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Is Bariatric Surgery Right For Me?

According to the U.S. Department of Health and Human Services more than 12.5 million Americans are severely overweight. At Garden State Bariatrics & Wellness Center, we know that being obese can include many health difficulties and comorbidities. It can put you at a higher risk for diseases such as high blood pressure, diabetes, heart disease, stroke, sleep apnea and more.

In this podcast Dr. Michael Bilof, founder of Garden State Bariatrics, joins the show to discuss the questions you should ask if you are severely obese and are considering Bariatric Surgery.
Is Bariatric Surgery Right For Me?
Michael Bilof, MD
Dr. Michael Bilof began his career as a vascular surgeon where he continuously saw chronically ill patients suffering from type 2 diabetes. Dr. Bilof was frustrated by the overwhelming acceptance of maintaining the comorbidities (e.g., obesity) associated with type 2 diabetes and believed there had to be something more doctors could do to help. In 2003, upon the urging of his wife, Dr. Bilof left his successful vascular practice and retrained in general surgery, specializing in bariatrics.  In April 2007, he founded Garden State Bariatrics and began offering lifesaving solutions for individuals with obesity and related diseases.

Learn more about Michael Bilof, MD

Bill Klaproth: Weight loss surgery has been shown to be very effective at producing significant and sustained weight loss, but there are many different options when it comes to weight loss, so how do you know if bariatric surgery is right for you? Here with us is Dr. Michael Bilof, a general surgeon specializing in bariatric surgery. He’s also the founder of Garden State Bariatrics and Wellness. Always a pleasure to talk with you. Thank you for your time today. This is a common question – is bariatric surgery right for me? How should someone evaluate that question?

Dr. Michael Bilof: There are several different ways to see if bariatric surgery is right for you. From a purely medical perspective, we look at something called body mass index, BMI is the abbreviation, and someone just goes on the Internet and types in ‘what's my BMI’ and it'll take them to any number of websites where they can calculate that or get that information. It’s really just a ratio of height to weight, and if your BMI is over 40, then you are essentially a candidate for bariatric surgery. If your BMI is less than 35, then you're not. Between 35 and 40, it depends on your particular medical situation. That’s how we determine from a medical perspective if someone’s a candidate. Whether or not it’s truly right for you depends on what your goals are and how comfortable you are doing this surgery and obviously that’s one of the things we determine when a patient comes in and we do a more thorough and complete evaluation of the overall situation.

Bill: So, you sit down with the person, ask certain questions, and you want to find out and try to probe and understand and help that person decide too if bariatric surgery is right for them.

Dr. Bilof: Exactly. We try not to do a one size fits all approach and we tailor and individualize things to the particular patient. That’s the thing we do when the patient comes in for the initial evaluation. It’s a pretty lengthy and extensive consultation. At the end of that, both us, that is the doctors and the medical staff and the patient, should be comfortable moving forward if that’s indeed the proper thing to do.

Bill: When it comes to bariatric surgery, can you talk about the health benefits of that surgery outside of the external weight loss and looking better? There are positive health implications too, is that right?

Dr. Bilof: Of course, and absolutely. As a doctor, that's really what I'm focused on, the health effects. Obviously, when someone loses 100 pounds, there's clearly effects in terms of appearance and all those sorts of things, but as a doctor, the health effects are really what I'm looking at and really what got me into this field in the first place. Just by way of a little bit of background, before I was a bariatric surgeon, I was a vascular surgeon and I dealt with diabetics and other people with severe vascular and circulation problems, and I saw how bad those were and how bad diabetes, in particular, was, how it really damages the human body in so many ways. What's fascinating and excited and really what got me into the field of bariatrics is the fact that it's quite effective at really improving diabetes in many patients and in some patients actually getting rid of diabetes completely. It's really an amazing thing to see a patient come in, taking insulin and various medications and then six months later, they're off all their medicines with a normal blood sugar. That's probably the thing that's the most impressive about bariatric surgery; it's a really dramatic effect on diabetes. In addition to that, high blood pressure, high cholesterol, sleep apnea, back pain, fatty liver – there's a whole host of medical conditions that are dramatically improved, if not, completely resolved after bariatric surgery.

Bill: Not to mention the benefits of improved confidence and quality of life.

