Understanding the Risks and Costs of Bariatric Surgery
If you listen to the popular press, you would think that every weight-loss patient has a complication or dies after weight-loss surgery. The truth of the matter is that the majority of people come through their operation with few to no complications. Even though the number of bariatric surgeries being performed is increasing exponentially, it has never been safer to undergo a weight-loss operation.
It is important to understand, however, that there are real risks when undergoing a major operation like weight-loss surgery. Let's start out with the worst possible complication: death. Despite what the media would have you believe, death is actually unusual after weight-loss surgery. If you look at the most popular weight-loss operations, the death rates are: Adjustable Gastric Banding - 0.1 percent; Gastric Bypass - 0.5 percent; and Biliopancreatic Diversion - 1.1 percent. In many experienced programs, the rates are even lower. While the risk of death is very low, it is very real and must be seriously considered when contemplating weight-loss surgery. It is vital that each individual considering weight-loss surgery ask themselves the question, "Does my weight problem concern me enough that I am willing to put my life on the line to get it under control?"
With any major surgery there are risks while you are in the hospital and after you have gone home. There are additional risks that are specific to a particular weight-loss operation and are beyond the scope of this article. You should talk to your surgeon about specific risks once you have decided which operation is right for you. Keep in mind that the medical problems you bring into the operating room also affect your level of risk (i.e. the "sicker" you are the riskier the weight-loss surgery).
On a more positive note, there are some things that you can do before your operation to minimize your risk. One of the most important things you can do is to select an experienced weight-loss surgeon with an established, multi-disciplinary program. Second, if you are a smoker, stop immediately. Smoking impacts multiple organ systems and has serious effects on the lungs and on wound healing. Most weight-loss programs will want you to lose some weight prior to weight-loss surgery. The 10-20 pounds that most programs want you to lose may not seem like much, but for your surgeon it makes a world of difference, especially if they are performing your surgery laparoscopically (through small incisions). Increasing your daily activity and modifying your diet prior to your weight-loss operation will also have a positive impact.
Finally, when considering the risks of weight-loss surgery, one must consider the risks of not having weight-loss surgery. Clearly there are a host of risks that come along with being morbidly obese including such life threatening problems as diabetes, high blood pressure, heart disease and sleep apnea. Morbid obesity also significantly impacts the quality of life of individuals by decreasing energy, stamina and mobility.
While weight-loss surgery is safer than it ever has been, it is still a major operation, which has inherent risks associated with it. Although the majority of patients will make it through their operation with minimal to no long-term problems, there is a small minority of patients that will have significant long-term problems. Each individual must decide if the risks of surgery are less than the risks of continuing to live with their morbid obesity.
Weighing the Risks
Operating Room Risks
- Injury to organs
- Problems with anesthesia
Hospital Stay Risks
- Wound infection
- Urinary tract infection
- Blood clots in the legs
- Blood clots in the lung
- Leak from bowel connections
- Heart attack
- Kidney problems
At Home Risks-Early
- Stenosis (narrowing)
- Kidney stones
- Prolonged nausea
Weighing the Costs
Bariatric procedures cost from $20,000 to $35,000. Medical insurance coverage varies by state and insurance provider. If you are considering bariatric surgery, contact your regional Medicare or Medicaid office or insurance plan to find out if the procedure is covered. For a list of approved Medicare/Medicaid approved facilities, visit the Centers for Medicare & Medicaid Services website.
Adapted and excerpted from Obesity Action Coalition.
Reviewed by Susan Weiner, R.D., M.S., C.D.E., C.D.N. 3/08
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