PEOPLE are constantly exploring methods for losing weight, especially when dieting and exercise simply don't make the cut, or in a bid to save their lives when battling life-threatening illnesses. And more people are beginning to look to surgical procedures for permanent solutions.But Senior Medical Officer at Savanna-la-Mar Public General Hospital and director at Island Laparoscopy and Medical Care, Dr Alfred Dawes, says that these surgeries are not a free-for-all.“Weight loss surgery is a misnomer. Whereas the original reason for the creation of the field of bariatric surgery was for weight loss, it has evolved into a surgery done to extend lives with the added effect of weight loss. So if your primary motivation is simply to lose weight, the question that determines if you are a candidate for surgery is simply, why do you want to lose weight? If your motivation is primarily because of cosmetic reasons, then you are not a candidate. Your motivation for keeping up with the lifestyle changes required will not be high enough,” Dr Dawes explained.He said that the primary motivation of those wishing to undergo these surgeries is a will to eat healthily — cutting out the junk food, eating mostly proteins, vegetables and fruits, eating small portions of food, and exercising consistently.Bariatric surgery, as described by Dr Dawes, is the reduction of the size of the stomach and/or rerouting the path that food takes in the intestines so that less is absorbed. He also pointed out that apart from contributing to weight loss, there are a number of other medical benefits that this surgery offers.“Yes, you lose up to 90 per cent of your excess weight, but it offers the only feasible cure for diabetes, hypertension, and hypercholesterolemia. Other conditions such as sleep apnoea, arthritis, reflux, benign intracranial hypertension, psoriasis and polycystic ovary syndrome are improved or cured with bariatric surgery. Persons who are overweight and have any of these conditions can benefit from surgery,” Dr Dawes advised.He explained that even if your Body Mass Index (weight in kilograms divided by the square of your height in metres) is between 30-35 with one of the associated medical complications, you may want to consider surgery since the weight not only exacerbates the condition, but could save you from a lifetime of living on pills.“An attractive benefit of these surgeries is the opportunity to come off medications completely or cut down on the need to take them all the time, since the conditions will be more controlled, especially when accompanied by the right diet,” Dr Dawes advised.For those interested in bariatric surgery with the single aim of losing weight, Dr Dawes said one criterion that must be met is that you must have a BMI of 40 or more. However, a number of other factors are considered.“This is because your chances of losing weight and keeping it off at that point has a success rate of about five per cent. Your best bet is bariatric surgery with a success rate of about 90 per cent. You would have also tried and failed at dieting and exercise programmes, and are in need of a permanent solution. Also, if your weight comes back after you come off your diet or you have a condition that limits your ability to exercise, such as an injury, and this results in inability to lose weight, or there is the possibility of a hormonal issue which affects your attempts to lose weight negatively,” Dr Dawes outlined.Having outlined the many benefits to be gained, especially for people struggling with medical complications, Dr Dawes said that bariatric surgery should not be considered as a last resort.“It is a life-saving surgery that can increase your life expectancy. Diseases can be improved or cured leading to a better quality of life. More and more studies are showing that people who undergo bariatric surgery live longer than similarly obese patients who try to lose the weight by diet and exercise. So it is really surgery to improve/cure diseases and live longer,” Dr Dawes reasoned.