This content is sponsored by the University of Maryland Medical System.
Today, people have more weight loss options than ever before. So, when and why should someone consider weight loss surgery?
WTOP spoke to Dr. Eric DeAngelis and Dr. Mark Rickford, bariatric surgeons at the University of Maryland Medical System, to answer that question and learn about the latest advancements in weight loss surgery for our 2026 Get on Top of Your Health series.
Most critical, DeAngelis and Rickford said, is ensuring that each patient gets the right type of surgery for them. Plus, they shared what happens after surgery is just as important to help patients maintain their health goals for the rest of their lives.
Sharing your weight and health history
DeAngelis said people’s bodies often want to retain weight. For patients with a higher BMI (body mass index — a measure of a person’s body fat based on height and weight), diet and exercise aren’t always enough.
“We’re wired for survival. We’re wired for a time when we didn’t have grocery stores at every corner,” he said.
Rickford noted it’s critical to learn about each patient’s history and relationship with food prior to discussing treatment options.
“From day one, the first thing we do is talk to the patient and get a better understanding of why they gain weight,” he said, adding that there are many reasons why people gain weight.
“Some people have been through significant trauma where they’re trying to hide, and they have so much stress just from their lifestyle, where the only way that they know how to deal with it is eating, and this becomes a coping mechanism,” Rickford said.
Preparing for weight loss surgery
He said patients can expect to work with his team, which includes a dietitian, for up to six months before surgery.
“This is where I start teaching my patients about nutrition, about the effects that certain hormones have on their bodies,” Rickford said. “It’s not just about surgery. It’s also about changing these habits, adopting these things and knowing that they have to follow up with me. … This is a lifetime process.”
Weight loss drugs are becoming more prevalent and accessible. Rickford said on occasion, he’ll recommend a patient use weight loss drugs in addition to surgery. For others, he said weight loss drugs aren’t a long-term solution.
“Bariatric surgery has been studied and has been around for decades. There’s a long track record of success,” DeAngelis said.
DeAngelis said, in general, patients with a BMI greater than 40 usually qualify for bariatric surgery. Those with a BMI of 35 with other conditions, including high blood pressure, diabetes or sleep apnea, could also qualify for surgery.
“There are still special populations or circumstances where, even at lower BMIs, patients may qualify for surgery. So, if patients are interested in learning more, they can always make an appointment with a bariatric surgeon,” DeAngelis said.
“Most importantly, the patient has to want to have surgery because it does require significant changes,” Rickford said.
Weighing your weight loss surgery options
There are different types of weight loss surgeries.
“Two that I do myself are the sleeve gastrectomy and the gastric bypass,” DeAngelis said. “Both of them are well-established surgeries, and they result in dramatic and durable weight loss in patients.”
DeAngelis said sleeve gastrectomy is where a surgeon removes the majority of the stomach.
“There’s a banana-shaped stomach that’s left behind, connecting the esophagus to the rest of the intestines,” he said. “When we do a gastric bypass, we create a pouch at the top of the stomach, and then we reroute the intestines up to that pouch.”
While many patients do research on their own, Rickford said he makes sure the surgery choice will be a good fit.
“There are certainly patients who could do well with either option, but there are certain reasons why we may want to avoid a sleeve. For instance, people who have bad acid reflux can have an exacerbation of those symptoms after a sleeve,” he said. “For other patients, it may be better not to operate on their intestines, and so we try to avoid the bypass. There are certain cases where I may try to guide a patient toward one or the other.”
Ultimately, Rickford pointed out that a patient needs to decide that they want the surgery to help them.
“I like my patients to understand it’s not just about the surgery. It’s a long-term process, and sometimes we have weight regain. We have them continue to follow up, and we help them lose that weight,” he explained.
Planning for post-surgery expectations
After surgery, there are numerous follow-up appointments and check-ins throughout the year so doctors can ensure patients stay on track, even years after their surgeries.
“The patients are very motivated when they come for the surgery. They’re very motivated in the period after, but then life happens,” Rickford said. “The stress comes, and so it’s dealing and coping with the trials and tribulations of everyday life, where they may fall back into some of the old habits.”
UMMS offers support groups to help long term. Patients preparing for surgery are also welcome to attend though, DeAngelis said.
“They can give each other tips and tricks about how to manage life after surgery, and then for people preparing for surgery, they can get a little bit of insight,” he said.
Both doctors said patients need to be wary of the information they’re receiving online, especially in the age of artificial intelligence.
“Look for bariatric surgeons. Look for weight loss specialists. There’s a lot of information out there. If it sounds too good to be true, it probably is,” DeAngelis said. “Ultimately, you are trying to create a lifestyle that you’re going to be able to adhere to for a long period of time, and it’s important to make sure that you’re joining with somebody who can help you along that process.”
Learn more now about UMMS weight loss surgery options. And discover more ways to get on top of your health on WTOP.
