Is bariatric surgery considered elective surgery?
Ragui W. Sadek, MD, FACS, FASMBS, is a well-versed bariatric surgeon who diagnoses and treats patients at Advanced Surgical & Bariatrics of NJ in Somerset, NJ. He is the Director of Metabolic and Bariatric Surgery at the Robert Wood Johnson University Hospital and the Director of the Adolescent Metabolic and Bariatric Program... more
Obesity is a health threat that has been affecting the world for decades. Physicians and scientists recognize the problem and spend countless hours in the lab researching and trying to find a solution. Everywhere we turn obesity is around the corner. Hypertension, diabetes, stroke, obstructive sleep apnea, and cancer are all related to obesity. Recent studies discuss data about fatty liver ‘NASH’ and the potential to increase hepatocellular carcinoma. NASH can be the cause of a liver transplant shortage soon. As surgeons started getting more and more involved, obesity treatment acquired a new treatment dimension. Finally, there was hope, we saw a significant improvement in management and we were able to provide a sustainable cure for the problem.
Weight gain and weight-related problems didn’t plateau, on the contrary, the problem worsened and now started to affect the future. Our kids are suffering from it, childhood obesity is now reaching 30%. Children are developing Diabetes type 2, HTN, and other preventable medical conditions that no child should experience. The reasons why we didn’t operate enough or only operate on 1% of people requiring the treatment are many, these reasons include:
1- Most people regain weight after surgery. That’s not true, the majority of people maintain 50% or more weight loss after surgery.
2- Bariatric surgery is dangerous. The truth is that mortality rates from bariatric surgery now are around 0.1%, bariatric surgery reduces death from diabetes by 80-90%.
3- Diet and exercise work as well as bariatric surgery. That’s a false statement because diet and exercise don’t change the metabolic aspects as well as bariatric surgery.
4- Bariatric surgery patients are malnourished. That’s false, data shows that a very small number of patients do get malnourished.
5- Physician education is lacking and needs to be improved utilizing talks and seminars. We need to discuss the benefits of surgery with our health care professionals and also guide health care workers on how to communicate with patients.
Bariatric surgery, one of the most important decisions to improve quality of life, had a significant reduction in mortality compared to individuals who didn’t. Studies also found that bariatric surgery leads to a 90% reduction in death from diabetes and 50% death from heart disease. Being overweight is the fifth leading risk for global deaths. At least 2.8 million adults die each year as a result of being overweight. About 44% is from diabetes, 23% is from ischemic heart disease, and between 7% and 41% are from cancer. Approximately 300,000 Americans per year pass away from obesity and related disorders.
Obesity is deadly. The health crisis that our country is facing from obesity exceeds most other medical problems. I don’t agree with calling bariatric surgery elective, elective means optional. Delaying the treatment of obesity in a diabetic, post-CABG patient with obstructive sleep apnea is increasing the risk of complications and possible cardiac death. The COVID-19 pandemic if anything showed that bariatric surgery is essential, bariatric surgery saves lives. Bariatric surgery is not elective.
