Comorbidities for Surgery

 

Comorbidities for Bariatric Surgery

What are comorbidities?

Comorbidities are medical conditions that are related to (or sometimes caused by) another medical condition. When thinking about bariatric surgery, the primary medical condition is morbid obesity, or being severely overweight. Morbid obesity often causes several comorbidities that can be resolved with bariatric surgery.

In order to be considered a candidate for bariatric surgery, insurance companies usually require that you have at least one comorbidity — but it’s common for patients to have more than one obesity-related comorbidity. Shawn M., for example, had high blood pressure, joint pain, sleep apnea, and type 2 diabetes before his surgery. Since his surgery less than a year ago, he’s dropped 172 pounds and has seen a huge improvement in his quality of life.

What are common comorbidities for bariatric surgery?

What is morbid obesity?

When an individual has a Body Mass Index (BMI) — the measurement of your weight in relation to your height — over 35 and is experiencing comorbidities, that person is considered morbidly obese. A normal BMI is in the range of 18 to 24.9, while 25 to 29.9 is considered overweight. A BMI of 30 or above is obese. You usually need a BMI of at least 35 to be considered for bariatric surgery. Your primary care doctor can measure your BMI for you, or we can help calculate this at your consultation. You can also use our online BMI calculator to determine this number.

Osteoarthritis

Osteoarthritis is the most common form of arthritis, and because it affects many people who are obese, it is among the most common comorbidities for bariatric surgery. It occurs when the cartilage or cushion between joints wears down. If you have osteoarthritis, you may feel pain and stiffness in your joints, especially first thing in the morning. Your joints may get swollen after activity.

Before her gastric bypass surgery, Carolyn S.’s arthritis prevented her from walking even half a block without pain. Now, she can walk up to a mile with less pain and stress on her joints.

Sleep apnea

Sleep apnea refers to repeated pauses in breathing during sleep. The sleep apnea pauses last at least 10 seconds and occur five to 15 times per hour. If you have sleep apnea, you may or may not recall waking up when your breathing stops, but in the morning, you will not feel well-rested. Your doctor can help you determine whether you have sleep apnea and may conduct an overnight test to measure your breathing.

Gary C.’s sleep apnea had become so severe that he had nearly maxed out his CPAP machine’s pressure. After his lap band surgery, he has been officially free of sleep apnea, impressing even his doctors.

High blood pressure (Hypertension)

Often, there aren’t any obvious signs or symptoms of high blood pressure — otherwise known as hypertension. While checking comorbidities for bariatric surgery, your blood pressure will be measured at your consultation or by your primary care doctor. Blood pressure is measured as two numbers, so when people talk about their blood pressure, they will refer to “X over Y.” A normal blood pressure rate less than 120/80.

Tammy W.’s high blood pressure went back to normal a week after her surgery.

High cholesterol

Like hypertension, high cholesterol has no symptoms. You’ll need to go to your doctor and get your blood tested to find out your cholesterol level. Everyone has some cholesterol in their blood, but if you get to have too much, it can create fatty deposits in your blood vessels, making it harder for blood to flow to your heart and brain. High cholesterol is among the most common comorbidities for bariatric surgery.

Jamie D. had high cholesterol before surgery. She’s now lost 111 pounds. “I have so much confidence and self-assurance,” she says. “I went for job promotions and job changes that I would not have done before.”

Type 2 diabetes

Type 2 diabetes, also known as adult-onset diabetes, is a chronic condition that affects how your body metabolizes sugar (glucose). Increased thirst, frequent urination, increased hunger, fatigue, blurred vision, and areas of darkened skin are some of the symptoms of type 2 diabetes. It’s a slow-building disease, so if you notice any one symptom, you should check in with your doctor.

Mary Ann M. was on three medications for her Type 2 diabetes before her bariatric surgery. Since the day of her surgery, she’s been off all of them.

Venous stasis disease (venous insufficiency)

“Venous” refers to veins, and “stasis” means still or not moving. With this chronic condition, the leg veins are not working properly, and it’s hard for blood to return to the heart after it’s been pumped to the legs. The blood in the leg veins pools, or doesn’t move as it should. Symptoms include swelling in the lower legs and ankles and aching or tiredness in the legs. Over time, the skin on the legs may take on a red-brown hue and become very sensitive.

Francine G. relates that before her surgery, “the weight was spiraling out of control and the edema in my hands, feet, legs, and ankles was ballooning to capacity.” Since her surgery, she’s gone from a size 5XXXXX to a size 5 or 6.

Soft tissue infections

Unfortunately, soft tissue infections can occur frequently in people who are obese. Sometimes these infections are treated with antibiotics. Frequent infections cause both discomfort and additional trips to the doctor. If you have documented treatment of multiple soft tissue infections, your insurance company may consider this as a qualifying comorbidity for bariatric surgery.

Cindy C. says, “I could never hold a steady job due to complications from weight, which made my life financially insecure.” After her gastric bypass surgery, “I can do just about anything I desire now with no more stress and pain in my body.”

Back or joint pain

Back and joint pain is common in people who are obese, because the excess weight puts additional pressure on these parts of the body. If you have joint pain that is being treated by a doctor, insurance companies will consider it among the qualifying comorbidities for bariatric surgery.

Maybe Nicole C.’s story before surgery sounds familiar: “Everything from my waist down ached on a daily basis. I was tired, limited in my physical activity, and intolerant of the summer heat. The podiatrist wanted to do surgery on my feet. I went to a chiropractor for my back pain. I couldn't sleep comfortably because my hips ached. I wore ankle braces for support. I felt old.”

Now, Nicole says, “I’m happier and my relationships have improved. It is hard to keep a good disposition when your body hurts all the time.”

Surgery options and benefits

Barix offers all bariatric surgery options covered by insurance:

No matter which option you choose, Barix offers support every step of the way, both before and after the surgery. Our patient Jennifer C. notes, “After talking it over with my husband, we felt that the gastric bypass would be the best option for me/us as a family. Dr. Poplawski was so very compassionate and kind, yet stern with me! The nutritionist was there every step of the way for me! I've had many medical problems and many surgeries in my life, and I have to say that this was absolutely the best experience I've ever had! From my first consultation, to the classes, to my hospital stay, and through my recovery, I felt I was their only patient!”

You don’t have to look hard to hear about the benefits of getting bariatric surgery. Our patients report a huge improvement in their quality of life, and even cite their bariatric surgery as a pivotal, life-changing event. Kim M. says that it’s the best decision she’s ever made, and that she is “free from the prison of morbid obesity. Thanks to Barix Clinics, I have probably added 20 quality years to my life.”

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