Everything You Need to Know About Weight Loss Surgery
Several weight-loss procedures are used in Weight Loss surgery. It can yield dramatic results, encouraging chronically obese patients to lose substantial weight and, in some cases, reversing obesity-related diseases such as Type 2 diabetes.
Weight-loss surgery, on the other hand, isn’t for everybody. To be considered for surgery, you must meet specific requirements. And Weight Loss surgery isn’t simple – it’s a long-term commitment. To retain your weight loss and health gains, you must make permanent improvements to your eating and drinking habits.
You’re not alone if you’ve considered weight-loss surgery. According to the most recent data available from the American Society for Metabolic and Weight Loss Surgery, almost 230,000 Weight Loss procedures were conducted in the United States in 2017.
According to Dr. Eric DeMaria, president of the ASMBS and professor and chief of the division of general/Weight Loss surgery at the Brody School of Medicine at East Carolina University in Greenville, North Carolina, the popularity of Weight Loss surgery has gradually increased, with annual rises varying from around 5% to 8%.
Weight-loss surgery has progressed to the point that the majority of patients now have minimally invasive laparoscopic procedures. In terms of longevity and average weight loss, each treatment has its own set of advantages, risks, and benefits.
How to Be Eligible for Weight Loss Surgery
To undergo Weight Loss surgery, patients must generally meet certain requirements. If you fit into one of the following ASMBS categories, you may be a candidate:
- You have a body mass index (BMI) of at least 40 or excess weight of at least 100 pounds.
- You have at least one obesity-related medical condition and a BMI of at least 35.
- In previous weight-loss attempts, you were unable to reach or sustain safe weight loss.
Type 2 diabetes, stomach diseases, heart disease, hypertension, osteoarthritis, and sleep apnea are all obesity-related conditions that can benefit from weight-loss surgery.
This online calculator from the Centers for Disease Control and Prevention will help you measure your BMI.
Types of Weight Loss Surgeries
Less is better when it comes to weight-loss surgery. You consume less food and lose more weight when your stomach volume is limited. Each form of Weight Loss surgery has its technique. The following are the most widely used procedures:
- Gastric bypass surgery. Roux-en-Y gastric bypass, also known as gastric bypass, is a procedure that reduces the size of your stomach. Using the top part of your stomach, surgeons make a tiny pouch. This limits how much food you can eat. A small amount of your small intestine, called the jejunum, is connected to a hole in your pouch during bypass surgery. Food will then pass directly from the bag into your small intestine, resulting in fewer calories being absorbed.
- Sleeve Gastrectomy: A sleeve gastrectomy is a surgical procedure that removes the stomach. Three-quarters of the stomach is surgically removed during the vertical sleeve gastrectomy. The only thing left is a tube- or sleeve-shaped segment that can only hold a fraction of the food it once could.
- Duodenal Switch: The switch between the stomach and the duodenum. Your stomach consumes less food when you use the duodenal switch. This operation, officially known as biliopancreatic diversion with the duodenal transfer, incorporates sleeve gastrectomy and bypass surgery elements. It’s typically carried out as a public practice. In some instances, the duodenal transition is achieved in two steps, separated by several months. According to DeMaria, it’s less common than gastric bypass or sleeve gastrectomy because it’s a more complicated operation with a higher chance of complications. “Long-term treatment may also be difficult because these patients have lost so much weight that they may be malnourished.”
- Lap-brand: A lap-band is a band that is worn around the waist. You have a soft implant that involves an expandable balloon mounted around the top of your stomach, effectively separating it into two parts, with laparoscopic gastric banding, also known as an adjustable gastric band. You can only eat enough to cover the top half of the plate. The food gradually passes through the bar and into the lower stomach, allowing normal digestion to resume.
“Roux-en-Y gastric bypass and sleeve gastrectomy are now the most common (surgery types) in the United States and around the world,” DeMaria says. “It’s mirrored in my work, as it is in the majority of practices around the world.” According to him, the popularity of adjustable gastric banding has dropped “dramatically” in recent years.
Physicians and patients need to rely on facts and surgical outcomes when deciding on the right treatment. Individual weight-loss requirements and coexisting medical conditions are also factors to consider.
“Over time, we’re gaining a better understanding of how to match the treatment to the patient and the patient’s characteristics,” says DeMaria. “So, if you’re a severely obese person who needs to lose 200 to 300 pounds, the duodenal move, which can achieve that level of weight loss despite a higher surgical risk, maybe a better option.” However, he adds that while a duodenal transfer might be suitable for someone with a BMI of 80, it is not for someone with a BMI of 36.
Side Effects and Risks
Significant risks have been reduced as most Weight Loss operations are now conducted as minimally invasive, laparoscopic procedures, according to DeMaria, compared to when they were mostly performed as conventional surgery. You may experience the following short-term surgical side effects or complications:
- Vomiting and nausea
- Soreness or discomfort around the surgical incision.
- There is an outbreak.
- There is a lot of bleeding.
- Leakage from the intestines.
- Clots in the blood.
- Gastrointestinal leakage.
- Dehydration is a problem.
