Bariatric programs are medical services, often offered to patients with severe obesity and associated medical conditions.
What does “Bariatric” mean?
Bartiatric programs are usually offered in a hospital setting, and as part of outpatient programs designed to help patients reach their healthy weight. The term “bariatric” comes from the Greek words “Baro” which means “weight” and “iatric”, which means “treatment”.
Should I get bariatric treatment?
Bariatric patient programs are focused on helping patients achieve medically acceptable weight loss to improve the health conditions they are experiencing, as well as achieving a higher quality of life. The programs usually also require and include providing knowledge and life skills to help change patients’ eating behaviours, emotional regulation and coping, as well we lifestyle choices that include physical activity.
What is the difference between Bariatric programs and Bariatric surgery?
Bariatric programs are lifestyle intervention programs that are often designed as a step therapy prior to providing bariatric surgery referrals. These programs may include lifestyle change, meal replacement, education and/or medications.
Bariatric surgery on the other hand, is done when diet and exercise haven’t worked. This type of surgery causes a reduction in the amount of food you are able to eat comfortably, and/or reduce the absorption of calories and nutrients from any food eaten by the patient. Examples include Gastric Rouyx-En-Y Bypass (Gastric Bypass), Vertical Sleeve Gastrectomy, or Duodenal Switch surgery.
What are the benefits of Bariatric medical programs versus surgery? How much weight can I lose?
With bariatric programs such as working with a Registered Dietitian (RD), nutritionist, intensive lifestyle change programs, severe calorie restriction or meal replacement, the successful weight-loss can range from below 1%, up to 8-10% of body weight. More than half of patients can maintain some of the success for several years after stopping treatment.
With bariatric surgery, a smaller stomach makes you full faster. As a result you reduce your appetite, keep you full longer, can lower food cravings, and change food preferences. Typically, people lose 20% to 30% of their highest lifetime weight, and this happens within the first year after surgery. There is often a period of weight regain while the patient stabilizes at a certain weight.
Bariatric programs may refer to lifestyle intervention programs that are designed as a step prior to providing bariatric surgery referrals. These programs may include lifestyle change, meal replacement, education and/or medications.
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How can I be seen and evaluated for bariatric programs?
Generally, you require a referral for bariatric medical weight-loss programs from your family doctor. You can generally get a referral if you meet the following conditions:
- 18 years of age or older
- BMI over 35, or over 30 with an associated condition (such as complicated T2 Diabetes, IIH, or uncontrolled blood pressure)
- Previously got bariatric surgery outside of Ontario or Canada, but now experiencing weight regain
- Completion of a medical weight management program
What type of medical program is required before being accepted for bariatric surgery?
Before being accepted for bariatric surgery, in some provinces you need to complete a program which can range from several months to 1 year. You usually get a single funded opportunity to complete a program like this, and if you complete it and still require surgery, you can receive a referral.
Within this medically supervised program, a multi-disciplinary medical team works with you to improve habits and promote a healthier lifestyle. You may also be provided options such as liquid meal replacement and medications. There may be a cost for these options which can range from $50- 100 per week. Often you are required to join classes from 30 minutes to 2 hours, as well as meeting regularly with an NP or a doctor.
Some facilities may also offer an intensive lifestyle intervention program (ILIP) which may provide weekly check-ins and classes and peer support, in addition with a very severely calorie restricted diet as well as weight-loss medications such as semaglutide (ozempic, wegovy, saxenda) or tirzepatide (mounjaro, zepbound), etc.
What factors should be considered prior to starting a medical weight-management program?
Before starting a program, you should consider the following:
- Are there any major life events or special occasions that can disrupt your treatment?
- Are you currently experiencing any major life stressors that could make it difficult to stay the course? This can include exams, training, moving or personal events.
- Are you going to be traveling or taking an extended vacation? This can make it more difficult to stick to a diet and attend classes or coaching
- Are you willing to make changes and try new things?
- Do you have any other medical conditions that may be affected, or any surgeries that may be scheduled?
Is lifestyle management required after bariatric surgery?
