Weight loss surgery, also called bariatric surgery, seeks to limit the amount of food the stomach can hold as well as limiting the absorption of nutrients. This causes the patient to lose more weight more rapidly.
Morbidly obese individuals may want to consider weight loss surgery when conventional dieting and weight loss programs have failed. Weight loss surgery candidates must have a body mass index (BMI) of 40 or over. Patients with a BMI of 35 and over are considered for surgery if they have medical problems that are caused by or associated with obesity such as diabetes, high blood pressure, and heart disease.
The short answer is no. Surgery is not a solution for everyone. We only determine whether a patient is right for surgery after a complete evaluation and discussion with the patient. Because weight loss surgery is a life-altering procedure, we want to make sure our patients are committed to making the lifestyle changes needed for a successful procedure.
Sleeve gastrectomy
Gastric bypass.
Adjustable gastric banding.
These procedures reduce the size of the stomach where food collects. Whenever possible, we will conduct laparoscopic surgery, which is less invasive than open surgery, so patients usually have less discomfort, a shorter recovery time and fewer complications. Our team will help you make the best decision after a careful evaluation.
Just about every type of surgery carries risks and possible complications. Potential risks and complications are detailed in our website and will be useful to research as this will be a decision tool for the candidates for surgery.
This depends on whether you are covered for this procedure through your health fund. It is possible to self fund and this will be discussed by the team.
Find out how many years of experience he/she has in the field. The surgeon you choose should be experienced with the procedure you are considering. Also, discuss their commitment to follow-up, because weight loss surgery is just the first step on your journey to a fuller and healthier life. You will want to be sure your care team offers guidance and support in nutrition, exercise and other areas.
That depends on the procedure and the patient. Patients generally return to normal activity in about one week after laparoscopic adjustable gastric banding, one to two weeks after gastric sleeve resection and two to three weeks after laparoscopic gastric bypass. You need to discuss with the team with regards to returning to work as there are a number of factors.
Immediately following adjustable gastric banding and sleeve gastrectomy, only sips of water are allowed. Over the next two weeks, patients gradually increase fluids to include clear broth, skim milk, low-calorie juice and sugar-free ice pops. After two weeks, low-fat pureed foods, mashed potatoes and protein-rich items like chicken and fish are added. Patients who undergo gastric bypass follow a similar progression for 12 weeks and then they are allowed regular, healthy foods. If you are taking medications, you may need to crush your pills or find out if they come in liquid form to make them easier to take in the first weeks following surgery. Your Care Team will work closely with you about the types of food you can eat and when, and will also determine whether vitamin supplements are needed.
Weight-loss results vary from patient to patient, and the amount of weight you lose depends heavily on your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won’t come off by themselves.. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. Remember that you should lose weight gradually. Losing weight too quickly creates a health risk and can lead to a number of problems. The main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity.
Check-ups with your doctor are a normal and very important part of the adjustable gastric band follow-up. Many surgeons see their patients biweekly during the first month and every four to twelve weeks for the first year. Adjustments are performed during some of these visits. It is typical for follow-up visits to be scheduled every three to six months during the second and third year, depending on the individual case.
The adjustable gastric band does not hamper physical activity including aerobics, stretching and strenuous exercise.
Adjustments can be done in an outpatient clinic or office, and local anesthesia may or may not be needed. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes and most patients say it is nearly painless.
There are no restrictions based on the access port. It is placed under the skin in the abdominal wall, and once the incisions have healed it should not cause discomfort or limit any physical exercise. The only sensation you may experience from the port occurs when you go in for adjustments. If you feel persistent discomfort in the port area, talk to your doctor.
Although the adjustable gastric band is not meant to be removed, it can be, in some cases laparoscopically. Surgeons report that the stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight. You may also gain more.
Weight loss surgery can eliminate or improve most obesity-related medical complications, including diabetes, hypertension, high cholesterol, sleep apnea, reflux and osteoarthritis, as well as stress incontinence, dermatitis, muscle and joint pain. Most patients are able to exercise much better, which helps them feel more energetic. Many patients also report feeling better emotionally, with less depression as their health and body image improves.
Lifetime follow-up with your bariatric doctors is recommended, with at least three follow-up visits during the first year. Adjustable gastric banding requires more frequent visits for band adjustments. You will need to adopt a healthy lifestyle, including a new nutrition plan and regular exercise. You will be strongly encouraged to join a support group or find other ways to meet your changing emotional needs. Remember, Bariatric surgery is not cosmetic surgery. You must commit to long-term lifestyle changes, including diet and exercise, which are keys to the success of bariatric surgery.
One way to be successful is by talking openly with others who are dealing with the same types of issues as you. Support groups provide a safe, comfortable place to talk, share problems and solutions, and encourage each other.
It is strongly recommended that women wait at least one year after the surgery before a pregnancy. Approximately one year post-operatively, your body will be fairly stable (from a weight and nutrition standpoint) and you should be able to carry a normally nourished fetus. You should consult your surgeon as you plan for pregnancy.
Regular exercise is extremely important for maintaining your weight loss. Your bariatric surgery team will help you with the types of exercise you should be doing, and how soon after surgery you should start doing them.
Many people heavy enough to meet the surgical criteria for weight loss surgery have stretched their skin beyond the point from which it can “snap back.” Some patients will choose to have plastic surgery to remove loose or excess skin after they have lost their excess weight. Insurance generally does not pay for this type of surgery (often seen as elective surgery). Ask your surgeon about your need for a skin removal procedure.