After gastric bypass, the body consumes even more alcohol from a single drink than it used to, and you might be at a higher risk of being addicted. Sugary foods and beverages contain an excessive amount of empty calories. Sugar consumption can cause side effects such as dumping syndrome, which includes diarrhea and cramping.
According to DeMaria, re-operation is done in 2% to 3% of cases for various issues. Weight regain can happen, but it’s typically a small percentage of the total weight lost, like 10 or 15 pounds.
What Kind of Weight Loss Surgery Is The Safest?
Each form of Weight Loss surgery has advantages and disadvantages. The type of surgery is recommended by the surgeon based on the patient’s condition and needs. Although all surgeries carry some risk, restrictive surgeries are better than restrictive/mal-absorptive surgeries because they do not mess with the digestive system permanently.
- Gastric banding is a form of gastric banding that is
This is the easiest and safest of Weight Loss procedures. However, the weight loss is less than for the other surgeries. Furthermore, people who have had gastric banding are more likely to gain weight in the long run. There is less chance of nutritional deficiency because the surgery does not affect nutrient absorption.
- Gastrectomy with sleeve
For morbidly obese patients with other health problems, this is a relatively healthy and quick surgery. Weight loss is substantial, and nutrient intake is unaffected. This is a relatively new technique, and the long-term benefits and consequences are still being measured.
- Bypassing the stomach
This treatment allows for rapid weight loss that lasts for up to two years. It is beneficial to patients with obesity-related illnesses who want to improve their health quickly. It also has a strong long-term weight-loss track record. Hernias and nutrient shortages due to malabsorption are the disadvantages. Dumping syndrome occurs when food is dumped from the stomach into the intestines before being fully digested.
- Switch in the Duodenum
This surgery is more complex and dangerous than the others, and it is also less common. It causes faster weight loss, but it also increases the risk of hernias, nutritional deficiency, and dumping syndrome.
Patients can benefit from Weight Loss surgery on many levels, including rehabilitation and prevention. “People who have Weight Loss surgery are doing it to lose weight because it’s therapeutic in that sense,” says Dr. John Daly, co-chair of the American College of Surgeons’ patient education committee and a surgical oncologist at Fox Chase Cancer Center in Philadelphia.
According to Daly, Weight Loss procedures can also be used as a preventative measure for people who have been obese for a long time and are at a higher risk of elevated blood cholesterol and atherosclerosis, stroke, and heart attacks. These risks are minimized with weight-loss surgery. “Most of the time, if they have diabetes, it is reversed – they no longer have diabetes,” he says. According to him, mortality rates are reduced as well: “They live longer after Weight Loss surgery.”
Nearly 2,300 obese patients with Type 2 diabetes who had weight-loss surgery were compared to almost 11,500 equivalent patients who received standard medical treatment in a new study released online Sept. 2 in the American Medical Association Journal. Those who had Weight Loss surgery were 40% less likely to suffer five significant complications throughout the eight-year study, including coronary artery problems, stroke, heart failure, atrial fibrillation, kidney disease – and 41% less likely to die from any cause.
According to Karen Flanders, integrated health president of the ASMBS and a nurse practitioner at Massachusetts General Hospital Weight Center, weight-loss procedures will benefit patients who are already too obese to undergo surgery for other conditions.
According to Flanders, a patient with congestive heart failure who is living on a left ventricular assist system, or mechanical heart pump, for example, can gain weight to the point that they are no longer eligible for a heart transplant. In other cases, people with a high BMI who wish to undergo surgery like a complete joint replacement face a greater risk of complications. She claims that weight loss surgery could help someone get back on the transplant list or make them a better candidate for orthopedic surgery.
Where Do You Get Surgery?
If possible, select a dedicated, high-volume facility specializing in Weight Loss medicine and surgical procedures, as with other forms of surgery.
Patients should check out an approved center for their Weight Loss surgery, according to DeMaria. “Every three years, approved centers are reviewed, and their results are analyzed and scrutinized so we know they follow the criteria,” he says.
Questions to Ponder
There’s a lot to learn about Weight Loss surgery, such as how it operates, if it’s right for you, and, if so, which treatment is better for you. Here are a few questions to consider:
- What are the potential advantages of weight-loss surgery for me?
- What are my unique risks?
- What treatment options do you provide?
- How much weight do patients lose on average for each procedure?
- What is your surgical care recommendation?
- How long does it take to recover?
- How would my eating habits and lifestyle shift as a result of this?
Before Surgery, What To Expect
At the weight-loss surgery center, you will typically attend a general orientation and information session.
Following that, you will have a one-on-one meeting with the health care team members who specialize in obesity, such as doctors, dietitians, and psychologists. This appointment requires a review of your weight-loss goals and aspirations, as well as a preliminary assessment of your medical conditions, weight and weight-loss experiences, lifestyle and eating habits, and another relevant history. It may be possible to plan for follow-up examinations or professional referrals.
You’ll get a customized plan that integrates different aspects of weight loss, depending on your situation. Nutrition and exercise therapy, as well as psychological and behavioral problems, can be included in the package. Alternatives, such as anti-obesity drugs, may be suggested.
