For many people struggling with obesity and obesity-related conditions, the time has come to consider bariatric weight-loss surgery. COVID-19 has added a new worry to their health.
Obesity is a major risk factor for serious illness and risk of death from COVID-19, according to the Centers for Disease Control and Prevention (CDC). Obesity may triple the risk of hospitalization from COVID, according to CDC.
People who may have been delaying a decision on surgery may now be taking action. Interest in bariatric surgery has increased during the pandemic due to concerns over the virus.
Early research shows bariatric surgery can help reduce the risk of severe outcomes from COVID-19. According to a Cleveland Clinic study, obese patients who had bariatric surgery were 25 percent less likely to be hospitalized, compared to those who did not have the procedure.
Studies show obesity can weaken the body’s immune system and make it difficult to fight viral infections. Bariatric surgery can be help in the most severe cases of obesity.
“Bariatric procedures are usually considered only when other efforts to lose excess weight, have failed,” says William Fuller, MD, a bariatric surgeon at Scripps Clinic. “Generally, the patient has severe obesity and obesity-related conditions, such as diabetes and heart disease, or is at risk of these conditions.”
Surgery can also help treat high blood pressure, arthritis and acid reflux. Studies show that people with type 2 diabetes experience rapid improvement in their blood sugar levels after weight-loss surgery.
Since obesity raises the risk of complications from the coronavirus, people with obesity should follow COVID-19 safety measures. Currently, the best way to avoid exposure to the virus is by practicing physical distancing, wearing a mask and washing your hands frequently or using hand sanitizer.
Bariatric surgery works by reducing the physical size of the stomach, limiting the amount of food it can hold and curbing appetite.
Most of these surgeries are done using minimally invasive techniques where a few small incisions are made instead of a long incision. This usually results in shorter hospital stays, fewer complications, shorter recovery and better cosmetic results.
“Your surgeon will recommend the proper weight-loss surgery based upon your medical condition, prior operations, weight history and other factors,” Dr. Fuller says.
Scripps also offers nonsurgical weight-loss services for patients who don’t qualify for surgery.
Having a body mass index (BMI) above 30 is considered obese. But this alone doesn’t make one a candidate for surgery.
Surgery is usually considered only after diet, exercise and medication have failed to do the job. “Even then, careful selection is critical for successful outcomes,” Dr. Fuller says.
To be a candidate for the procedure, a patient must:
- Have a BMI of 40 or higher OR have a BMI between 35 and 39.9 AND a serious obesity-related health problem (such as Type 2 diabetes, coronary heart disease or severe sleep apnea)
- Be motivated, stay well-informed and be able to participate in long-term care follow-up
- Be willing to make lifestyle changes to achieve long-term success
Bariatric surgery is not a quick fix. Candidates must undergo medical, psychological and nutritional evaluations to make sure they are ready for surgery and can make the required lifestyle changes.
Like any surgery, bariatric surgery has risks, including gastrointestinal leakage which can lead to infection, but these risks are low. Regular check-ins with a physician are necessary.
Some health experts say the threat of COVID-19 has made obesity more urgent to address and bariatric surgery more important to have available.
The American Society for Metabolic and Bariatric Surgery (ASMBS) recently declared metabolic and bariatric surgery to be “medically necessary” for people with the “life-threatening and life-limiting disease of severe obesity.”
The group says COVID-19 has added a new threat to worry about. “COVID-19 is the most recent of many diseases in which underlying obesity worsens the prognosis.”
People who are overweight, but not obese,should still be cautious. They “might” still be at increased risk of severe illness from COVID-19, according to CDC. Simple lifestyle changes can make a difference.
Health officials recommend:
• Following your doctor’s recommendations for nutrition and physical activity
• If receiving medicines for obesity or severe obesity, taking them exactly as prescribed
• Calling your doctor if feeling sick or concerned