Billings Clinic


5 things to know about metabolic surgery

Posted at 12:47 PM, Apr 09, 2021

Years spent on diets. Struggles keeping weight off after losing it. An overload of advice and myriad resources without a clear path forward.

The path to achieving and maintaining healthy weight loss is littered with hurdles and challenges that can make it difficult for just about anybody. Most people have the willpower to lose weight temporarily, but the truth is that we don’t always have complete control over this in the long run. The physical makeup of each of us different, and our bodies have incredibly powerful mechanisms that might limit weight loss or even cause us to gain weight despite our very best efforts.

But there are effective and long-lasting treatments that can help. Losing weight can lead to improved health and quality of life, but there are other important reasons too: it can result in easier day-to-day mobility, more energy, better sleep and the ability to enjoy more active family or personal activities.

The Billings Clinic Metabolism Center is available to answer questions and, if appropriate, help with metabolic surgery options to provide long-term solutions and healthy weight loss.

What is metabolic surgery?

Metabolic, or bariatric, surgery is a procedure that aims to surgically help with weight loss or treat metabolic diseases. Billings Clinic offers two metabolic surgery procedures. A sleeve gastrectomy involves reducing the size of the patient's stomach by about 75%, thus restricting how much food can be consumed at one time. A roux-en-Y gastric bypass involves creating a smaller stomach pouch while also bypassing a portion of the intestine. This results in restricting food intake as well as reducing the number of calories that are absorbed by the body by about 30%.

Does it work?

Studies continue to show that metabolic surgery can help patients lose and keep off weight, while reducing or managing obesity-related health conditions. Within a year, patients may lose up to 75 percent of their excess weight and, on average, after five years patients keep off 50% of their excess weight.

Additionally, a 2004 study published in the Journal of the American Medical Association noted that most bariatric surgery patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea saw their conditions either go away or improve after surgery.

Who can have metabolic surgery?

Patients with a Body Mass Index (BMI) of 40 or greater automatically qualify. Those with a BMI between 35 and 39.9 must have at least one weight-related co-morbidity.

Co-morbidities are medical conditions that often occur along with obesity that are expected to improve with weight loss. Some of the more common weight-related co-morbidities are type 2 diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, heart disease and joint problems.

What are the benefits of metabolic surgery?

As mentioned above, losing weight, especially for the severely obese, can have dramatic effects on personal health and lifestyle. It can also greatly reduce the risk and effects of many diseases and other health conditions, including but not limited to: high blood pressure, high cholesterol, infertility, certain cancers, back pain, depression, migraines, foot/ankle or knee problems, diabetes, sleep apnea, heart disease, arthritis, gout and many others.

With an overall reduction of 52% for deaths from obesity-related diseases, metabolic surgery may help many people live longer and healthier lives.

What happens if I decide this is right for me?

Patients wanting to have metabolic surgery will spend several months working with the team from the Billings Clinic Metabolism Center in preparation for surgery. Metabolic surgery is a big change and involves many lifestyle changes, and the goal is to adequately prepare you so that you have the tools to be successful long-term.

Patients in the Billings Clinic program work with a medical provider, dietitian, trainer, licensed clinic social worker and a surgeon, as well as a nurse navigator to help coordinate care throughout the process.

The program is accredited by MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program). This means that it must meet and uphold certain standards along with continually improving the quality of the program. The multi-disciplinary team will help you prepare for surgery and will continue to work with you afterward. Obesity is a chronic, relapsing condition, which means that surgery doesn’t cure obesity – it is just part of the treatment. The team at the Billings Clinic Metabolism Center will help you manage your obesity long-term.

To learn more information, view real patient testimonials, or schedule an appointment, visit or call 406-238-2258.