Absolutely! The success of any intervention including bariatric surgery depends on lifestyle change. Some important tips:
- Activity such as movement or exercise is critical for long-term access, and activity should be gradually increased
- Peer support can help and is often an important component of a successful program
- You should always seek reliable information from your clinical team, and not rely on social media or the internet for medical advice.
What are the side-effects of bariatric surgery?
Success and results can vary for patients, as can side effects. However some of the most common side effects of bariatric surgery include excess skin, gallstones, pancreatitis, kidney stones, hair thinning, constipation, hypoglycemia, and electrolyte imbalance or changes.
What are the possible risks of bariatric surgery?
Each surgery has risks that should be weighed against the benefits. Some common risks for bariatric surgery include infection, nausea, vomiting, hernias, blood clots (0.4% risk), leaks (1-2% risk), bleeding (1-2% risk), strictures/narrowing (3-5% risk) and dehydration after surgery (5% risk). For many patients, the most important and likely risks to consider remain significant vitamin deficiency (5% risk), or ulcers (5-10% risk).
Who can qualify to receive bariatric surgery in Canada?
Generally you require a body mass index (BMI) of over 40, or BMI above 35 with comorbidities such as diabetes, high blood pressure or cholestrol. You also need to be show commitment to lifestyle changes. In addition, the medical team may assess if the surgery can be performed safely.
In some provinces, you cannot receive surgery if you are using nicotine or marijuana, are not agreeable or able to quit all types of smoking or vaping due to bleeding, ulcer and perforation risk. Screening is also performed for substance abuse issues and eating disorders. If you had recent cancer, or are pregnant or breastfeeding, you may not be a suitable candidate for bariatric surgery.
How many people get Bariatric surgery in Canada?
An estimated 8,000 to 10,000 patients per year get bariatric surgery in Canada each year.
What is a typical bariatric surgery patient like?
On average, a typical patient for bariatric surgery is 45 years old, and 78% of them are female. Generally the BMI is over 40.
What are my options other than bariatric surgery?
Intensive lifestyle change, surgery and medication are three approaches often used to help patients with excess weight or obesity. Nutrition, physical activity, and lifestyle changes are required for all of these approaches to work effectively.
How can cloudcure help patients with weight loss?
Cloudcure offers one of the most comprehensive metabolic health and obesity programs in Canada. We are building a centre-of-excellence for metabolic health, which provides the most cutting-edge treatments personalized for your unique biology. In addition, all weight-loss medications are paired with our lifestyle-as-a-medicine program where you work with a trained health coach to build important skills that can help you keep the weight off in the long-term.
How much weight can I lose with GLP-1s versus bariatric surgery?
Cloudcure offers personalized prescribing of effective weight-loss treatments, including combination therapies where appropriate. In addition, our lifestyle change program can help you make gradual changes that can create lasting weight-loss results. While bariatric surgery patients can lose 20% to 30% of body weight, GLP-1 agonists are associated with 15% to 20% of total body weight.
Which medications does Cloudcure offer?
If you are interested in getting treatments such as Xenical (Orlistat), Liraglutide (Saxenda), Contrave, Semaglutide (Ozempic, Rybelsus, Wegovy) or Tirzepatide (Mounjaro or Zepbound), your Cloudcure program can help provide access to these treatments within a comprehensive medical program that emphasizes realistic, effective and lasting lifestyle change.
How can I pay for my treatment?
If you have an employer-paid extended health or insurance plan, it may cover the cost of the Cloudcure program. If you receive a Health Spending Account (HSA), you can also expense the cost of your membership against this program.
In addition, it may also cover the cost of medications. If you do not have access to employer-paid coverage for medical weight loss, we encourage you to reach out to your Human Resources team to request an exception for this coverage.
Where can I get more information?
If you are looking for more information for Bariatric surgery, you can consult the following provincial resources:
Alberta: Bariatric Surgery information from AHS
British Columbia: HealthLink BC’s resource on weight-loss surgery
Manitoba: Winnipeg Regional Health Authority’s Centre for Metabolic and Bariatric Surgery
Nova Scotia: Halifax Obesity Network from Nova Scotia Health Authority
Ontario: Ontario Bariatric Surgical program can provide in-depth information