The first step is to learn as much as you can about the obesity, the surgery and the lifestyle changes required to be successful after weight loss surgery. Talk to our friendly team and they will help you through the process.
You should be able to take prescribed medication, though you may need to use capsules, break big tablets in half or dissolve them in water. Always ask the doctor who prescribes the drugs. Your surgeon may tell you to avoid taking aspirin and other nonsteroidal anti-inflammatory pain relievers because they may irritate the stomach.
Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.
Alcohol has a high number of calories and breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.
After your stomach has healed, you may eat most foods that don’t cause you discomfort. However, because you can only eat a little, it is important to include foods full of mportant vitamins and nutrients as advised by your surgeon and/or dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of “empty” calories, such as milkshakes, the effect of the weight loss surgery will be greatly reduced or even cancelled.
There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fiber. This should not cause you severe problems. If difficulties do arise, check with your doctor. He or she may suggest you take a mild laxative and drink plenty of water for a while. Your needs will vary, but you should drink at least 6-8 glasses of water a day.
The Lap Band adjustments are done in the office by adding or removing saline to the subcutaneous (under the skin) port. The adjustments take minutes and are described by the patient as essentially painless.
The only special diet after surgery is the first six weeks where you start with liquids and work up to soft solid food.
Yes. It’s possible to not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron. Your surgeon may advise you to take supplements
Laparoscopic or “minimally invasive” surgery is performed by making tiny incisions in the abdomen and using specialized instruments to accomplish surgery with less pain and quicker recovery. A small fibro optic camera provides the image for the surgeon to operate
You can eat normal foods in smaller quantities. You will learn to chew your food well. Gastric bypass patients have learned that high-fiber foods can be difficult to pass through their small gastric pouch. LAP-BAND patients have learned that fresh bread and sticky rice are hard to pass. You will learn to eat to the point of feeling full and then stop. Eating too much at once or not chewing well will cause negative side affects that will hopefully reduce the likelihood of improper eating habits again. It will be hard to gulp large quantities of liquids so you will need to drink water throughout the day so you don’t get dehydrated. You will need to concentrate on the number of calories you are eating. Sugar gives you a lot of calories that will need to be burned. You should eat sugar-free foods and use sugar substitutes like Equal and Splenda. Milkshakes are very high in fat and sugar. You don’t have to avoid milkshakes altogether, but drinking six per day will make the operation fail—you won’t lose any weight. You should also drink diet sodas and low-fat milk. Protein is very important. The body needs 60 grams of protein per day. You should eat your protein first, because you can only eat a half of a cup of food for each meal. If you eat a half of a cup of salad, you will not be getting any protein and then will have to play catch-up, which is hard to do when you have such a small stomach. The whole point of weight loss surgery is that you lose weight without feeling starved or deprived.
Most patients go back to work about one week after LAP-BAND surgery, and two weeks after gastric bypass surgery.
Exercise will help you lose weight. At first, we expect you to walk thirty minutes per day and gradually increase your exercise as you lose weight. The most successful weight loss surgery patients are those that exercise in addition to the caloric restriction provided by surgery. Water aerobics are easier to do for patients with joint pains and arthritis.
Yes. It’s possible to not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron. Your surgeon may advise you to take supplements
One of the reasons weight loss surgery is so successful is because the background hunger so typical of dieting goes away. Patients no longer crave food and sometimes, if you can believe it, have to be reminded to eat! A hormone related to hunger, ghrelin, is decreased after weight loss surgery.
Some hair loss is typical of weight loss. This means more hair in the brush or shower drain. You do not go bald. Watching your vitamin (esp. zinc & biotin) and protein intake certainly helps reduce this, but all patients that lose a significant amount of weight will experience some hair loss. It will grow back. Hair loss usually occurs during the first year.
The restrictive component of weight loss surgery works by filling a small gastric pouch with food that sends a signal to your brain that you are full and to stop eating. If you drink liquid with your meals, it will flush the solid food out of your pouch and will decrease the success. You should stop drinking 15 minutes before you eat and not drink for one hour after you eat.
Bariatric surgery is a life long commitment to change. It is not a decision taken by yourself or by us within a short period of time. It involves a number of appointments with the surgeon, dietician and exercise physiologist before a final decision towards surgery. From the team point of view we need to see a commitment towards a program of weight loss prior to surgery. This will be discussed by your surgeon during the first appointment.
Not for the first six weeks. They can cause slippage of the LAP-BAND and leaks in gastric bypass patients. After six weeks, they can cause a lot of crampy gas pains, but are less harmful to the surgery. It is advisable to avoid any drinks with sugar in them.
Symptoms of vitamin deficiency can include anemia, neurological alterations, skin changes, and other metabolic abnormalities. These are difficulty to diagnose and may take time to correct. Vitamins, calcium, and iron supplements should be taken for life after weight loss surgery. This is particularly important after gastric bypass.
Yes. Some medications will need to be crushed or taken in liquid form early after the surgery due to swelling. Eventually you should be able to take most medications normally. Large tablets, such as adult multivitamins, will need to be cut in half. Extended release or long acting medications, as a general rule, cannot be crushed or cut in two. This will reduce their effectiveness.
The LAP-BAND is easily reversible since it does not involve cutting or rearranging your intestines in any way. The gastric bypass is irreversible. Some surgeons write about reversing the gastric bypass, but this is a major operation with much higher risks that even a gastric bypass. Patients should think of a gastric bypass as permanent.
