There are just a few big decisions in life that change everything and forever alter your life going forward, sometimes for the better, occasionally, for the worse. Major life decisions like who you choose to marry, where you decide to live and whether or not to have children are rarely taken lightly. The decision about whether or not to have bariatric surgery should be viewed with the same degree of consideration.
Many people come to the Michigan Weight Management Institute who still have significant doubts about whether or not to have surgery. We welcome indecision in our practice and usually are able to help our patients gain a better understanding of why they’ve been unable to maintain a healthy weight.
Because our practice is deeply committed to both surgical and non-surgical solutions for weight loss, we work with our patients to select the right plan. We often see patients who come into the office set on undergoing a bariatric procedure who are able to find success without surgery. Other times, we work with patients who are against the idea of surgery who come to realize that, for a number of reasons, surgery represents their only chance for success.
In order to determine whether or not surgery is necessary, you must first look at all your options for losing weight. Currently, there are only three scientifically proven ways to obtain durable weight loss – this means losing the weight and keeping it off for life.
- Nutritional Change – We are careful not to use the word diet in our practice which most people associate with a short term change in your eating habits. Rather, in order to lose weight successfully for the long run, you must change the types of food you eat – more specifically, you have to change the ratio of good calories to bad calories. By eating lots of vegetables, fruits, nuts, seeds and beans and very little processed food, you can lower your body’s “metabolic thermostat” (link to long introduction video) to a lower weight. This is a critical part of any successful plan, whether or not it includes bariatric surgery.
- Exercise – The role of exercise in weight loss is frequently misunderstood by our patients. First, most people overstate the importance of exercise and are quick to discount their chances of losing weight because of arthritis or an injury. For most of our patients, exercise plays only a small role in our weight loss plan. The reason is that only very vigorous, intense exercise will drive significant weight loss. The majority of our patients are unable to participate in these programs (at least at first) and so we do not emphasize it in the early stages.
- Surgery – The question that we answer with our patients is not “should I have bariatric surgery?” Rather, we ask whether or not it will be necessary to add surgery as a treatment to the first two items on the list. Some patients are able to lose weight successfully with nutritional change and exercise, others are not. There are many reasons why some succeed and other do not and we’ve outlined them below (notice that we don’t list willpower).
Likely to Succeed WITHOUT surgery
Likely to REQUIRE surgery
1. Minimal family history of obesity
2. Gained weight later in life
3. Young (under 35)
4. Eat large amounts of processed food, including sugar sweetened beverages, fast food and sweets
5. Do not “plateau” when dieting and are able to easily lose more than 10% of your total body weight
1. Everyone in your family is overweight or obese
2. Overweight as a child
3. Women who are approaching or have gone through menopause
4. Have a very good diet compared to your peers
5. Are unable to lose more than 10% of your body weight before you reach a “plateau”
Although this list represents our experience at the Michigan Weight Management Institute, it is not exhaustive and in no way should be viewed as a final determination. We have many patients who have been able to lose weight without surgery who meet every criteria listed under the right hand column.
Although this list represents a starting place, each person in our program is an individual and the ideal plan can only be determined over time, as you meet with our team in an effort to better understand the factors that have contributed to your weight gain and are preventing you from finding success.