Is Bariatric Surgery Right for You in the New Year? A Q&A with Siva Vithiananthan, MD

January 7, 2015

Weighing on Scale With the new year comes quite a bit of interest in losing weight. Unlike wanting to go on a diet, weight loss surgery decisions are mulled over by patients for months – even years. It is a decision that requires time and often involves significant research and observation of friends and family members who have undergone surgery. 

Siva Vithiananthan, MD, chief of minimally invasive and bariatric surgery, offers tips to help potential candidates make an informed decision about bariatric surgery: 

What is a generally healthy weight or body mass index (BMI) and who is a good candidate for bariatric surgery?

The “healthy weight” range is considered to be 18.5 to 24.9 kg/ m2. Anyone under BMI <18.5 kg/ m2 is considered underweight. Obesity is defined as BMI >30 kg/ m2.

A well-informed patient who is ready to make a lifetime commitment to a change in lifestyle and exercise is the best candidate.

Currently, based on The National Institutes of Health consensus statement published in 1991, bariatric surgery is reserved for patients who have failed medical diets and have a BMI> 40 kg/m2 (or 100 pounds over ideal body weight) or a BMI > 35 kg/ m2 (80 pounds over ideal body weight) with medical conditions such as high blood pressure, diabetes, sleep apnea, high cholesterol.

However, many in the medical community believe these recommendations are antiquated since they were published before the laparoscopic era and establishment of a programmatic approach to treating bariatric surgery patients. Since the risks and safety profile of these surgeries and outcomes are much superior to the open surgery era of the 1990s, coupled with our better understanding of and the effectiveness of treatment of numerous metabolic diseases such as Type 2 diabetes, bariatric surgery is now proposed for those with a lower threshold for surgery.

What is your advice for those interested in undergoing weight loss surgery?

Obesity is a chronic disease – not a failure. It has many causes: nutritional, environmental, genetic, behavioral and metabolic. Like any other chronic disease, the struggle is going to be a long-term one. 

Currently, for someone who has a BMI >35 kg/ m2, the most effective long term solution for his or her obesity and metabolic diseases is weight loss surgery. The patient also needs to do his or her part in terms of making independent behavioral/lifestyle modifications and committing to a new way of living for the long run. This all sounds great, but it is often difficult to make such changes. That’s where a program such as that offered at The Center for Bariatric Surgery at the Miriam and Rhode Island hospitals can help. 

We have more than 5,000 cases worth of experience in bariatric surgery in Drs. Dean Roye, Beth Ryder, Todd Stafford and myself, and our cumulative bariatric surgical care experience totals more than 40 years!

We also have a very robust support system for our patients: a free support group program for patients, program-based dieticians specializing in bariatric surgery, nationally known behavioral health and medical weight loss and diabetes programs, and Magnet-awarded nursing care – all within the center. 

We are in it together and patients, when they seek treatment through an experienced program where all these services are available, are likely to have better long-term outcomes and better overall care.

To learn more, please call The Miriam Hospital Bariatric Surgery hotline at 401-793-3922 or visit The Center for Bariatric Surgery online.

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