Should You Recommend Bariatric Surgery to Obese Patients?

January 22, 2019

  Obesity is one of the biggest health problems facing American society. It’s a struggle to instill basic nutrition and exercise habits into your patients. Those who ignore your advice develop a number of serious, life-threatening problems. It seems like bariatric surgery could be an easy way out, but is it the best thing for your patient? As the presiding medical officer, you’ll have more insights about the best course of action. In some cases, bariatric procedures are extremely beneficial for patients and in other cases, it’s better to stick to more traditional methods of weight loss. As you review your patient’s case, consider the following factors. Is the Patient a Good Candidate? Bariatric surgery not only has its risks, but it’s also a life changing procedure. It’s important that candidates be in general good health without exterior risks that could make the surgery more dangerous. These procedures can be extremely effective and useful for patients, but they’re usually more of a last resort than a first choice. Typically patients are only considered if they have a BMI of 40 or higher, and have first tried other methods of weight loss without success. It may also be recommended for those classified as obese with a BMI of 35-39 with serious weight-related health problems like type 2 diabetes or sleep apnea. Go over these conditions with your patient to make sure they understand the severity of their condition and their future health. Weight loss surgery should not be considered for those who don’t meet the qualifications above. It’s not a surgery that patients can simply request. If they don’t meet these conditions but still request bariatric surgery, explain why it would not be a good idea in their condition. Will It Be Effective? The physical need for bariatric surgery will be the first factor. If it’s a matter of life or death, or it could extend their overall lifespan by a decade, the procedure is worth considering. You know the risks of bariatric procedures, and it’s also an expensive procedure that may or may not be fully covered by the patient’s insurance. For that reason, you should also consider whether or not the procedure will be effective. There are a couple of factors to consider here. The first is the severity of the patient’s condition. In some cases, the potential complications may outweigh the benefits, making it less effective. If a patient is taking a medication or has a condition that makes them gain weight despite the procedure, it may be better to consider another alternative to weight loss. Secondly, consider the patient’s personal capacity for sticking with the diet that follows the procedure. Patients who undergo bariatric surgeries must stick to a strict diet with an eventual exercise routine for the effects to be long lasting. Some patients with compulsive eating disorders or other behavioral problems may not be able to safely sustain their weight loss. It’s important to carefully evaluate the habits and lifestyle of patients being considered for bariatric surgery. If there are factors that will impede the after program, first focus on changing habits before surgery begins in order to increase the chances of success. Can the Patient Afford It? Like any medical procedure, bariatric surgery can be costly. Influential factors include the patient, type of procedure, severity of the condition, insurance coverage, and location. Without insurance, such a procedure can cost more than $20,000. Some insurance firms won’t cover the procedure or the coverage will be minimal. Even though physicians often classify weight loss surgeries as primary to the patient’s health, many insurances consider it to be cosmetic. Before considering bariatric procedures with your patient, go over the medical costs and have them check with their insurance providers. If they can’t afford it, you may want to go a different route. Bariatric surgery shouldn’t have the bad reputation it’s gained over the years. It’s important to carefully consider the positives and negatives with your patient before pursuing the best course of action for their condition.

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