Diet and nutrition education is a vital part of preoperative treatment. The dietary phases of Weight Loss surgery will be discussed. According to Patricia Morrison, a licensed Weight Loss dietician and Weight Loss program coordinator at UT Southwestern Medical Center, you’ll learn just how much food you’ll be consuming and how to supplement it to suit your dietary needs.
According to Morrison, patients in the UT Southwestern program see a dietitian three to four times before surgery. She will reinforce knowledge about new meal routines and behaviors, food volume and hydration requirements, and which foods to consume or avoid as a dietitian. The emphasis is on what you should drink, which includes high-protein, organic foods.
However, you’ll discover why improvements in your metabolism and absorption can be exacerbated by alcohol and sugary foods.
What To Do Before Surgery
Preoperative efforts such as the following may be needed to achieve the best surgical outcome:
- Improving your physical fitness will improve. “People with mobility problems should become more mobile because they can heal faster this way,” DeMaria says. “Surprisingly, losing a little weight is one of the things you can do to improve the result. It has been shown that if we can get patients to lose weight before surgery, we can lower their risk.”
- Any form of surgery, including Weight Loss surgery, is associated with a higher risk of smoking. Assistance with stopping smoking could be part of your personalized treatment plan.
- Before undertaking Weight Loss surgery, mental health therapy or drug abuse treatment may be recommended. “From a psychological perspective,” Flanders says, “we want (patients) to be in a safe position.” “We want to make sure they don’t have any drug abuse issues, and if they do, we’ll deal with it.”
According to Flanders, pregnancy is one of the few absolute contraindications to weight-loss surgery. Surgery should, however, be reconsidered after the birth of a child.
According to DeMaria, gastric bypass surgery typically takes one to three days in the hospital. A single overnight stay is usually needed for a sleeve gastrectomy.
He reports that it takes two to three weeks to resume much of the daily activities. People with more sedentary employment may be able to return to work faster, whereas if your career needs physical labor, you may need to take more time off.
According to DeMaria, pain control is generally not a big concern. Patients can feel pain as a result of their small surgical incisions.
According to Flanders, patients at Mass General usually return for their first follow-up appointment one to two weeks after surgery. “Some of them come back bouncing off the walls, bursting with energy and excitement,” she says. “Others are exhausted and have no idea why. As a result, everybody is special.”
Patients join wellness groups and learn how to advance their diets through this and subsequent visits, she says. A good diet, physical activity, mindfulness, eating triggers, and obesity causes are all included in the lifestyle group sessions. Blood samples are also collected from patients for regular lab work to ensure that everything is in order.
Most patients should feel better in four to six weeks, according to Flanders. Their bodies will have had time to recover from surgery by then wholly, and they will have become used to eating fewer calories.
Depending on your BMI and coexisting medical conditions, your policies can cover Weight Loss surgery for extreme obesity. Psychological screening and other related programs may or may not be included.
The price varies. For example, a Midwestern health system currently provides discounted gastric bypass and sleeve gastrectomy rates for patients who meet prescreening requirements on its website. For Weight Loss surgery, another health system lists a general price range of $15,000 to $23,000.
It’s possible that getting the surgery covered would be difficult. The Obesity Action Alliance, a nonprofit organization dedicated to fostering obesity awareness, prevention, and recovery, provides services such as a guide to dealing with insurance companies while considering weight-loss surgery.
It’s one thing to be told about the improvements that come with weight-loss surgery; it’s another to go through them.
“No matter how much you hear about your volume loss, the tiny amount of food that makes you feel full still surprises you,” Morrison says. For many patients, the most challenging part is learning to take small bites, chew thoroughly, and eat more slowly – eating mindfully rather than quickly. Overcoming old eating habits, on the other hand, will help you prevent issues like regurgitation.
For patients, getting daily exercise can be a significant lifestyle change. Flanders says, “We tell them 30 minutes, five days a week.” “We’ve instructed them to take it slow and gentle at first.” She claims that walking at a slow speed is perfectly natural. Activity may, however, steadily increase. “They may be doing Zumba or something similar to get their heart rate up. They could do incline treadmills, stair climbing, or some other aerobic exercise. But we still want them to do some lifting so that they don’t lose muscle mass.”
Eating is a huge part of social life, and it can be a problem after weight loss surgery. According to Morrison, you can feel completely at ease “telling the world” and sharing your situation with others. On the other hand, restaurant dining can be difficult, particularly if you don’t want to confide in family, friends, or coworkers.
“It’ll be a challenge for those people,” Morrison says, “because it’ll be obvious that you’re not able to eat all of your food, and it’ll be difficult to conceal.” Ordering appetizers that are easier to chew will improve. “We give people special menu-request cards to share with the restaurant (noting that) they have a medical need to order a kid’s portion or small portion,” she says. “As a result, they’re more likely to get their request met.”
Binge or emotional eating are examples of psychological disorders that may occur. Some people may be put off by the drastic shift in appearance and the subsequent remarks – even compliments. Relationship dynamics, such as those between partners, can change. You will discuss these concerns with a member of your Weight Loss team during follow-up appointments.