Weight loss can be a difficult battle, but it can be especially difficult if the battle has raged on for many years. One solution to overcome the war is bariatric, or weight loss, surgery. Each year, bariatric surgery offers thousands of people numerous benefits of weight loss such as the relief of Type 2 diabetes, hypertension, high cholesterol and sleep apnea, just to name a few. If you’re considering bariatric surgery or plan to seek consultation, below is what you can expect before, during and after surgery.
Bariatric Surgery: The Requirements
To be considered for bariatric surgery, a few requirements must first be met. Most people with a Body Mass Index (BMI) of 40 or greater are ideal candidates for bariatric surgery; however, good health and a lifestyle free of addictive behaviors such as smoking and drinking are important factors as well. Those experiencing severe ailments due to weight issues also may be considered for surgery if their BMI is 35-39. Additionally, physicians emphasize bariatric surgery is a last-resort option, not a “quick fix.” It is a tool to help you lose weight and must be accompanied by a good diet and exercise program for long-term success. If a person has tried numerous diet and exercise plans or prescription weight-loss drugs to no avail, weight loss surgery may be the best solution.
Bariatric candidates are required to go through an evaluation process, which includes dietary counseling and psychological tests to determine whether or not a person is ready for bariatric surgery. This process ensures a complete understanding of the surgery process and the lifelong changes required for success as well as to help determine which surgery option is best.
Types of Surgery
Adjustable Band– The banding procedure involves an adjustable band placed around the top part of the stomach creating a small pouch. This restriction limits the amount of food consumed at any time. Generally, each pouch is approximately one cup and requires patients to chew foods completely before swallowing. Each band is unique to each person and can be adjusted to determine how quickly food leaves the pouch after a meal, creating the effect of fullness to last longer.
The Sleeve – This procedure also creates a smaller stomach pouch. The sleeve, however, reduces the size of the stomach from the size and shape of a football to a banana. The remaining stomach is then removed. This is a restrictive procedure only and the digestive process remains intact.
Gastric Bypass Roux-en-Y– According to the American Society for Bariatric Surgery and the National Institutes of Health, Gastric Bypass Roux-en-Y is the most popular weight loss surgery procedure. Like the sleeve, this procedure also creates a small stomach pouch by cutting the stomach. In this procedure, however, the remainder of the stomach is not removed but the digestive process is altered. The newly formed, much smaller pouch empties directly into the lower portion of the small intestine causing less calorie absorption. This is done by dividing the small intestine for the purpose of bringing it up and constructing a connection to the stomach pouch. The remaining stomach is connected to the side of the Roux limb of the intestine creating a “Y” shape and still works to produce digestive juices, which are mixed with the food down lower in the digestive tract.
Eating After Surgery
The diet initially begins with clear liquids and progresses to full liquids within the first week. After one week, the diet will be progressed to three small meals and one to two protein supplements a day. Due to the decreased size of the stomach, portions are much smaller. Hydration is extremely important and sipping water throughout the day is required. Additionally, liquids should not be consumed 15-30 minutes prior to or during a meal. Doing so can cause discomfort in the pouch by allowing food to travel too quickly into the intestine. Multivitamins and minerals are very important to take after surgery, especially with the gastric bypass surgery. Due to malabsorption with gastric bypass, taking vitamin B-12, iron, calcium and multivitamins is important to receive all nutrition needs.
Adjusting to a New Life
Weight loss surgery can produce dramatic results; however, the benefits from losing weight are not automatic. The process requires permanent lifestyle changes to be successful, including eating small, frequent meals and committing to a good nutrition and exercise regime. It is common to feel happy or excited as the weight comes off; however, feelings of being overwhelmed or frustrated by changes in diet, activity and lifestyle also are common. Family and friends should also be prepared for changes as they offer support.
To Learn More About Weight Loss Surgery
If you are considering weight loss surgery, FMC’s Bariatric Surgical Weight Loss Center invites you to attend a free information session. Information sessions are held the second Tuesday of each month from 6 to 7 p.m. at the DoubleTree by Hilton, 1175 W. Route 66 in Flagstaff. These sessions include a presentation on the causes and health complications of obesity, as well as the different types of bariatric surgeries. To register, call 928-214-3737. To learn more about FMC’s Bariatric Surgical Weight Loss Center, visit FMCBariatrics.com. QCBN
Gigi Sorenson, R.N., M.S.N., is the director of Flagstaff Medical Center’s Bariatric Surgical Weight Loss Center.
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