Even though we are not surgeons and do not perform weight loss and bariatric surgery many people ask us about these surgeries; So I decided to write this article in the hopes of giving you correct information. The most asked question I am asked is.
Weight Loss Bariatric Surgery is It For Me?
Bariatric surgery is an appropriate treatment option for patients with a BMI of greater than 40% of patients with a BMI of greater than 35% who also have other medical conditions placing them in a higher risk category for cardiovascular diseases, such as hypertension, diabetes, high cholesterol, or previous heart attack or stroke. Bariatric surgery is the final treatment option when diet, exercise, and medication have failed to achieve the desired results. Very often health insurance companies will approve coverage of bariatric surgery after documented participation in a weight loss program that can include medications to lose weight.
There are several types of bariatric surgeries available. In the past (20 years ago or more) an open procedure was performed that basically bypassed part of the intestines so that food and nutrients could not be absorbed very well. As expected this had side effects ranging from food intolerances to nutritional deficiencies, and this is not performed currently. The most common types of current bariatric procedures are performed laparoscopically. The surgeon can either reduce the size of the stomach by stapling the stomach, placing a band around the stomach – sometimes adjustable, performing a sleeve procedure which permanently reduces the size of the stomach, or something similar, or they can reconnect the intestines so that food and nutrients are not as well absorbed (bypass). The type of procedure depends on the patient’s other health conditions, previous abdominal surgeries, and patient preference.
After surgery patients are started on a liquid diet and gradually advanced as tolerated. With procedures that reduce the size of the stomach, it is necessary to eat smaller, more frequent meals. In general, patients will experience bloating, nausea, and regurgitation if they try to eat beyond the limits of their stomach size. Occasionally additional procedures need to be performed to allow the stomach size to be larger due to patient intolerance. With procedures that bypass some of the intestines, it is not uncommon to have food intolerances, especially fatty foods, and a more common adverse reaction is something called “dumping syndrome”. “Dumping syndrome” is an abrupt need to use the bathroom immediately after eating, very often with diarrhea, due to poor absorption of foods. Generally, patients with bypass procedures also have certain vitamin needs, including monthly vitamin B-12 shots, and are unable to digest certain capsules and delayed-release medications. Often patients need adjustments in their day to day medications to accommodate these absorption problems.
It also should be noted that these are surgical procedures and carry the normal anesthesia and surgery risks, some of the more common being wound infections, pneumonia, and urinary tract infection. Depending on the procedure there is also the risk of incisional hernia which is a hernia of the surgical incision.
In conclusion, bariatric surgery is a good option for some patients who have not achieved successful results with aggressive diet and exercise, with or without weight loss medications. The results are a greater weight loss, but there are also more risks.
For a free medical weight loss consultation, call us now at 215-821-7336.