skip to content, health centers and clinics, search, accessibility statement

Healthy Outlook

Weight Loss Surgery an Option When Diet and Exercise Fail

By Dr. Irene Lo

Thursday, September 24, 2015

We all know that the ideal way to maintain a healthy body is through exercise and a sensible diet. But what if you can’t lose weight? Sometimes it is more than a matter of willpower.

Obesity is common in the United States, and many struggle to lose weight for a variety of reasons, including physical limitations. As a result, they face a greater chance of life-shortening medical problems, such as diabetes or heart disease.

For people in danger because of their size, or who have been unable to keep off weight by following other treatment plans, bariatric (weight loss) surgery may help.

Bariatric surgery is not a cosmetic procedure or a weight-loss scheme from a commercial. It involves altering the stomach or gastrointestinal tract, resulting in life changes that are not always easy.

There are several bariatric procedures, but all of them either restrict the amount of food the stomach can hold, or reduce the body’s ability to absorb nutrients from food, or do both.

This kind of procedure is for patients who are very obese, in the medical sense. Doctors calculate obesity with the body mass index (BMI), which is a measurement of body fat based on height and weight.

People with high BMI scores are at higher risk for a number of medical conditions, such as diabetes, reflux, heart disease, cancer, arthritis and depression. People with a BMI score higher than 40, or 35 or higher with an obesity-related condition, may be good candidates for surgery.

As a surgeon who specializes in bariatric procedures, I work with patients who have already been extensively evaluated by their healthcare providers, and talked over their options with their doctors.

That is because recuperating can take months, and patients must be closely monitored for complications and to ensure that their bodies are receiving proper nutrition.

People who have bariatric surgery definitely cannot eat whatever they want. Patients must strictly follow their diet and exercise plans or risk getting very sick, or even hospitalized.

On the other hand, I’ve also had patients who stopped needing medication for obesity-related conditions, such as high blood pressure. Most patients lose weight quickly, maintain healthy body weight and feel comfortable with their new lifestyles, if they follow their plans.

There are several bariatric procedures to consider, each with advantages. All of them are laparoscopic, meaning the surgeon uses special instruments that only need a tiny cut to see and work inside the body.

Gastric bypass surgery creates a small pouch in the stomach that restricts how much food can be eaten, and reattaches the small intestine so food passes without being broken down and absorbed.

A sleeve gastrectomy turns the stomach into a slender tube that limits the amount of food one can eat. Gastric banding, meanwhile, places an adjustable, inflatable band around the stomach to limit food consumption.

If you are thinking about bariatric surgery, talk to your healthcare provider about your options. Bariatric surgery is not easy, but it is an effective way to lose weight.

Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at For more health information, go to
About the Author

Dr. Lo practices general and bariatric surgery with West Coast Surgical Associates, operating at Contra Costa Regional Medical Center and John Muir Medical Center. For more information, visit and