Having realistic expectations is helpful before jumping into weight loss surgery. Among the most common questions we hear is how much weight someone can expect to lose following their procedure. Pounds lost is important, but so are other outcomes of weight loss surgery.
The good news is that all the main procedures have now been around for many years. Researchers have extensively studied these surgeries among seniors in large databases across many countries, and outcomes among millions of people have been evaluated.
One of the first take-home points before we get to the expected specific number of pounds, is that the studies show unambiguously that individuals over 60 having weight loss surgery, or metabolic surgery as we call it, live longer and healthier lives.
The procedure reduces risks by lowering the chances of medical conditions developing from obesity. For example, a long-running Swedish obese subjects study reported in the New England Journal of Medicine last year found that after 25 years of data, they can conclusively show that survival and health are significantly improved by weight loss surgery when compared to similar overweight individuals receiving weight management treatment in the national health system.
Other large studies, including some in the United States, show dramatic reductions in heart attack, stroke, kidney disease, blindness, amputations, especially among seniors with type 2 diabetes. So, regardless of the specific number of pounds we can expect to lose, we know definitively that health is improved and risks are reduced by this safe, 45-minute procedure.
The exact number of pounds lost varies a lot from person to person, and there is also variability among the different types of procedures. For the most often performed procedure in the United States, the laparoscopic sleeve gastrectomy, most studies show that the amount of weight lost is around 65 or 70% of excess body weight (EBW).
Some studies show quite a bit more weight loss, and others less, but this is a good ballpark. To figure out your excess body weight, look at a chart for ideal body weight at your height, and subtract it from your current weight. These are excess pounds, and you might lose about two-thirds of them after the procedure.
It can get a little confusing because sometimes studies report the loss of total body weight (TBW), and this is usually closer to 25% after surgery. As a comparison, the best studies with the newest FDA approved drugs show something like 7% total body weight lost after or year.
Non-surgical weight loss studies show poor to no actual success beyond two years. Surgery studies go 25 years and more showing enduring success because of the permanent change in the body hormones created by surgery.
Let us take an example of a person who weighs 280 pounds. After surgery, that person loses 25% of total body weight, or around 70 pounds. That same person had around 100 extra pounds before surgery and lost 70% of excess body weight, or 70 pounds.
While this is great, and it results in tremendous improvement to both health and quality of life, it might yet be a disappointment to a person hoping to lose 95% of excess pounds. Does it mean that you simply cannot lose more pounds? No, individuals can outperform the averages, but it takes extra effort.
Dedication to a seven-days-a-week habit of exercise will enhance the weight that is lost, and sticking to a healthy long-term diet that emphasizes vegetables and proteins over carbohydrates will also help that effort.
Are there some reasons why people under-performed the averages? Yes, studies show that advanced age and disability predict mildly lower weight loss, and specific health conditions, such as type 2 diabetes and polycystic ovarian syndrome, also create some hormonal headwinds that may mildly reduce the average weight that is lost. Surgery is still the best option for these seniors, but pounds lost may be slightly under the average.
And a lot of the result is going to stem from genetics and biochemistry, which is largely out of our hands. In the case of the sleeve procedure especially, when the amount of weight lost is not sufficient, there are excellent revision options that can create successful weight loss through a second procedure.
The amount of weight lost after gastric bypass surgery in many studies is a few percentage points higher than after the sleeve, especially when one looks at the longer-term outcomes at, say, 10 years.
The procedure with the greatest amount of average weight lost is the duodenal switch procedure. In many studies, the longer-term percentage of excess body weight loss is greater than 80% but with more side effects.
In the end, metabolic surgery is not perfect, but it is a highly proven, safe, and effective treatment for one of the worst health problems people commonly face today.
Is excess body weight an issue you are struggling with? What do you do to keep your weight in check? Have you explored surgical treatment options for weight loss? Which ones do you know about? Would you consider a surgery, if you knew you might lose over half of your excess weight? Please share your thoughts with the community.