The Free Press, Mankato, MN

September 24, 2012

Speaking of Health: Obesity and Weight-Loss Surgery

Megan Gilmore, M.D.
Mayo Clinic Health System

— Obesity is an epidemic in this country. More than one-third of Americans – 78 million people – are considered obese, according to the Centers for Disease Control and Prevention. The impact of obesity on a person’s health is quite serious, but the good news is that even modest weight loss can lower the risk of major health problems.

Q: When is a person considered obese?

A: Anyone with a body mass index (BMI) greater than 30 is considered obese. BMI is calculated by dividing your weight in kilograms by your height in meters squared. You can also divide your weight in pounds by height in inches squared, and then multiply that number by 703. There are also many free BMI calculators available online, including on

Q: Why are so many Americans obese?

A: It’s a complex issue that involves a variety of factors. What it boils down to is that many Americans are taking in more calories than they burn. That could be due to inactivity, poor diet, oversized food portions or other factors.

Q: How does obesity affect a person’s health?

A: Being obese puts someone at greater risk for heart disease, diabetes, high blood pressure, sleep apnea, osteoarthritis and certain cancers. By losing even a small amount of weight, a person can improve – and possibly prevent – those health problems.

Q: At what point is surgery an option?

A: When diet and exercise aren’t sufficient to achieve a healthy weight, a person with a BMI greater than 35 is a candidate for bariatric surgery, also called weight-loss surgery, provided he or she meets certain medical criteria. That person must be committed to dramatic lifestyle changes.

Q: What is the preparation for weight-loss surgery patients?

A: Patients meet with a team of health care providers to evaluate physical and mental health. They are required to attend an information session and complete a behavior modification program staffed by registered dietitians, behavior health specialists and physical therapists.

Lifestyle modifications also need to occur, such as smoking cessation and diet changes. After a few months, the bariatric team reviews the patient’s progress and determines if the patient is ready for weight-loss surgery.

Q: What are the various types of weight-loss surgery?

A: The three most common types of bariatric surgery are gastric bypass, gastric sleeve and laparoscopic banding. The principle behind all three surgeries is the same – limiting the amount of food a person can eat and/or decreasing the amount of calories the body is able to absorb.

Gastric bypass involves significantly reducing the size of the stomach into a small pouch that is then connected to the small intestine.

Gastric sleeve is a surgical removal of one side of the stomach, leaving a much smaller stomach, about the size and shape of a banana.

Laparoscopic banding is the surgical installation of an inflatable band around the opening of the stomach, restricting the amount of food a person can consume. The band is adjustable through a port that is placed in the abdomen. The banding procedure is reversible.

Q: How effective is weight-loss surgery?

A: It’s important to remember that surgery is not a quick fix and takes a serious commitment from the patient. With healthy eating and consistent exercise, patients can lose as much as 70 percent of their excess body weight. However, the degree of weight loss – and the maintenance of that weight loss – is not guaranteed. It is critical to maintain healthy lifestyle changes long after the procedure.

Megan Gilmore, M.D., is a Mayo Clinic Health System bariatric surgeon.

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Health & Fitness coverage is supported by Mayo Clinic Health System, preserving the health and well-being of southern Minnesota communities.