In certain circumstances, less morbidly obese patients (with BMIs between 35 and 40) may be considered for surgery (patients with high-risk co-morbid conditions and obesity-induced physical problems that are interfering with quality of life).

Important Considerations
Surgery should not be considered until you and your doctor have evaluated all other options. The proper approach to weight-loss surgery requires discussion and careful consideration of the following with your doctor:

1. These procedures are in no way to be considered as cosmetic surgery.
2. The surgery does not involve the removal of adipose tissue (fat) by suction or excision.
3. A decision to elect surgical treatment requires an assessment of the risk and benefit to the patient and the meticulous performance of the appropriate surgical procedure.
4. These weight loss surgical procedures (approved in the United States) are not reversible.
5. The success of weight loss surgery is dependent upon long-term lifestyle changes in diet and exercise.
6. Problems may arise after surgery that may require reoperations.

Success of surgical treatment must begin with realistic goals and progress through the best possible use of well-designed and tested operations.

Complications and Risks
As with any surgery, there are operative and long-term complications and risks associated with weight loss surgical procedures that should be discussed with your doctor. Possible risks include, but are not limited to:

• Bleeding*
• Complications due to anesthesia and medications
• Deep vein thrombosis
• Dehiscence
• Infections
• Leaks from staple line breakdown
• Marginal ulcers
• Pulmonary problems
• Spleen injury*
• Stenosis

*Removal of the spleen is necessary in about 0.3% of patients to control operative bleeding.

If surgery is performed laparoscopically and complications occur during the operation, your doctor may choose to perform open surgery.

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