Dr. Bilof: Absolutely. Quality of life issues are very important. It's interesting. As a doctor, I focus on medical conditions and we follow the medical conditions and their improvement, but honestly, for the patient, I think the quality of life issues are as important, if not, more important. Patients are excited that they're not diabetic and their blood pressure is better, but the thing that really gets them turned on is that they can play with their kids or their grandkids or they didn't have to ask for the seatbelt extender when they got on the plane and they can go out to a movie and sit in the seat comfortably. These little things that you wouldn't even think of if you weren't morbidly obese, but are just really big quality of life issues for our patients, and when they get better, it's really a dramatic effect on a patient's quality of life.

Bill: Even with all of these great benefits, can you talk about some of the common fears of bariatric surgery? I'm sure you hear them all the time.

Dr. Bilof: Absolutely. Probably the most common one is ‘is it safe?’ Without getting into all kinds of technical details, the short answer is very simple: yes, it is. It’s been very well studied, multiple studies in different countries with different procedures, all kinds of different patient populations. This surgery is very safe. The way I’ll usually explain it to a patient when I'm meeting with them one on one is this bariatric surgery is about as risky as having your gallbladder taken out, which is a surgery and obviously has risks, but most people when they go to a doctor to have their gallbladder taken out aren’t really worried that they're not going to survive or have some really devastating complication that'll change their life. In fact, that on very rare occasions does happen and bariatric surgery is about as risky having a gallbladder surgery. It’s certainly safer than having hip replacement surgery or heart surgery, other things that are done on a relatively routine basis, and it’s clearly safer than even those procedures.

Bill: Can you tell us about the day of the procedure and the procedure itself? How long it takes? How long does the person have to stay overnight? Basic recovery time? Can you talk about that a little bit?

Dr. Bilof: Sure. It depends obviously on the procedure and somewhat depends on the individual patient’s medical condition and situation, but in general, most of these surgeries involve one or two nights in the hospital. Someone will come in, have their surgery on a Monday, they’ll come home either Tuesday or Wednesday, so it’s one or two nights in the hospital, and the recovery then after they leave the hospital usually is one to two weeks, maybe they'll take three weeks to recover fully, but it's on the order of one to two weeks before they're back to their routine as it were.

Bill: That’s amazing. Can you talk about support after surgery?

Dr. Bilof: Sure. There's any number of different support structures that we have in place; everything from a support group that we have at different hospitals that we work out of – typically they're once a month where patients can talk to other patients who have gone through the process and share their own best practices; there are nutritionists that we have actually in our office and she's here every week to meet with patients both before and after the surgery; we have psychologists that specialize in the bariatric world and dealing with the bariatric population if patients feel that they need that kind of support. We really have all the bases covered in terms of what a patient would need both before and after the surgery.  

Bill: Those are very important programs. Once the surgery is over, there still needs to be discipline on the part of the patient to make this a long-lasting success. Is that right?

Dr. Bilof: Absolutely. What I typically would tell a patient when I meet them for the first time is the surgery will get the weight off, but keeping it off is up to the patient. This is an incredibly effective tool, an incredibly effective method for weight loss, but it's not 100% - nothing in life is 100% - and there are certain things that the patient will need to do after the surgery to keep on track and make sure that there's no weight gain. The number of patients who regain weight really depends on the different procedure and where they were before the surgery, but it's probably in the 105 to 20% range of patients who will have some significant weight regain. I don't know how that sounds to people if that sounds high or low, but you can look at it that 80% of patients will keep the weight off and I can tell you, with nonsurgical methods, the success rate is maybe 5% and 95% of patients will regain weight. It’s clearly the most effective intervention for this population for people will BMIs over 40.

Bill: Lastly, I just want to touch on this quickly. Do most insurances cover bariatric surgery?

Dr. Bilof: That’s a great question. It’s probably one of the things that’s most difficult to deal with. We have this incredibly effective tool and not all patients can utilize it because of insurance restrictions and other barriers that are put up by the insurance company. There is no answer for that. We have to check into each individual patient’s plan and see if they have coverage. One of the things we do here at Garden State Bariatrics is we will check that for the patient because as anyone who’s ever dealt with an insurance company knows they can sometimes be difficult to deal with, so we deal with that, we’ll handle that for you, if we get your insurance card and the information, we’ll confirm that you have the proper benefits and can utilize these services. Once we do that, then you come in for the visit.

Bill: Thank you again for your time. Always great talking with you. For more information, please visit the Garden State Bariatrics and Wellness Center website at That’s This is Winning Through Losing: A Weight Loss Surgery Podcast with Garden State Bariatrics. I'm Bill Klaproth. Thanks for listening.