Severe obesity is reaching epidemic rates in this country. And with this rise there is a significant increase in major weight-related illnesses such as diabetes, high blood pressure, and heart disease. More than 68 percent of adults in the United States are overweight or obese. The majority of these people have lost weight in the past, but have been unable to keep it off with diet, exercise, or medication. Weight loss surgery may be an option for some.

What it is

Weight loss surgery, or bariatric surgery, is a treatment of last resort for people who are more than 70 pounds overweight and have tried a variety of other weight loss methods without lasting success.

Health problems commonly associated with severe obesity include diabetes, high blood pressure, heart disease, breathing problems, high cholesterol, arthritis, severe back pain, and acid reflux.

"Severe obesity and the associated health problems often have an extremely negative impact on the person's quality of life and ability to enjoy normal activities," notes Horacio Asbun, MD, medical director of the weight loss surgery center at John Muir Health.

"Weight loss surgery has been shown to be the only treatment that can provide permanent weight loss results for the majority of severely obese people," he adds.

How it works

Weight loss surgery provides very effective tools for achieving significant, permanent weight loss. However, it is very important to understand that major dietary and lifestyle changes are also necessary after weight loss surgery in order to achieve optimum, long-term success.

"There are several different weight loss surgery options" says Dr. Asbun. "These procedures all reduce the size of the stomach to decrease food intake, and some also bypass part of the small intestine to decrease calories absorbed from foods eaten.”

“By altering the person's internal anatomy and drastically reducing calories consumed and absorbed, weight loss surgery helps break the cycle of overeating and gaining weight," Dr. Asbun explains.

Patients also need to adopt a healthy diet, avoid starchy, sugary or "junk" foods, and begin a program of regular exercise.


The most common weight loss surgery procedure is called roux-en-y gastric bypass, which involves reducing the stomach to a tiny pouch and bypassing a section of the small intestine.

Many surgeons also offer placement of an adjustable gastric band, which fits snugly around the top part of the stomach to limit the amount of food eaten at one time.

A more complex surgery called a duodenal switch includes removing a large portion of the stomach, re-routing food away from the small intestine, and re-directing bile and other digestive juices.

A newer surgery option called sleeve gastrectomy is available which involves the removal of 75 percent of the stomach, leaving a narrow pouch that holds less than a cup of food.

Research studies show each of these surgical procedures demonstrate safety and effectiveness for major long-term weight loss. The patient makes the decision to have weight loss surgery, then chooses the procedure in consultation with a qualified bariatric surgeon.


Following surgery, patients who are compliant with the dietary guidelines usually lose a significant amount of weight at a rapid rate during the first 12-18 months.

"Most patients report feeling full and satisfied after eating only a small amount of food, and not feeling excessively hungry between meals," says Anne Timberlake, RN, nurse manager of the weight loss surgery center at John Muir Health.

She adds that, “While many do not reach ideal weight range, they enjoy tremendous improvement in their health, appearance, self-esteem, mobility, and ability to engage in physical activities."

Patients who suffer from weight related problems usually see a significant improvement in their health as they lose weight. Many are able to eventually discontinue medications for diabetes, high blood pressure, and high cholesterol, and discontinue nighttime support for sleep apnea.

"Success after surgery is measured not just by pounds lost and change in appearance, but also by improvement in the patient's overall health, well-being, and enjoyment in life," notes Timberlake.

Insurance coverage

The majority of health plans will cover weight loss surgery if the person meets specific criteria. If you are interested in weight loss surgery, it is important to check with your health plan to confirm coverage before contacting a weight loss surgery program or surgeon.

Health plans often require documentation of previous weight loss attempts to demonstrate that you have already made a serious effort to lose weight without lasting results. If your insurance does not cover weight loss surgery, self-pay packages are available.