There are a number of widely accepted criteria which make a patient suitable for Bariatric or weight loss surgery:
Weight greater than 45kg above the ideal body weight for sex, and height.
BMI > 40 by itself or >35 if there is an associated obesity illness , such as diabetes or sleep apnoea
Reasonable attempts at other weight loss techniques
Age 18-65
Obesity related health problems
No psychiatric or drug dependency problems
A capacity to understand the risks and commitment associated with the surgery.
Pregnancy not anticipated in the first two years following surgery
There is considerable flexibility in these guidelines. Patients as young as 12 have been offered surgery. Sometimes a lower BMI between 30-35 is accepted if comorbidities exist.
Why are patients opting for surgery nowadays?
Well patients are coming in asking for laparoscopic obesity surgery, because they have tried everything else in the past, and it has failed. Diet, exercise, all of the tablets, whether it is Xenical or Duromine, have a period of effect and everything works well or three or six months, and then we get back to our normal routines, that's why Jenny Craig and Weight Watchers do so well, because weight will reduce over a period of time, six months and then we will all lose our mojo, and put it back on with a vengeance. And I have heard this 1000 times. And so the advantage of surgery is that it is actually permanent. Once you put something inside, from a laparoscopic procedure, then it's there for life and is out of your control, and you work with it. The good thing about laparoscopic gastric banding is that, you can tighten it up as tight as you like it's yours you in charge if you want to tighten it up a bit further then you can lose a bit more weight. So it's adjustable and it's there to suit the patient.
How much weight can I expect to lose?
If you're meant to be 50 kgs and you are 100 kgs, we call that 50 kg of excess weight and we would expect that 50% to 60% of the excess weight is lost with obesity surgery. Which means, of that 50 kgs that you are overweight, we would expect 25-30 kgs to be lost. So if you are a 100 kgs now, we would like you to be down to 70 kgs within 12 to 18 months after the surgery.
