Gastric bypass surgery and lap-band surgery has been gaining popularity over the past several years, and may be available to you as a tool for weight loss. The American Society for Bariatric Surgery and the National Institutes of Health estimate that in 2003, 103,000 Americans underwent this operation. This is up significantly from 63,000 in 2002.  Several celebrities have gone public with some amazing results; however, the results can be temporary if the behavior is not changed.

However, this is really a last resort quick weight loss measure. Gastric bypass surgery is a major medical weight loss method and, as such, has all the risks associated with any other invasive procedure. It should not be considered unless other less invasive means of weight loss have been given your full effort but still not helped you achieve a stable reduction in your weight. The Roux-en-Y is the most commonly performed gastric bypass operation. The procedure involves two steps: (1) Sectioning off a small segment of your stomach so that you can only take in small amounts of food, and (2) Cutting and reattaching a portion of your small intestine to this new small stomach, thereby reducing the amount of nutrients and calories you absorb from the food that you do eat.

To qualify for a gastric bypass, potential patients must meet criteria set by the National Institutes of Health. For example, a person must have a minimum BMI of 40, or a BMI of 35 with associated co-morbidities. In addition, prospective patients are required to have tried other weight loss methods or treatments already.

Although you must discuss this with your doctor, and ultimately your surgeon, to know whether you qualify for the weight loss surgery, here are the general guidelines.

If your Body Mass Index (BMI) is 40 or greater, and there are no medical or psychological reasons that surgery would be too risky for you, most bariatric surgeons would accept you.

If your BMI ranges from 35 to 39.9 and you have medical co-morbidities such as sleep apnea and diabetes, and there are no medical or psychological reasons that surgery would be too risky for you, most bariatric surgeons would accept you.

Although the comprehensiveness of programs varies from location to location, we recommend that you seek a surgeon who does have a comprehensive program. Such a program would require that you meet with a Registered Dietitian and a Clinical Psychologist both in preparation for and following surgery, and have at least a year of follow-up visits with your surgeon and his or her team. In spite of the dramatic results publicized in the media, the truth is that the surgery does not “solve” your obesity problem. Rather, it provides you with a strong aid to changing your eating patterns – it does not change them for you. Thus, you will still have to address such issues as food preferences, emotional eating, and the challenges of socializing without overeating.

Depending on your weight and your surgeon’s program, you may be required to participate in a weight loss program in preparation for surgery. Many surgeons require this participation as a means of your demonstrating that you will be able to follow the strict dietary and behavioral requirements posed by the surgery. Also, if you are very large, a weight loss program such as a very low calorie diet (VLCD such as Optifast, HMR, Medifast, etc.) may be needed in order to lower your weight and thereby reduce the probability of surgical complications.

Surgical treatment is gaining in popularity because it is the best method currently available for achieving long-term weight control for the extremely obese. However, you should be clear on the fact that surgical treatment is not a cosmetic procedure. It does not involve the removal of adipose tissue (fat) by suction or excision. Bariatric surgery involves reducing the size of the gastric reservoir. This helps the individual reduce caloric intake and practice healthier eating behaviors such as moderating portion size, eating slowly, chewing each mouthful well, and attending to visceral signals of satiety….