Weight Loss Surgery

Understanding the various surgical options and lifestyle commitments needed for weight loss surgery is the first step in making an informed decision. Without a clear picture of what is and is not possible with weight loss surgery, it is impossible to make a quality informed decision. Bariatric surgery is a lifestyle changing procedure that needs to be approached with care and careful planning.

Bariatric surgeries for obese patients were originally discovered accidently during more severe operations for patients with stomach cancers or ulcers that required surgical removal. The patients that underwent these procedures ended up losing a large volume of excess weight as a side effect. Considering the high percentage of obese people in the United States the potential for a weight loss procedure was very large. Voila, the birth of the weight loss surgeon was a short step away.

There are two types of weight loss surgeries with different procedures targeted to different types of patients. In order get a clear picture of what this means, you should have a working knowledge of the digestive process, its sections and a little bit about how the weight loss procedures affect them. Let’s first examine the digestive process.

Digestive Juices and enzymes mix with your food as it travels from your mouth to your esophagus, then to your stomach. The average stomach has a volume of about three pints and contains very strong digestive acids which are used to break down your food into smaller components and absorbable sizes.

After passing through your stomach, your food moves to the duodenum. This is the first section of your small intestine. Your body produces bile and pancreatic juices to continue the breaking down of your food. The duodenum is where Calcium and Iron nutrients are absorbed into the bloodstream.

The next stop is the Jejunum sometimes referred to as the mid-gut. After the Jejunum it travels directly through to the ileum. The jejunum and the ileum are responsible for absorbing the remainder of all other nutrients and calories that were not absorbed by the Duodenum.

After all nutrients have been absorbed in the small intestine the remaining matter is then passed to the large intestine where they are eliminated from the body.

“All weight loss surgeries are based on placing restraints or eliminating parts of the digestive tubing and stomach.”

The two types of gastric weight loss surgeries are Restrictive Gastric Surgery and Malabsorptive Gastric Surgery. Let’s examine them both.

Restrictive Gastric Surgery

There are two types of restrictive surgeries used for weight loss.

A bariatric surgeon will remove a portion of your stomach. This causes you to feel full much faster and reducing portion-sizes when you eat which results in weight loss. This procedure is permanent and does not need annual maintenance from your doctor after your weight loss is stable and a foreign device is not implanted into your body.

Another version of a restrictive surgery is the Lap-Band. This is also known as a Gastric Band. This is a physical device that restricts the amount of food that can be taken at one sitting. The devise requires several annual visits to your doctor to be maintained. But a Gastric Band used in weight loss surgery does have a distinct advantage in that can be removed at a later date if desired. Gastric Banding is more popular of the two types of restrictive surgeries used for obese patients. Gastric Sleeve is the second most popular, but in the last few years is gaining in popularity very quickly.

Malabsorptive Gastric Surgery

A section is cut away from the small intestine. The small intestine is where your body absorbs most of its nutrients and calories. A section is removed so basically the food passes too quickly through the digestive track to be fully absorbed. This also means that the nutrients are not absorbed as well either. Patients choosing to get this procedure will be on supplements for life due to shortages in vitamins being absorbed. Sometimes and ony for the most serious cases, a malabsorptive surgery like a gastric bypass is combined with a restrictive procedure like a Lap-Band. Surgeries like Gastric Bypass are the most invasive and have the highest rates of complications

Other important considerations to look at are the benefits and possible risks involved in a getting weight loss surgery. Only by having a thorough understanding of the procedures, the pros and cons weighted carefully can you make a good decision that is likely to work well and integrate into your lifestyle.

The Positives

The most obvious is weight loss, after all this is the point of the surgery at its core. If you get a gastric procedure and you follow your surgeons nutritional guidelines you can expect to lose up to 100 percent of your excess fat during the first two years. This is a generalization as each patient and each weight loss surgery is different. But this is a realistic outcome of the process. A small percentage of patients will gain some of the weight back after this time, but will never regress back to their prior level of obesity.

