This common misconception undermines the significant commitment required from patients. Successful bariatric surgery requires extensive preparation, lifestyle modifications and long-term dedication to dietary and behavioral changes. Patients must undergo comprehensive medical evaluations, psychological assessments and nutritional counseling before and after surgery. The procedure is simply one tool in a complex treatment approach that demands ongoing patient engagement.  

While malabsorption plays a role in some procedures, the primary mechanisms of weight loss are reduced stomach capacity and hormonal changes. Most bariatric procedures, particularly the sleeve gastrectomy, work by altering gut hormones that influence hunger, satiety and metabolism. These physiological changes can help patients maintain long-term weight loss when combined with appropriate lifestyle modifications. 

Research shows bariatric surgery has a strong safety profile with a low early mortality rate of just 0.25%. In fact, the data shows the surgery significantly reduces long-term mortality risk – including a 92% reduction in diabetes-related mortality over seven years and a 58% reduction in death from any cause at five years. The risk of fatal heart attacks drops by nearly 60%. When performed at high-volume medical centers by experienced teams, it is comparable in safety to other routine surgical procedures.  

While some patients may experience weight regain, research shows that most maintain significant weight loss long-term. The Swedish Obese Subjects study demonstrated that patients maintained an average of 18% weight loss after 15 years across all procedures, with gastric bypass achieving even better results at 27% sustained weight loss.  

Success rates are highest when patients:  

• Maintain regular follow-up care
• Adhere to nutritional guidelines
• Participate in support groups
• Engage in regular physical activity

Myth five: Bariatric surgery is only about weight loss and cosmetics 

This common misconception overlooks the substantial medical benefits of bariatric surgery. Despite the widespread use of GLP-1 medications to enhance weight loss, bariatric surgery remains the gold standard for achieving the most significant weight loss, long-term management and resolution of comorbidities. Meta-analysis of 135,000 patients showed 86.6% of those with type 2 diabetes experienced improvement or remission. Long-term health improvements include:  

• Lower rates of hypertension at 12 years (16% vs 47% in non-surgery patients)  
• Significantly reduced risk of diabetes complications (16.9% vs 34.7% at five years) 
• High rates of diabetes improvement or remission (92% in randomized trials)  
• Improvements in sleep apnea and joint pain 
• Overall enhancement in quality of life 

Clinical implications  

As physicians and APPs, we should evaluate each patient’s candidacy for bariatric surgery based on current evidence rather than outdated misconceptions. The procedure represents a valuable treatment option for appropriate candidates with severe obesity, particularly those with obesity-related comorbidities.  

For more information about HonorHealth Bariatric Center’s weight loss and bariatric surgery program, visit our website.