both of the following approaches:

Restrictive procedures result in a smaller stomach pouch. Normally, the stomach can hold about 6 1/2 cups of food. A surgically modified, smaller stomach pouch holds about 1/4 cup.

Malabsorptive procedures alter the pattern of flow from your stomach to your intestine, decreasing the number of calories absorbed by the intestine.

What procedures are offered at North Fulton Regional Hospital?

     Gastric Bypass Surgery (Laparoscopic): Gastric bypass surgery is a combination procedure that uses both restriction and malabsorption to achieve weight loss. It is the most common type of weight loss surgery performed. The most frequently is called the Roux-en-Y gastric bypass.  In this procedure staples are used to permanently close off part of the stomach.

     Laparoscopic Adjustable Banding System:  This surgical approach consists of a silicone band that is placed around the upper part of the stomach. It creates a much smaller stomach pouch. The band also slows the passage of food from the stomach into the intestine. This allows you to feel full for a much longer time after eating.    

What can I expect after bariatric surgery?            

     Following Roux-en-Y gastric bypass, you may expect to lose a great deal of weight during the first year. The average weight loss is 10 to 15 pounds per month. Patients who carefully follow the dietary and exercise guidelines may lose even more weight in the first year and continue to lose weight into the second year.            

     Following adjustable gastric banding, you may expect to lose 2 to 3 pounds per week during the first year. You may lose more with exercise and by following your dietary guidelines.            

     After surgery, you may feel full and satisfied after eating only a small amount of food. You may not feel excessively hungry between meals.            

     If you have diabetes, high blood pressure, breathing problems, sleep apnea, back, foot or weight pain, or other weight-related problems, you may see a significant improvement in these conditions. After consulting with your doctor, you may even be able to stop taking some previously prescribed medications.            

     Success after surgery is not just measured by the weight you lose and the change in your appearance. Your success also can be measured by your overall health, well being and enjoyment of life.  

Will insurance cover my surgery?

     Many insurance plans cover all or part of the cost of weight loss surgery. Coverage is determined by your individual policy.  Many managed care plans have benefits that cover the costs for patients. Because insurance plans and benefits can vary, we recommend that you discuss the costs with your company health benefits coordinator.  

Additonal Resources

     We offer educational seminars on both obesity and weight loss surgery. You can go online to register on our Find an Event page or call 1-888-TENET-4U (1-888-836-3848) for more information.  

American Association of Bariatric Surgery

Questions? You can e-mail our bariatric program coordinator at kym.carter@tenethealth.com.