A bariatric surgeon is a surgeon who specialises in the care of obese patients, and specifically a surgeon who performs weight loss surgery. They have years of experience in medicine and surgery and have chosen bariatric surgery as their specialty. Obesity is a growing concern in many areas around the world. Being very overweight can be a problem in itself, and is associated with a negative self-image and an impact on people’s mental health. Obesity also increases a person’s risk of developing certain health problems, including type 2 diabetes, cardiovascular disease, and pressure damage to the skin and underlying tissues. This means that the demand for specialist bariatric surgeons is growing. Bariatric surgery is performed on people with a high body mass index (BMI), especially those who have health problems related to their obesity and have been unable to lose weight through less invasive methods. People are usually referred to bariatric surgeons after trying extensive diet and exercise regimes, and surgery is generally considered a last resort after these lifestyle changes.
Although bariatric surgery is specifically surgery intended to reduce a person’s BMI, performing any surgery on people with high levels of body fat requires particular skills and carries extra risks for the patient. Surgeons specialising in the bariatric patient are therefore often consulted by surgeons from other specialities who have patients with obesity issues affecting their ability to safely undergo other kinds of surgery.
Bariatric surgeons work with the gastrointestinal system and assess patients’ need and suitability for weight loss surgery. The kinds of interventions they can offer include ways to surgically reduce the capacity of the stomach, such as gastric band surgery or intragastric balloon, or to reduce the body’s ability to absorb food.
Bariatric surgeons work within a large surgical and medical team including counsellors, dietitians, and specialist nurses. People who have undergone bariatric surgery generally have a long period of follow-up from their clinicians, because surgical weight loss interventions come with long-term effects and require certain lifestyle amendments. Bariatric surgeons’ teams run specialist weight loss clinics for care and advice before and after surgery, and will advise about recovery periods and the special diets people have to follow after bariatric surgery; usually, a liquid diet gradually changing in texture back to a normal solid diet over around six weeks.
When referred for bariatric surgery, you will meet your surgeon or another member of the team involved in your care. They will ask about your lifestyle, attempts at weight loss, and any other health conditions. They will need to monitor your weight, take blood tests and basic physiological observations, and talk you through the risks and benefits of the intended surgery. There is usually a monitoring period before bariatric surgery to ensure that your weight is reasonably stable and that you are fit for surgery. In the surgical theatre, the bariatric surgeon has a team of assistants including junior doctors and surgical nurses, and a specialist anaesthetic team.
Bariatric surgeons may also be involved in health education and promotion, medical research and clinical trials.