Channing Chin, MD, bariatric surgeon at Chilton Medical Center, answers some commonly asked questions about bariatric surgery.
Q: Am I a candidate for weight loss surgery (bariatric surgery)?
A: This is a very common question I get from prospective patients as well as from primary care doctors. There is a lack of awareness among the public and medical community, despite the well-established benefits of weight loss surgery for several decades.
The eligibility criteria for bariatric surgery was established by the National Institutes of Health (NIH) in 1992 and has not changed since. It is essentially based on a person’s height and weight, using those numbers to calculate the body mass index (BMI). According to these criteria, eligible patients should have a BMI ≥ 40 kg/m2, or a BMI between 35 and 40 kg/m2 if they have high-risk, weight-related health problems such as diabetes, high blood pressure, high cholesterol, sleep apnea, etc.
Let’s take a look at two people who qualify:
1) a 65-year-old female, who is 5'4'', 204 pounds, treated for hypertension
2) a 21-year-old male, who is 6', 295 pounds, with no medical problems
Both qualify for surgery. A big misconception is that a person needs to be 100-200 pounds overweight to be a candidate for surgery. Due to the profound effects of weight loss surgery on metabolic diseases such as diabetes and high cholesterol, I believe the criteria for bariatric surgery will become less restricted to a patient’s height and weight.
Many other countries, and some specialized centers in the United States, are performing bariatric surgeries in patients who have BMIs lower than 35, but have significant diabetes. Bariatric surgery is the most effective treatment modality for morbid obesity, and should be discussed with all obese patients.
Q: Is there a correlation between COVID-19 and obesity?
A: People who are obese are at higher risk for complications related to COVID-19 infection. This is related to multiple factors, and all are equally important. Obesity is a pro-inflammatory state, which can affect one's immune response and the ability to fight off infection.
Obese patients often have impaired organ function due to comorbidities associated with obesity. Some of these organs, such as the lungs, heart, and kidneys, are targeted by the coronavirus, and can result in failure. Excess weight also physically impairs lung movement and makes the need for intubation and mechanical ventilation higher. Weight loss is critical in decreasing the risks associated with being overweight and COVID-19 infection.
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