The Challenge of Long Term Bariatric Success

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Nagle A. Bariatric surgery – a surgeon’s perspective. J Am Diet Assoc. 2010; 110(4):520-523. doi:10.1016/j.jada.2010.01.007.

Growing numbers of patients are having bariatric surgery as a weight loss method and many of these individuals choose bariatric surgery after attempting numerous other weight loss strategies without success. Obesity has been linked to numerous chronic health conditions, including hypertension, hyperlipidemia, sleep apnea, type II diabetes, and heart disease, making weight loss crucial to the health and life span of morbidly obese individuals. Currently, bariatric surgery is one of the only effective treatments for morbid obesity and has shown to provide a chance for survival for these patients.
            The Academy of Nutrition and Dietetics published a commentary article in 2010, from the perspective of a bariatric surgeon. This article emphasized the recent dramatic increase in the number of these surgeries. Several contributing factors have led to the increased incidence of bariatric surgery including improved technology allowing for minimally invasive procedures, accumulation of reliable information on short and long-term results, and insurance coverage by Medicare.
            As bariatric surgery continues to grow in popularity, the need for dietetic practitioners will also continue to expand. One of the greatest challenges with bariatric surgery is maintaining long-term patient follow-ups. It is crucial for patients who undergo weight loss surgery to be screened for potential nutritional deficiencies, and dietetic practitioners will play an important role in identifying these problems. In addition, old habits will need to be re-addressed over time to prevent weight regain. Research has shown that regular counseling with a dietitian can have a positive impact on maintenance of weight loss. The key to achieving success with bariatric surgery is lifelong behavior modification.
            As dietetic practitioners, it is important to stay up-to-date on the ins-and-outs of bariatric surgery, as it will continue to thrive in light of the obesity epidemic. Dietitians need to take an active role in the multidisciplinary care team to ensure the best possible outcomes for these patients.  Dietitians should also push for further research on the short and long term nutrition implications associated with bariatric surgery and how the dietitian can be a valuable asset in the care of these individuals. 

 -JW

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