Overweight, obese, chronically obese, and morbidly obese are some of the terms used to categorize the different levels of weight-related health issues. What makes a person overweight or obese depends on several factors, including height, weight, body mass index (BMI), and percentage of body fat. Diet and physical activity level also play a part in a person’s body weight and overall health. All of these factors must be taken into account when choosing the right bariatric/weight loss surgery for your specific body type and weight loss issue.
Terms such as overweight and obese are used to describe people who have a greater than average weight for their height. The Centers for Disease Control and Prevention (CDC) defines being overweight as having a BMI of 25 to 29.9, and being obese as having a BMI of 30 or more. These terms are also used to define a weight range based on height that puts people at risk for certain weight-related diseases. A person’s height and weight are used to calculate their body mass index, which, for most people, accurately determines whether or not their weight falls into a range that’s considered healthy, underweight, overweight, or obese for their height.
BMI is just a start to determining a person’s weight category. Other factors must be accounted for as well in order to decide whether a person is actually overweight and/or if they have any conditions or diseases contributing to their weight issues before solutions such as weight loss surgery are considered. For example, you may have heard that muscle weighs more than fat. This isn’t entirely true, and reminds us of the riddle, “which weighs more, a pound of feathers or a pound of steel?” A pound is a pound. However, muscle is denser than fat, and so a pound of it will take up less space than a pound of fat. It’s not uncommon for athletes to have a BMI that puts them in an overweight category even though they have a low percentage of body fat. Athletes are not usually candidates for bariatric surgery.
So it’s not just BMI that makes a person overweight or obese. A person’s weight becomes a health issue when they aren’t able to enjoy regular activities and/or they develop additional health problems as a result. An active person with a healthy diet who has experienced unexplained weight gain should be tested for hypothyroidism and other conditions associated with weight gain before moving forward with a weight loss surgery.
There are several different bariatric surgery options available for people with different weight issues, ranging in severity from chronic obesity to difficulty losing weight through diet and exercise alone.
Liposuction: Liposuction is a surgery that’s usually reserved for people who are overweight but not obese, or as a body contouring procedure for otherwise active and healthy people who need some help taking inches off certain parts of the body. Liposuction can help people lose weight initially, but patients must be prepared to practice healthy eating and exercise habits afterward in order to keep the weight off and, ideally, to help them continue to lose weight post-surgery.
As a body contouring procedure, liposuction is very effective at removing inches from the midsection. Many people who choose liposuction surgery will follow up with one or more cosmetic surgery procedures like a tummy tuck or breast lift to help restore their bodies to their pre-weight gain state. Health insurance does not normally cover liposuction surgery unless it’s been recommended to prevent or combat health issues related to weight; however, many liposuction clinics offer financing and payment plans to their patients.
Gastric Banding: Gastric banding is a weight loss surgery that uses an adjustable band to divide the stomach into two sections, making the upper portion significantly smaller so patients fill up faster when eating. It is different from gastric bypass surgery because it does not reroute the flow of food in the body, but it is similarly recommended for people with a BMI of 40 or higher.
Gastric banding is a highly successful weight loss surgery with few side effects. The band is also adjustable and removable, so the procedure can be impermanent for people with successful weight loss stories. Since gastric banding is only recommended for obese people as a medically necessary procedure, it is covered under most health insurance plans.
Sleeve Gastrectomy: The sleeve gastrectomy is a permanent surgery that’s usually only recommended to morbidly obese patients with a BMI of 60 or more. It removes most of the stomach so that what remains is only about 15% of the stomach’s original size. The portion of the stomach that’s removed produces hunger stimulating hormones, so patients both fill up faster and don’t get as hungry to begin with, helping them to control their eating and lose significant amounts of weight. As with other weight loss surgeries that are considered medically necessary for a person’s overall health, the sleeve gastrectomy is covered under most health insurance plans.
Gastric Bypass: Gastric bypass surgery is the most common type of weight loss surgery, but it is usually reserved for chronically obese people with a BMI or 40 or higher. While it can be very successful for permanent weight loss when patients are able to follow a diet and exercise program afterward to help keep off the weight, it’s also the weight loss surgery with the longest recovery time and greatest number of side effects.
Gastric bypass surgery reduces the size of the stomach and reroutes food so that it bypasses certain parts of the digestive system where nutrients are absorbed. Patients fill up faster and don’t assimilate all the food they take in, causing them to absorb significantly fewer calories. Since gastric bypass surgery is only recommended as a medically necessary procedure for obese patients, it is normally covered by most health insurance plans.
Post Bariatric Reconstruction: Many patients who undergo major bariatric surgeries later opt for additional cosmetic procedures to help restore their bodies. Significant weight loss can result in loose, sagging skin and breasts, so many patients will choose one or more elective procedures to tighten the skin, such as a face and neck lift, breast lift, butt lift, and tummy tuck. Certain procedures are covered by insurance under certain circumstances, but financing and payment plans are usually available at most clinics as well.