Is Weight-Loss Surgery Right for You?

by Winnie Yu

If your body mass index (BMI) is greater than 40—for example, if you're 5'4" and weigh over 235 pounds—then you're a potential candidate. People with a BMI over 30 are also eligible if they have a weight-related condition such as diabetes or high blood pressure.

But just because you qualify doesn't mean you should do it. First, surgery is expensive—anywhere from $11,500 to $26,000—but your insurance may cover part or all of it (check with your provider). And while weight-loss surgery is life-changing and can even be lifesaving by reducing the odds of dying from cancer, diabetes or heart disease, it does have risks, both during the operation and afterward. So it's crucial to try losing weight through diet and exercise first. Photo: Thinkstock

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Surgery isn't a magic bullet; you don't just have it and see the pounds effortlessly come off. "It can help a lot, but you still have to do the work," says Robin Blackstone, MD, president of the American Society for Metabolic & Bariatric Surgery and medical director at Scottsdale Healthcare Bariatric Center in Arizona. "You must exercise and change the way you eat." Otherwise, you run the risk of not losing or regaining the weight.

If you've reached the point where you're seriously considering surgery, you'll most likely be deciding between the two most popular options: gastric bypass, which is what Brooke and Jackie had, and gastric banding (such as Lap-Band). This chart tells you what you should know about both of them.

Gastric Bypass (Roux-en-Y gastric bypass)

How It Works

A surgeon closes off part of your stomach, shrinking it. The smaller section gets attached to the middle part of your small intestine (jejunum), allowing food to bypass the upper part of the small intestine (duodenum). This triggers changes in hormones that control hunger and metabolism, as well as physically restricting the amount of food you can eat.

Who's Eligible

People with a body mass index (BMI) greater than 40 or a BMI over 35 with one obesity-related condition (such as diabetes, high blood pressure or sleep apnea).

Why Choose It

You'll probably lose weight faster. In one year, bypass patients shed an average of 85 percent of excess body weight; banding patients lose an average of 48 percent, according to research from the University of Wisconsin. Bypass may also be better for people with diabetes, since the procedure seems to immediately affect hormones that impact this condition.

The Downsides

You'll probably be hospitalized for 48 hours after surgery; there's a 1 in 1,000 risk of mortality during the procedure. After, patients may develop hair loss, vitamin deficiencies, and dumping syndrome (undigested food gets dumped into the small intestine too rapidly, causing nausea, vomiting, cramps, diarrhea and profuse sweating).

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Gastric Banding (laparoscopic gastric adjustable banding; brands: Lap-Band and Realize)

How It Works

A surgeon makes a small incision and inserts a silicone band around the upper part of your stomach, creating a small pouch that restricts how much you can eat. A plastic tube connects the band to a device just under your skin (the band stays in forever unless the surgery needs to be reversed or redone). After surgery, patients return to the doctor periodically so he can inject or remove saline solution from the device (through a port in the skin) to make the band tighter or looser as needed.

Who's Eligible

People with a BMI greater than 40 or a BMI higher than 30 with one weight-related medical condition (such as diabetes, high blood pressure or sleep apnea).


Why Choose It

This is a less complicated procedure than bypass surgery because there's no resectioning of the intestines or stomach. You'll probably go home from the hospital the same day, and complications are less likely than with bypass (1 in 2,000 mortality rate).

The Downsides

Twenty percent of patients don't lose enough to reverse a medical condition. Five to 10 percent need to have a repeat procedure to correct a problem, such as slippage of the band. If you have diabetes, the condition won't reverse until you shed significant weight. Side effects include heartburn and difficulty swallowing.