Bariatric comes from the old Greek word, baros, pressure or weight. It is most commonly used in relation to atmospheric pressure (barometric pressure) and used to predict weather. Bariatric surgery is the general term used to refer to weight loss surgery.

Understanding BMI and Morbid Obesity

Bariatric surgery is an option for people who qualify as morbidly obese. It is a one-two punch combating both obesity and the health risks it poses. Doctors like Dr. Christine Ren-Fielding use BMI, or Body Mass Index, to determine a patient’s eligibility. BMI uses the height and weight of a patient to classify their weight. Weight on its own is not a good indicator of obesity: a 300 pound person standing around five feet tall will have a BMI of 48, morbidly obese, while a person standing six feet six inches but the same weight will have a BMI of 32.

Obesity comes with several life-threatening risks like high cholesterol and blood pressure, diabetes, and sleep apnea. When a patient presents these conditions and has a BMI of 35-40 they are considered morbidly obese. A patient who does not have these conditions must have a BMI of 40 to be considered morbidly obese.

Why Consider Bariatric Surgery?

Dr. Christine Ren-Fielding notes that while “health” is the most uniformly given reason for patient interest in the surgery there are also other reasons patients identify. People who are morbidly obese have a lower quality of life, die younger, and often spend a considerable portion of their lives sick. Especially those who exhibit other conditions – many of which will resolve themselves after losing the considerable amount of weight with surgery. Patients often give quality of life as a determining factor. Patients desire a normal life where they can participate in activities, work without issues and have less pain and illness.

Weight loss is not easy. While a person can lose and keep off ten or twenty pounds, many people who are morbidly obese have tried to lose weight for a long time without sustained success. While they may lose some weight they usually regain lost weight and can gain more. There is very little evidence that diet and exercise are enough for sustainable weight loss for the morbidly obese. About one in 50 patients can lose 50 pounds and keep it off for a year – people choose bariatric surgery because nothing else works in the long term.

There are two main types of bariatric surgery. Restrictive procedures work by reducing the desire to eat and increasing the feeling of satiety. They include the Roux Y gastric bypass, sleeve gastrectomy, mini gastric bypass and Lap Band.

Malabsorptive procedures reduce the calories absorbed in the intestine. Biliopancreatic diversion, or BPD, with or without a Duodena switch is the most common.

These surgeries are mostly done laparoscopically through several small incisions; using long, thin instruments; and a telescopic camera connected to a monitor. These minimally invasive surgeries mean less discomfort during healing.

Bariatric surgery is a well-established, legitimate treatment of. It should never be viewed as a cop out or short cut – it is useful treatment that treats a deadly disease.

Learn more about Dr. Christine Ren-Fielding and the procedures offered by NYU Langone Weight Management here.