Bariatric surgery includes a number of surgical procedures meant to help patients lose weight through the limitation of food intake. The surgery works by reducing of the stomach’s capacity and size, and/or the rearrangement of the digestive system. It causes malabsorption of calories, which is an effective approach to weight loss in cases of severe or morbid obesity. Currently, it is possible to perform bariatric surgery using minimally invasive techniques due to improvements and advancements to the procedures.
The four main types of bariatric surgery are gastric bypass, sleeve gastrectomy, adjustable gastric band (gastric banding), and biliopancreatic diversion with duodenal switch. All of them are different and meant for patients with different characteristics. However, bariatric surgery is not for everyone, and it is the most extreme option for medically supervised weight loss methods, which has both advantages and disadvantages. The main benefit is that the process of losing weight is quicker and easier with the surgery, but patients still need to make changes in diet and exercise habits.
Prior to Deciding for a Bariatric Surgery
Before deciding to seek a bariatric center and surgeon, it is important for patients to understand what bariatric surgery is. A healthcare team can give patients the basic information on eligibility criteria, the procedures, risks and demands. There other numerous types of medically-supervised weight loss programs that may be recommended to obese patients. Surgery is often the last resort for patients with a Body Mass Index higher than 40, or a BMI of 35 and an associated disease, such as high blood pressure, heart disease, diabetes, metabolic disease or sleep apnea.
The type of surgery that may be of the most benefit to a patient depends on a series of factors and should be discussed together by both physicians and patients, taking into consideration benefits and risks associated with surgery, which include bleeding, infection, leaks, diarrhea, and blood clots. In addition, undergoing a bariatric surgery does not directly provoke weight loss, it will only help in the process, as patients need to be fully committed as well. Therefore, the first step is to seek a family physician or other to explore all options and get to known the first information about bariatric surgery.
How to Decide for a Bariatric Center or Surgeon
If a patient believes bariatric surgery might be an option after the first step, then it is time to seek specialized help. This next step is very important and may determine the success of the treatment, according to the American Society for Metabolic and Bariatric Surgery (ASMBS). “A recent study showed that the mortality rates at non-accredited facilities are on average three times greater than the mortality rates at accredited facilities. Accreditation is an important, life-saving process and we encourage patients and referring physicians to seek out those facilities that meet these rigorous standards,” state the organization.
There are many options for where to have the surgery, but one of the most important variables to consider is accreditation. The bariatric and metabolic surgery accreditation process is called Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) and was established by the ASMBS and the American College of Surgeons (ACS) in 2012. The program conducts a rigorous process of evaluations to ensure the level of quality across safety, training, followup, and surgical volume standards in order to to foster patient safety and surgical excellence. The organizations offers an online tool in its website to help patients search for a bariatric medical center and surgeon near them.
Recommendations When Choosing a Bariatric Center and Surgeon
In addition to seeking an accredited facility, the ASMBS also makes other recommendations regarding the choice of a center or surgeon. The society advises patients to discuss early in the process insurance coverage and payment options. Getting insurance for bariatric surgery is not easy and the procedures are expensive. Therefore, discussing it with the company or employer provider, and asking the physician for assistance can be help chose a facility where it may be easier to get insurance coverage or facilitated payment plans.
Medical tourism is, however, discouraged due to the unique characteristics of the bariatric patient, the potential for major early and late complications after bariatric procedures, the specific follow-up requirements for different bariatric procedures, and the nature of treating the chronic disease of obesity. Choosing a facility that implicated extensive travel before and right after the surgery is not recommended. In addition, follow-up and regular medical visits are determinant to long-term success, but are more difficult with distance.
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