The Challenge of Long Term Bariatric Success
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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