The resulting health benefits of losing the excess weight are dependant on the pre existing conditions that are individual to each person’s medical history but most often include many of the following;

  • Diabetic conditions minimize or return to normal
  • Reduction in cholesterol related diseases

  • Patients with hypertension will eliminate medications
  • Significant reduction in risks of heart disease,

  • Major reduction in pulmonary disease
  • Major reduction in certain cancers

  • Life expectancy goes up by as much as 20 percent
  • Greater earning potential, studies have shown that morbidly obese people do not earn as much as those that are not.

  • Less discrimination in getting hired in workplace
  • Tremendous boost to self esteem.

  • Reduction or elimination of sleep apnea
  • Reduction in arthritis and joint related issues

  • The ability to have a physically active lifestyle, participate in sports, etc.
  • Large boost to energy levels, not feeling tired all the tim

The Negatives

What are the risks and possible complications associated with weight loss surgery?

This is mainly the result of over eating after your stomach size has been surgically reduced, or have not chewed your food enough

Delaying PregnancyIt is not recommended that you become pregnant after a gastric surgery, particularly before your weight becomes level and any nutritional issues that might arise can be dealt with . Becoming pregnant immediately after a weight loss surgery could pose a risk to the baby.

Dumping syndrome
This in a side effect of malabsorptive surgeries. The food passes to rapidly through the small intestines. Signs for this include weakness, sweating, diarrhea shortly after eating and nausea. Candy and sweet foods can bring about a feeling of extreme tiredness.

Thirty percent of obese patients that undergo gastric procedures will develop gallstones. This can be avoided potentially with the addition of bile salts during the first 6-8 months. Talk to your doctor about this option.

Nutritional Deficiencies
Patients who get a weight loss surgery can develop various deficiencies. These include but are not limited to; osteoporosis, anemia and bone disease. But these symptoms and diseases can be controlled by taking the correct mineral and vitamins.

Surgical ComplicationsA small percentage of gastric surgeries will need to be redone. Possible complications are hernias, infections, separation of any incision made during the gastric procedure.

Staples Leaking
If you have a procedure that uses staples, there can be leaking into the abdomen. This is a very serious situation that can generally be corrected with antibiotics. If the antibiotics are not successful the leak can be cause to require emergency surgery.

Every surgical procedure has a degree of risk. The risk depends a lot on your health, age and other factors. Obese patients pose special risks over a person with a normal BMI. This is something you should check with your doctor in detail to ascertain your individual risk.

Lifestyle modifications are critical, weight loss surgery will go a very long way to getting your body back to a normal size and health. But you will have to adhere to a new way of eating and exercising. Failure to make the necessary lifelong change puts you in danger of sliding backwards. The old adage” if you do what you have always done, you will get what you have always gotten” applies completely. You will have to make new habits and rituals to live a healthier lifestyle. 

Some questions to ask yourself to see if you are ready for a weight loss surgery

If you are male, are you over 100 pounds past your ideal weight.
If female the number is closer to around 70 to 80 pounds.

Do feel that you have given an honest attempt at normal weight loss methods? Have you tried, meal plans, counseling etc. and those methods have just not gotten you to your ideal weight.

Are you prepared to commit to the lifestyle changes that will be required after your surgery?

Do you feel you thoroughly understand the procedure you are considering? Have you actually sat down with pen and paper and listed all the pros and cons and how they apply directly to you.

Have you considered that if dieting did not work for you because of self discipline issues, those issues will need to be addressed as self control is required to have the optimal outcome from any surgery. You will still have a diet plan after gastric surgery, and it is critical to follow your doctor’s dietary recommendations. Are you prepared for this?

Have you considered setting a weight loss goal prior to surgery that will help the outcome and empower you to feel that you will do everything required for your follow up lifestyle after surgery?

Getting a weight loss surgery is a major decision. Most are non reversible surgeries that require a lifelong commitment to eating changes, exercise changes and an emotional relearning of the major habits that brought on the obesity in the first place.


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