It’s always been difficult medically to live with obesity. Obese patients have a higher risk of medical problems, such as high blood pressure, type 2 diabetes, heart disease, increased risk of cancer. But then, you add the challenges of coronavirus and COVID-19, and these problems get magnified.
Obese patients have an increased risk of inflammation. They have decreased immunity. They have restrictive lung disease that can be quite severe, type 2 diabetes. The combination of those things is quite challenging medically when it comes to COVID-19. Patients with obesity have an increased risk of being hospitalized if they get COVID-19, increased risk of needing intensive care unit support and increased risk of mortality with the coronavirus.
Bariatric surgery has been around for a long time. It’s evolved to what we do now. It is an operation to shrink the size of our stomach.
We shrink the size of the stomach by about 80 to 90%, depending on which operation that we do.
With the gastric bypass, we also rearrange the intestine and create new intestinal connections. This has an effect on our bodies such that we have decreased appetite, and decreased ability to eat as much as we did before. The combination of decreased appetite, and less volume of eating creates a perfect marriage for weight loss.
Based on the National Institute of Health, patients with a body mass index of 35 or greater are candidates.
The body mass index is your weight divided by your height. That can be calculated quite easily.
If your BMI is between 35 and 40, you typically have to have a weight-related medical problem also. If you BMI is above 40, you do not.
Patients typically have to go through a medically, or doctor-supervised weight loss program. They have to go through an educational seminar to learn about the operations. They have to start getting support through a dietician about nutrition before surgery and after surgery.
All patients have to get a psychological assessment to make sure we’re doing a safe, and correct operation.
In the short-term, patients are in the hospital, generally, one or two nights after surgery. Recovery time ranges from about three to six weeks.
As far as time off from work, patients will take off anywhere from three to six weeks, depending on the type of work that they do. It’s not because they’re in bed not able to do things. Patients can get up and walk around and start an exercise regimen almost right away. They start on their diet right away. But what I recommend is for patients to just take some extra time to start on the right track.
Absolutely, it is safe to come in during COVID. We all have our own protective personal equipment. Patients are getting tested on a regular basis. Our hospital has completely isolated any coronavirus, or COVID-19 patients. We have been doing weight loss surgery for many months now during this pandemic, and have not had any ill effects from doing this.
It’s a good time to look into this. There are many reasons to try to gain your health back. Most patients with obesity that I see have obesity as their biggest health hazard.
There’s no better way to gain back their health and to lose weight. There’s no better way to lose weight than with bariatric surgery, especially with patients with a BMI over 35.
Lightly edited for clarity.
Watch the San Diego Health video with host Susan Taylor and Dr. Takata discussing who is a candidate for bariatric surgery during COVID.