Bariatric Surgery

Bariatric, or weight loss surgery, is indicated for patients who are morbidly obese and already have tried diets, exercise, and other non-surgical means of losing weight. The surgery helps patients eat less through a variety of mechanisms that differ with the type of procedure done. Although the definition varies depending on the insurance company, in general a person is a candidate for weight loss surgery if he or she has a body mass index (BMI) of at least 40. Patients with a BMI of at least 35 may qualify if they have additional conditions such as diabetes, hypertension, sleep apnea, or degenerative joint disease. Candidates for bariatric surgery must meet certain goals and requirements before surgerycan be approved, and typically it requires a serious commitment to substantial lifestyle changes.

The three most common types of weight loss surgery are gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A gastric bypass is performed by creating a small pouch out of the stomach and routing the gastrointestinal tract to this pouch, so that food empties into the pouch and bypasses the remainder of the stomach and first portion of the intestine, greatly limiting the amount of time the food spends in the digestive tract. A sleeve gastrectomy is performed by removing about 80% of the stomach, leaving an area approximately the size of a banana and leading to a diminished appetite. Gastric banding involves placing an inflatable belt around the top of the stomach to reduce the flow of food into the stomach.



Obesity is a medical problem that can have wide-ranging mental and physical effects on a person. If you or a loved one has struggled with obesity for some time and has tried unsuccessfully to combine a healthy diet with exercise to lose weight, UAB Medicine is the place to turn. Led by Richard Stahl, MD, and Jayleen Grams, MD, the bariatric surgery program at UAB Medicine has been performing weight-loss procedures for more than 30 years, and it is the first American College of Surgeons Level 1 Bariatric Surgery Center in Alabama. This history, combined with our standing as a respected academic medical center, puts UAB Medicine at the forefront of weight-loss surgery.

Complicated pre- and post-operative bariatric patients frequently are referred here, which gives us a unique perspective on weight-loss surgery, its risks, and its limitations. We do not view surgery as a quick fix for weight loss, nor should it be a patient’s first consideration when contemplating weight-loss methods. A multidisciplinary approach involving surgery, varied medical specialists, nutrition, psychology, and physical therapy is used in the evaluation and management of a patient’s obesity. An active and ongoing weight-loss support group meets regularly and is open to all patients, whether they have had surgery or are considering it.


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