Weighing Your Bariatric Options
Everything You Need to Know About Weight-loss Surgery
If you have a love/hate relationship with diet and exercise that’s far more “hate” than “love,” you’re in good company. Eating healthy and living an active lifestyle is the best thing you can do for your overall health and well-being, but it’s not always easy.
Especially when it doesn’t give you the results you desperately want (or need).
When all other methods of weight loss have failed, or you have a serious health condition that’s caused by your weight, bariatric surgery may be able to help you succeed.
What bariatric surgery is
Bariatric surgery is a collective term for gastric bypass and other weight-loss surgeries. The procedures make physical changes to your digestive system to help you lose weight. Some procedures limit how much you can eat, while others reduce your body's ability to absorb nutrients.
What bariatric surgery isn’t
While bariatric surgery was created for weight loss, it’s not to be taken lightly. All forms of weight-loss surgery are major procedures that may include serious risks and side effects. Another thing most people don’t realize is that you have to make permanent changes to your diet and get regular exercise to help make sure the surgery is a success.
“The journey to achieving and maintaining a healthy weight is a lifelong one,” according to Igbagboyemi Olatunde, MD, a board-certified internal medicine and obesity medicine specialist at Adena. “It involves the daily choice with regards to a healthy diet and physical activities. Medications and surgery alone do not fix it.”
It’s all about BMI
The ideal candidate for bariatric surgery has a body mass index (BMI) greater than 35 with two or more weight-related medical conditions. This could include high blood pressure, diabetes or sleep apnea.
BMI measures your weight with respect to your height:
18 – 24.5 is considered a healthy BMI
24.5 – 29.9 is considered overweight
30 and up is considered obese
If you’ve tried self-directed lifestyle changes, professionally-directed lifestyle changes and weight loss medications with no success, then weight loss surgery may be your next step.
What to expect
As far as overall results, Dr. Olatunde shared national averages for different types of weight-loss strategies:
- Lifestyle changes: 3-8% loss of body weight
- Medication: about 8-16% loss of body weight
- Surgery: 16-32% loss of body weight
As far as the procedure, bariatric surgery is performed in a hospital using general anesthesia. Most types of bariatric surgery are performed using a laparoscope - a small, tubular instrument with a camera attached – inserted through small incisions in the abdomen. This allows the surgeon to see and operate inside your abdomen without making larger incisions, which can make your recovery time much shorter.
Surgery usually takes several hours. After surgery, you may need to stay a few days in the hospital.
Types of bariatric surgeries
There are three basic types of bariatric surgery:
- Roux-en-Y (roo-en-wy) gastric bypass is the most common procedure. This surgery decreases the amount of food you can eat in one sitting. The surgeon cuts across the top of your stomach, sealing it off from the rest of your stomach. The resulting pouch is about the size of a walnut and can hold only about an ounce of food (instead of the usual three pints). Then, part of your small intestine is sewn directly onto the pouch. Food bypasses most of your stomach and your small intestine and goes directly into the middle part of your small intestine.
- Sleeve gastrectomy removes about 80% of the stomach, leaving a long, tube-like pouch. This smaller stomach can't hold as much food. It also produces less of the appetite-regulating hormone ghrelin, which can curb your desire to eat.
- Biliopancreatic diversion with duodenal switch is a two-part surgery. The first part is similar to a sleeve gastrectomy. The second part connects the end of the intestine to the duodenum near the stomach, which causes food to bypass most of the intestine. This surgery limits how much you can eat and reduces the absorption of nutrients.
Talk to your doctor about the pros and cons of each procedure based on your medical condition.
What to expect after surgery
After weight-loss surgery, you won't be allowed to eat for a day to two to help your stomach and digestive system heal. Then, you’ll start a liquid diet that slowly progresses to pureed, very soft foods and eventually regular foods. You will have many restrictions and limits on how much and what you can eat and drink.
You'll also have frequent medical checkups to monitor your health in the first several months after weight-loss surgery. You may also need laboratory tests, blood work and exams.
Gastric bypass and other weight-loss surgeries won’t always work the way you might have hoped. It's also possible to not lose enough weight or to regain weight after any type of weight-loss surgery, even if the procedure itself works correctly. This weight gain can happen if aren’t following recommended lifestyle changes, such as getting regular physical activity and eating healthy foods.
There’s hope for success
If you are dedicated to changing your life for the better, a bariatric procedure may be right for you.
“My advice to someone who wants to embark on a journey to a healthier weight is to seek help with a trusted health professional,” says Dr. Olatunde. “Options exist. Do not give up. Walk the journey. You will be healthier and happier for it!”