How to choose a bariatric surgeon
Bariatric or weight loss surgery is a helpful and often necessary step in treating obesity. It is often the only way people with severe obesity can regain control of their weight and lead a healthier life. It is not a decision that people make lightly — there are a lot of elements to consider. One of the top questions prospective patients have is: “How do I choose a bariatric surgeon?” It is a good question but it does not have a simple answer.
There are many different factors that go into choosing the best bariatric surgeon for you. Not all surgeons will be a good fit but, with careful consideration, you can choose a surgeon that will give you confidence in their ability to perform the surgery with minimal complications and support you during recovery.
Let us take a look first at bariatric surgery, and then explore how to choose a bariatric surgeon.
Who is a candidate for bariatric surgery?
Once you’ve decided to explore having bariatric surgery, you will need to go through a qualification process. A team of doctors, nutritionists, and psychologists will work with you to make sure you are physically and emotionally prepared to have weight loss surgery.
Physical requirements for bariatric surgery
Carrum Health’s partners for bariatrics (such as Scripps Health), follow the National Institutes of Health (NIH) eligibility requirements for bariatric surgery:
- a body mass index (BMI) of 40 or more, OR
- a BMI of 35 or more with a serious health problem linked to obesity, such as type 2 diabetes, heart disease, or sleep apnea
Emotional and psychological evaluation for bariatric surgery
Though people with obesity do not necessarily fit a specific psychological profile, yo will still be required to meet with a psychologist. This is a critical part of your weight loss journey. In order to ensure that you will be successful, your care team will want to make sure that you have the motivation to exercise after surgery, have a good understanding of what bariatric surgery entails, and have a solid support system in place. A psychologist will also be able to help you identify areas where you might need additional support after surgery, such as dealing with depression or emotional eating triggers.
How experienced is the surgeon with bariatric surgery?
While some general surgeons can perform bariatric surgeries, there are surgeons who specialize in weight loss surgery. For you to have the best surgery possible, it is a good idea to find a surgeon who has experience performing the type of bariatric surgery you need.
One study analyzed surgeons at a hospital in Michigan and found that as surgeons performed more bariatric surgeries, the number of patient complications decreased:
| # of bariatric surgeries performed over 3 years | % of surgeries with serious complications within 30 days after surgery |
|---|---|
| 100 surgeries | 2.4% |
| 100 – 249 surgeries | 2.4% |
| 250 + surgeries | 1.9% |
When a surgeon has more experience performing bariatric surgeries, your success rate goes up. This is one of the top factors you should consider as you choose a bariatric surgeon.
Which type of surgery will the surgeon perform?
Overall, bariatric surgery is a relatively safe procedure and most patients who have it experience successful weight loss and uncomplicated recovery. Still, like with any surgery, it is wise to evaluate the risk of complications and compare them to the potential for success. With an understanding of the possible complications for each type of bariatric surgery, you can have an honest conversation with your surgeon about any concerns you have.
The two most common types of bariatric surgery offered by our partners are gastric sleeve surgery (also called sleeve gastrectomy) and gastric bypass surgery. Let us take a look at the success rates and complications rates for each, based on studies done in 2012 by Stanford University, Cleveland Clinic Florida, and the Naval Medical Center in San Diego. While this data is a few years old, it accurately reflects the overall success and complication rates for bariatric surgery.
Gastric sleeve surgery, or sleeve gastrectomy
Gastric sleeve surgery, or sleeve gastrectomy, is a restrictive weight loss surgery performed under general anesthesia. Your surgeon removes about 85% of your stomach, leaving only a thin vertical “sleeve”, and closes your stomach with surgical staples.
Gastric bypass surgery
During gastric bypass surgery, the upper portion of your stomach is stapled to create a small pouch. This helps you feel fuller while eating less. Then, your surgeon attaches your small intestine to the small pouch, allowing the food you eat to bypass most of your stomach. This causes your body to absorb fewer calories.
Comparison
| Outcome | Gastric Sleeve Surgery | Gastric Bypass Surgery |
|---|---|---|
| Average weight loss after 1 year | 30% average drop in body mass index (BMI), from 47.5 to 34.1 | 40% average drop in BMI, from 47.7 to 31.2 |
| 30-day serious complication rate | 0.96% | 1.25% |
| 30-day mortality rate | 0.08% | 0.14% |
As you talk to different bariatric surgeons to find the right one for you, do not hesitate to ask about the success and complication rates of past patients. High-quality surgeons will be happy to discuss these different rates and what they mean to you.
Are you comfortable talking to your surgeon?
Your bariatric surgeon should be someone you can build a comfortable rapport with. Feeling awkward or uneasy are red flags to pay attention to. Even if a surgeon is highly rated, if you do not feel comfortable asking them questions, they probably are not the best choice for you. This is highly subjective — be sure to trust your instinct and, if you feel uncomfortable, keep looking.
Does the surgeon answer all of your questions to your satisfaction?
It is natural to have a lot of questions about getting bariatric surgery. When deciding between surgeons, look for someone who can confidently answer all of your questions. You should not be left with unclear answers — if you need more information, make sure you ask.
Where is the surgeon located?
Traveling for surgery can be helpful, especially if you live in a rural area that doesn’t have bariatric specialists readily available. That being said, consider whether the surgeon you’re consulting with is easily accessible to you both before, during, and after your weight loss surgery.
What are the surgeon’s credentials?
While general surgeons can and often do perform bariatric surgeries, you’ll want to decide whether you feel more comfortable seeing a specialist. As we explored above, surgeons with experience in bariatrics can have higher success rates than those who do not. To get a better understanding of a surgeon’s credentials, you can ask:
- How many bariatric surgeries have you done in the past year?
- Do you participate in bariatric-specific continuing education?
- Are you a member of the American Society for Metabolic and Bariatric Surgery (ASMBS)?
- Are you board certified in general surgery?
- Are you MBSAQIP, or Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, qualified? Our partner hospitals (such as Scripps Health) are qualified members of MBSAQIP
Does the surgeon have testimonials from past patients?
It is only natural to want to hear from other patients about their experience with a surgeon. If you ask, your surgeon may be able to provide testimonials about the success of their past patients after bariatric surgery. Some might even be willing to talk to you about their experience.
Does the surgeon offer postoperative support?
Bariatric surgery isn’t an isolated event. It requires preparation beforehand, as well as lifestyle changes afterward. Surgeons who offer postoperative support can be a great resource to have on hand as you navigate a new phase of your life.
Questions to ask each bariatric surgeon you meet with
This is a lot of information, but it is all useful when you are choosing a bariatric surgeon. Also, it is a great idea to meet with several bariatric surgeons before choosing one. Here is a list of questions you can ask each surgeon you meet with:
- How many bariatric surgeries have you done in the past year?
- Do you participate in bariatric-specific continuing education?
- Are you a member of the American Society for Metabolic and Bariatric Surgery (ASMBS)?
- Are you board certified in general surgery?
- Are you MBSAQIP, or Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, qualified? Our partner, Scripps Health, is a qualified member of MBSAQIP.
- Can I see reviews from your other patients?
- Do you offer postoperative support?
- What are your success, failure, and complication rates for each type of bariatric surgery you perform?
- Are my risks higher than other patients? Why?
- Which type of bariatric surgery do you recommend for me? Why?
- What pre- and post-op instructions do you give to patients having bariatric surgery?
Choosing a surgeon can be complicated, but when you book your bariatric surgery with your Carrum Health benefit, you will have access to the highest quality doctors in the country. They are carefully selected and have experience completing different types of bariatric surgery. You can schedule a free consultation to start the process of choosing a bariatric surgeon.
