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What does BMI mean for your overall health? A bariatric surgeon weighs in

Last updated: Dec 05, 2019

As appears in: Jersey's Best

Maintaining a healthy weight can help lower the risk of developing illnesses, such as diabetes, high blood pressure, sleep apnea, heart disease and other potentially life-threatening conditions.

One’s body mass index (BMI) can be used to categorize a person’s weight category. BMI is not 100% indicative of the body fatness  or health of an individual, rather it is an indirect measure of body fat based on a person’s height and weight. And while it isn’t a perfect measurement, it can help predict future health problems as a result of excess body fat, explains Alexandra Argiroff, MD, a bariatric surgeon at Summit Medical Group.

BMI categories are as follows:

  • under 18: underweight
  • 18-24: normal
  • 25-30: overweight
  • 30-35: obese
  • over 35: morbidly obese
  • over 40: severe morbidly obese
  • 50 – 60 super-morbidly obese

“By determining where individuals fall on the above scale, health care providers can start to risk-stratify patients for health problems they might face,” says Dr. Argiroff. “For example, obesity increases your risk of heart disease, lung disease, kidney problems and certain cancers, including breast cancer, colon cancer and ovarian cancer.” Through lifestyle interventions, such as adopting a healthier diet or embracing an exercise plan, those who fall into that category may be able to prevent potential illnesses. Talk to your health care provider about achieving a healthier weight.

As a bariatric surgeon, Dr. Argiroff sees patients in the morbidly obese category and beyond.

“Being morbidly obese increases your risk of new or worsening high blood pressure, heart failure, sleep apnea, kidney disease and kidney failure,” she said. “Diabetes is the biggest complication that we see and that attacks every organ in your body. The more overweight you are, the more stress that puts on your body, including your heart, your kidneys and your lungs.”

Arthritis is another ailment that often plagues the morbidly obese, as excess weight impacts the lower back as well as load-bearing joints such as the hips, knees, and ankles.

“For every 5 pounds you lose, that’s like 20 pounds of stress off your joints,” Dr. Argiroff said.

Considering Weight Loss Surgery

The bariatric surgeon also explained that while a healthy diet and exercise are essential for people with morbid obesity, they are usually effective in helping people lose between 10% and 15% of their body weight. And often, patients have difficulty keeping the weight off long term.

For patients with morbid or severe obesity, weight loss surgery may result in loss of up to 60% to 70% of that excess body fat, Dr. Argiroff explained. For example, if a patient needs to lose 100 pounds, he or she should be able to drop between 60 to 70 pounds following surgery, compared with just 10 to 15 pounds with diet and exercise alone. Additionally, 85% of patients who undergo weight loss surgery are successful in keeping that weight off long-term, which is defined as five years and beyond.

Bariatric surgery is very effective for weight loss in the morbidly obese Dr. Argiroff said. Gastric bypass surgery — one of the most common forms of weight loss surgery — is a procedure that reduces the size of the stomach and bypasses part of the small intestine, limiting the amount patients can eat. Additionally, this surgery promotes hormonal changes that may help improve insulin regulation and glucose metabolism, which affects diabetes.

Criteria for weight loss surgery include:

  • Body mass index (BMI) > 40 kg/m2 or BMI > 35 kg/m2 with obesity-related disorders
  • Age 18 to 70 years (patients who do not fit this age range can be considered individually)
  • Desire to achieve a healthy weight and improve overall health
  • Willingness to make significant, lifelong dietary, nutritional and lifestyle changes
  • Understanding the limits, risks and permanent adjustments for weight-loss surgery
  • Commitment to lifelong medical follow-up
  • Qualifying for medical and behavioral evaluations to help ensure safety and success

Providing Holistic Support

Summit Medical Group offers a multidisciplinary team to support patients throughout their weight-loss journey. In addition to a team of bariatric surgeons, patients have access to dietitians and the behavioral health department. Additionally, patients have access to primary care services and complementary specialties, including cardiology, pulmonology and sleep medicine, and endocrinology.

“It takes a lot of work on the patient’s part and a lot of support from the bariatric department and the whole weight loss center,” Dr. Argiroff said, adding that weight loss surgery isn’t “a magic bullet.”

Patients need to be mindful of making healthy dietary choices and exercising. With the support of the bariatric department, patients meet with dietitians before and after surgery to make sure they’re on track and understand what they’re supposed to be eating.

Tips for Keeping Weight Off

Planning can be the key to maintaining weight loss. Often when people are hungry and unprepared, they tend to make an unhealthy choice or eat more than they would if they’d had a protein-rich snack.

“Meal prepping is really important,” Dr. Argiroff said, adding that something as simple as bringing lunch to work can make a big difference.

Waking up a few minutes early to pack a turkey sandwich, apple and side of vegetables, as well as healthy snacks, helps avoid becoming overly hungry and giving in to temptation at lunchtime, she said.

Exercising as much as physically possible also is a crucial part of maintaining weight loss. Dr. Argiroff recommended aiming for 30 minutes of vigorous exercise at least three to four times per week. For those who need to be gentle on their joints, she suggested pool aerobics or chair exercises involving weight lifting or resistance bands.

Many patients Dr. Argiroff sees tell her they wish they’d had weight-loss surgery sooner.

“Most people, from the first time they think about having it to when they first see a doctor, is on average two years,” she said. “I’ve never had a patient say, ‘I wish I had waited longer.’ Most of them say, ‘I know was nervous and I wasn’t ready, but I’m so glad I’m here now. Why didn’t I do this two years ago?’”

Patients also routinely tell her that they’ve tried a myriad of diets and lost weight but regained it, leaving them feeling like failures.

“What I tell them is, it’s not a failure,” she said. “Your metabolism after you’ve reached the point of morbid obesity doesn’t function the same as someone with normal weight,” she said. “Your health care provider can help set you up for success.”

For more information about BMI and weight loss surgery, visit Summit Medical Group’s website or call (908) 273-4300.

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