10 Things To Know About Bariatric Surgery
1. Bariatric surgery has emerged as a treatment option for morbidly obese patients who fail traditional weight loss approaches.
2. Bariatric surgery induces weight loss by malabsorption, restriction, or hormonal alterations.
3. Considerations for bariatric surgery include a BMI greater than 40 kg/m2 or BMI greater than 35 kg/m2 with one or more comorbid conditions, such as diabetes, dyslipidemia, coronary artery disease, hypertension, OSA, or nonalcoholic steatohepatitis.
4. Common bariatric procedures include the Roux-en-y gastric bypass (RYGB), the laparoscopic adjustable gastric banding (LAGB), and the laparoscopic sleeve gastrectomy (LSG).
5. Weight loss is usually rapid within the first year after surgery (especially with the RYGB) and ranges from 62%-70% of excess weight lost, but usually stabilizes after 2 years.
6. Despite significant weight loss after bariatric surgery and improvement in the severity of OSA, it may persist in some cases.
7. Bariatric surgery by itself is not a cure for OSA, which is defined by a normal AHI and complete discontinuation of CPAP.
8. Bariatric surgery as a weight loss therapy is effective in reducing obesity- related comorbidities and mortality; however, obese patients should not expect a complete cure of their OSA but could achieve improvements in the severity of disease.
9. OSA often persists in many patients despite significant weight loss and patients should anticipate continued use of CPAP or Oral Appliances.
10. Due to the reduction in the severity of OSA after bariatric surgery, patients who were not a candidate for Oral Appliance Therapy may now be able to discontinue the use of CPAP and be treated effectively with an Oral Appliance.