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Bariatric surgery is a procedure used to treat severe obesity in people who have failed to maintain a healthy body weight through diet, exercise and medication. Although bariatric surgery typically results in greater and faster weight loss than these methods, it is usually considered an option of last resort for most individuals because the surgery itself presents potential health risks.

Bariatric surgery is generally reserved for people who are more than 100 pounds overweight, or have a body mass index (BMI) over 40. BMI is a calculation of a person’s height and weight that is used to determine whether the person is within a normal weight range. A healthy BMI is between 18 and 25. Some people with a BMI of 35 or more will be considered for the surgery if they have certain illnesses that could be improved with weight loss, such as type 2 diabetes, sleep apnea and heart disease.

Researchers recently devised a new scoring system that helps to determine which candidates are at greatest risk of experiencing complications from gastric bypass surgery. However, this tool requires additional study before it can be routinely used by physicians.

Even though research shows that bariatric surgery has tripled among adolescents in recent years, concerns about the potential long-term effects usually preclude them from receiving bariatric surgery. However, it is sometimes considered for severely overweight adolescents who have significant health problems related to obesity (such as type 2 diabetes or heart disease) and for whom weight-loss efforts remain unsuccessful after a period of at least six months. A patient must reach adult height (around age 13 for girls and 15 for boys) before the surgery will be considered.

Some research also suggests that the risk of complications following bariatric surgery increases proportionately for each year of age for individuals over age 60.  

A team of health professionals, including physicians, surgeons, dieticians and psychologists, work together to help determine if a patient is a good candidate for this surgery.

Bariatric surgery promotes weight loss through one of two methods: by restricting food intake or by interrupting the digestive process.

The digestive process begins as soon as a person swallows food. Once the food enters the digestive tract, digestive juices and enzymes begin digestion, and calories and nutrients are absorbed in the small intestine. The food moves down the esophagus and into the stomach, where acid continues to digest the food. In the average person, the stomach can hold about 3 pints of food at one time.

As food is digested, it moves to the first part of the small intestine (known as the duodenum), where bile and pancreatic juices promote digestion and absorption of nutrients including the minerals iron and calcium. Most of the remaining calories and nutrients are absorbed in the final two segments of the small intestine (jejunum and ileum). Any leftover food particles move into the large intestine before they are eliminated from the body.