Top 10 Weight Loss Surgery Myths Debunked

Weight loss surgery can be a life-changing choice for people with obesity. However, there are many myths that prevent people from considering these procedures. Leena Khaitan, MD, a bariatric surgeon at University Hospitals, helps clear up some common misconceptions.

1. Surgery Is Only for People With No Willpower.
   Weight gain and obesity aren’t just about overeating or not exercising. There’s a complex system of signals between the brain, gut and other organs that control weight. Even after losing weight with diet and exercise, hormone levels shift in an attempt to return you to your previous weight. In fact, studies show that 90 percent of people who lose weight with diet and exercise regain it within 2-5 years.
   
   Bariatric procedures like gastric bypass and sleeve gastrectomy interrupt this vicious cycle by surgically modifying the stomach and/or rerouting the intestines. This changes how food interacts with the gut microbiome, significantly reducing the production of hunger hormones and increasing hormones that promote a feeling of fullness.


2. Surgery Is Only for the Very Obese.
   Eligibility for weight loss procedures isn’t just about pounds – it’s about overall health. Surgeons assess each person individually to determine if surgery is a safe and appropriate option. In general, people with a body mass index (BMI) of over 40 or those with a BMI of 35 to 39.9 with weight-related conditions like diabetes or hypertension will qualify.


3. Bariatric Surgery Is Dangerous.
   All surgical procedures carry some risk, but weight loss procedures are extremely safe with complication rates of less than 3 percent. Surgical weight loss procedures are done laparoscopically or with robotic assistance, resulting in shorter hospital stays, less pain and fewer complications.
   
   The benefits of weight loss typically outweigh the risks of surgery. Significant weight loss can greatly improve or cure over 40 obesity-related medical conditions, like diabetes, heart disease, high blood pressure, high cholesterol, sleep apnea and acid reflux. Even seemingly unrelated conditions like asthma, COPD, urinary incontinence and infertility have been shown to improve with weight loss. One long-term study found bariatric surgery drastically reduced the risk of developing cancer, colorectal and breast in particular. Overall, weight loss surgery can add years to your life and greatly reduce the risk of premature death.


4. You’ll Never Be Able to Eat Normally Again.
   It’s important to make sustainable changes to your diet after weight loss surgery, but it won’t affect your ability to taste and enjoy your favorite foods. Smaller meals with a focus on protein are necessary, but with guidance from nutritionists a healthy diet can include almost anything – just less of it.


5. Your Stomach Will Stretch if You Eat Too Much
   The stomach can’t enlarge to its original size after surgery; however, since it’s a muscle, it may stretch a bit. If you regain weight after surgery, it’s usually because healthy eating and exercise habits have lapsed.


6. You’ll Never Gain the Weight Back
   Bariatric procedures can certainly lead to dramatic weight loss, typically 60-80 percent of excess weight. The surgery shrinks your stomach or reroutes digestion to help control hunger, but it doesn’t rewire your mindset. Weight gain can occur with unhealthy habits. However, with an ongoing commitment to healthy eating and regular exercise, weight loss results are very sustainable.


7. You’ll Have a Lot of Loose Skin
   Depending on how much weight you lose, excess loose skin is possible but not inevitable, especially if you exercise regularly and stay hydrated. Strength training can be particularly helpful in maintaining skin tone as you lose weight. Some people may consider body contouring procedures after extreme weight loss if excess skin is an issue.


8. Insurance Won’t Cover Surgery
   Although insurance plans vary, bariatric surgery is often a covered procedure if deemed medically necessary and certain criteria are met, including BMI thresholds and related health issues.


9. Weight Loss Drugs Are Cheaper Than Surgery
   Weight loss medications like Ozempic and Wegovy are synthetic hormones that help to regulate blood sugar and promote a feeling of fullness. They are currently a very popular weight loss tool and are generally safe and effective. However, they are often not covered by insurance and can cost $12,000-16,000 annually, out-of-pocket.
   
   Weight loss surgery typically costs $10,000-20,000 out of pocket, even with insurance, but it’s a one-time cost. Surgery offers a permanent solution whereas medications must be taken long term in most cases to prevent weight gain after stopping.


10. Weight Loss Drugs and Surgery Can’t Be Used Together
    Surgery and medication are often used together to help people reach their weight loss goals. For example, weight loss drugs may be used before bariatric surgery to reach a healthy body weight for anesthesia. Medications may also be prescribed after surgery to prevent weight regain or for people who are close to reaching their goal weight but have stalled.

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University Hospitals offers a range of medically-supervised weight loss programs that include weight loss surgery and non-surgical weight loss procedures, as well as medical nutrition and diet-based programs. Our multidisciplinary team of experts can help you find the right program to help you achieve your weight loss goals.