Nov 10, 2022 What Have You Got to Lose?

woman walking with weights in her hands

If you're significantly overweight, bariatric surgery can lower your risk of certain diseases—and may even add years to your life.

Bariatric surgery had its first big moment back in the late 1990s and early 2000s when celebrities like Roseanne Barr, Carnie Wilson, Al Roker and others underwent procedures that resulted in dramatic and seemingly overnight weight-loss transformations.

But the history of bariatric surgery dates back decades earlier, to the 1950s, when the first surgical weight loss procedure, the jejunoileal bypass, was performed. This operation was succeeded in the 1960s by gastric bypass surgery, which, though safer and less primitive than its predecessor, still carried a litany of risks and side effects. “Stomach stapling,” as bariatric surgery was known, was not quite as scary as it sounded—but it was close.

Naveen Ballem, MD
Naveen Ballem, MD

Fortunately, weight loss surgery has come a long way since then. “When these surgeries started being performed decades ago, there was a lot of risk because we were doing open surgery,” says Naveen Ballem, MD, Director of Bariatric Surgery at Clara Maass Medical Center (CMMC).

But today’s bariatric procedures are more sophisticated and less invasive than ever before.

“Nowadays, we do everything laparoscopically and robotically so there’s less pain, less risk, quicker recovery and better outcomes overall,” says Dr. Ballem.

There are also more surgical options than in the past.

Sleeve gastrectomy, which has been done for about 10 years, is one of the newer procedures,” says Dr. Ballem. “It probably has the most benefits and least risk and is a good choice for most people.”

According to Dr. Ballem, if you’re extremely overweight, bariatric surgery can literally be a lifesaver.

“Extreme obesity can cut as much as 14 years from your life expectancy,” he explains, “and I think the risks of living with a body mass index (BMI) of over 35 is 10 times riskier than any surgery we perform.”

Still, Dr. Ballem cautions, bariatric surgery is not a quick fix, and choosing to have a procedure should not be a snap decision.

“That’s one of the biggest misconceptions about these procedures,” he says. “Many people are looking for an easy way out. That’s not what bariatric surgery is. It’s a tool, and, if you use it effectively, you can have amazing results.”

How can you use it effectively? For starters, you need to recognize and commit to changing unhealthy behaviors.

“If you’re going to continue to hit McDonald’s, drink sugary soft drinks regularly and avoid exercise, you’ll gain weight no matter what kind of surgery you have,” says Dr. Ballem. “So, you need to be committed to eating healthier, making better food and lifestyle choices and incorporating exercise into your routine. Our team at Clara Maass includes nurses, psychologists and dietitians who can help you in these areas. We also work with exercise therapists.”

It’s also important to have realistic expectations about how much weight you’ll lose.

“The average person loses about 70 percent of their excess weight with these procedures,” says Dr. Ballem. “While some people do lose 100 percent, that’s not the norm.”

Which Bariatric Procedure Is Right for You?

According to Naveen Ballem, MD, Director of Bariatric Surgery at CMMC, the four most common surgical weight loss procedures are:

Sleeve Gastrectomy

About 80 percent of the stomach is removed, limiting the amount of food you can eat.

Pros: Excellent weight loss, generally safer than other procedures.

Cons: Not reversible, may cause or increase acid reflux, may not improve metabolism.

Gastric (Roux-En-Y) Bypass

Limits food intake by reducing the size of the stomach, limits calorie absorption by shortening the digestive process. Most effective for patients with a BMI of 35 to 55.

Pros: Rapid weight loss, good long-term results, can improve acid reflux.

Cons: Complex, irreversible procedure, may inhibit absorption of nutrients, higher risk of bowel obstruction and ulcers, “dumping syndrome” (some foods may make you feel sick), must follow a strict diet.


A band with an inflatable balloon is placed around the top of the stomach, limiting the amount of food you can eat.

Pros: Band can be removed or adjusted as necessary, quick recovery, smaller scar, less chance of nutritional deficiency than other procedures.

Cons: Slower weight loss, less weight loss, risk of band slippage, potential swallowing difficulties, higher rate of complications than other procedures.

Duodenal Switch

Food bypasses 45 to 60 percent of the small intestine, resulting in greater weight loss than other procedures, best choice for improving diabetes, best for patients with a BMI greater than 50.

Pros: More weight loss than other options, smaller chance of “dumping syndrome,” more effective for keeping weight off.

Cons: More invasive than other procedures, higher chance of nutritional deficiency and osteoporosis, may increase acid reflux.

What You Need to Know About BMI

BMI or Body Mass Index is a measurement sometimes used by health care providers to estimate body fat and broadly classify a person’s weight as underweight, normal weight, overweight or obese. The higher your BMI, the greater your risk of developing high blood pressure, Type 2 diabetes, sleep apnea, heart disease, and certain cancers, among other health conditions.

To Calculate Your BMI:

  • Multiply your weight in pounds by 703.
  • Divide that number by your height in inches.
  • Divide that number by your height in inches again.

BMI = Weight Classification

  • Below 18.5 = Underweight
  • 18.5 – 24.9 = Normal weight
  • 25 – 29.9 = Overweight
  • 30.0+ = Obese

To learn more about weight loss surgery at Clara Maass Medical Center, call 973-450-2393.