Bariatric Treatment Options in Fort Worth

Surgical & Non–Surgical Solutions

Choices abound for anyone considering a weight loss program. In fact, to qualify for insurance coverage of weight loss surgery, many patients are required by their insurers to have a history of medically supervised weight loss efforts.

Most nonsurgical weight loss programs are based on some combination of diet/behavior modification and regular exercise. Unfortunately, even the most effective interventions have worked for only a small percentage of patients.

It is estimated that less than 5 percent of those who participate in nonsurgical weight loss programs do in fact lose a significant amount of weight and remain at that lower weight for a sustained period. According to the National Institutes of Health, more than 90 percent of participants in such programs regain any weight they may have lost within one year.

Sustained weight loss for patients who are morbidly obese is even harder to achieve. Serious health risks await people who move from diet to diet, subjecting their bodies to the severe and prolonged cycle of weight loss and gain known as “yo–yo dieting.”

The fact remains that morbid obesity is a chronic disease the causes of which are multiple and complex.

For many patients, going without surgery carries a higher risk of death than do the possible complications associated with a given procedure. This is the key reason some 177,600 Americans underwent weight loss procedures in 2006, according to the American Society for Metabolic and Bariatric Surgery.

Patients who have undergone surgery and are benefiting from the results report improvements in their quality of life, social interactions, psychological well–being, employment opportunities and economic condition.

Diet & Behavior Modification

Literally hundreds of diets are available. Moving from one diet to another in a continual cycle of weight gain and loss – “yo–yo dieting” – poses its own health risks.

Doctors who prescribe and supervise diets for their patients usually create a customized program with the goal of greatly restricting calorie intake while maintaining nutrition. These diets fall into two basic categories:

  • Low Calorie Diets (LCDs) are individually planned so that the patient takes in 500 to 1,000 fewer calories a day than he or she burns.
  • Very Low Calorie Diets (VLCDs) typically limit caloric intake to 400 to 800 a day and feature high–protein, low–fat liquids.

Many patients on Very Low Calorie Diets lose significant amounts of weight. However, after returning to a normal diet, most regain the lost weight in less than a year. Ninety percent of all dieters regain whatever weight they’ve lost within two years.

Behavior modification uses therapy to help patients change their eating and exercise habits. In most patients, it produces results that mirror those for low–calorie diets – short–term success that tends to reverse itself after the first year.

If diet and behavior modification have failed you and surgery is your next option, it is important to understand that these measures still have a very important role to play in sustaining your weight loss after your surgery. The surgery itself is only a tool to get your body started losing weight. Complying with diet and behavior modifications will determine your ultimate success.


Starting an exercise program can be especially intimidating for someone suffering from morbid obesity. Your health condition may make any level of physical exertion next to impossible.

However, the benefits of exercise are clear. A National Institutes of Health survey of 13 separate clinical studies concludes that physical activity:

  • Results in modest weight loss in overweight and obese persons.
  • Increases cardiovascular fitness, even when there is no weight loss.
  • Helps in maintaining weight loss.

New research focusing on the body’s “set point” (the weight range in which the body is programmed to remain) highlights the importance of exercise. When you reduce the number of calories you take in, the body reacts by slowing metabolism to burn fewer calories. Daily physical activity helps counter this by speeding up your metabolism, thereby increasing your chances of long–term success.

Some examples of simple ways to start getting more exercise:

  • Park at the far end of parking lots and walk.
  • Take the stairs instead of the elevator.
  • Cut down on television.
  • Swim or participate in low–impact water aerobics.
  • Ride an exercise bike.

Overall, walking is one of the best forms of exercise. Start out slowly and build up. Your doctor, or people in a support group, can give you encouragement and advice. Regular exercise is a key part of any long–term weight management program, including weight loss surgery.

Over–the–Counter & Prescription Drugs

New over–the–counter and prescription weight loss medications have been introduced. Some people have found them effective in helping to curb their appetite. The results of most studies show that patients on drug therapy lose around 10 percent of their excess weight and that the weight loss plateaus after six to eight months. As patients stop taking the medication, weight gain usually occurs.

Weight loss drugs can have serious side effects. Still, medications are an important step in the morbid obesity treatment process. Do not expect an insurance company to cover weight loss surgery unless you have followed a well–documented treatment path.

Weight Loss Surgery

Weight loss surgery is a major undertaking. Its growing use to treat morbid obesity is the result of several factors:

  • Growing knowledge of the significant health risks of morbid obesity.
  • The relatively low rate of complications associated with the procedures versus not having the surgery.
  • The ineffectiveness of current nonsurgical approaches in producing sustained weight loss.

Surgery should be viewed first and foremost as a method for alleviating a debilitating, chronic disease. The minimum qualification to be considered a surgery candidate is a body weight 100 pounds above that considered ideal for a given height, or a Body Mass Index of 40 or greater. A BMI of 35 or higher qualifies if the patient also has an obesity–related health condition that creates a medical need for weight reduction which can only be accomplished through surgery.