Weight Loss Surgery
Weight loss surgery, or bariatric surgery, is performed to help seriously overweight individuals lose significant amounts of weight – without gaining it back. It is considered the “gold standard” for weight loss, with a success rate of over 80%. Most patients lose at least half of their excess weight and keep it off for more than ten years.
In LapBand surgery, a soft silicon-based belt or band is placed around the upper stomach. It is tightened by means of an inflatable inner cuff that is filled with saline. A small access port for adjusting the tighness is placed at the level of the muscles in the abdominal wall. The LapBand is the least invasive weight loss procedure and highly successful due to the restriction of nutrient consumption.
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In gastric bypass surgery, the surgeon uses sutures and staples to create a pouch in the top of the stomach. The pouch is then connected directly to the intestine using a length of small intestine, called a Roux limb. The smaller stomach pouch restricts the amount of food that can be digested at any time, and bypassing the majority of the stomach and some of the small intestine limits the body’s ability to absorb calories. This combination of restrictive and malabsorptive techniques makes the Roux-en-Y procedure one of the most successful weight loss procedures.
Laparoscopic weight loss surgery, in experienced hands, usually takes an hour or less to complete. Increasingly the surgery is performed on an outpatient basis with little or no hospital stay. Patients who qualify for minimally invasive (laparoscopic) surgery enjoy smaller scars, lower risk of hernias, less post-operative discomfort and a shorter recovery time. Other types of weight loss surgery may have a role in certain circumstances and are discussed further in Dr. Sasse’s newsletter, blog, and books.
The New Stomach
After surgery, the stomach can usually hold an ounce or two of food. This may expand over time but will not exceed one cup. (A normal stomach holds one quart.) Because the stomach size is substantially reduced, patients are limited in the amount of food they can eat in a single meal. They also usually don’t suffer from constant hunger. Smaller meals eaten throughout the day are recommended.
One risk of gastric bypass surgery is vitamin and mineral deficiency and anemia. Regular meetings with your surgeon and a dietician will be scheduled before and after surgery to establish a diet and exercise plan and determine whether nutritional supplements are necessary.
Weight Loss After Surgery
Patients who undergo LapBand or Roux-en-Y gastric bypass surgery must be willing to make lifestyle changes to achieve and maintain weight loss and prevent complications from the surgery. With determination, good nutrition and regular exercise, the results can be dramatic. Most patients lose about 1-2 pounds per week and reach a stable weight 18 to 24 months after surgery. Weight loss is typically fastest immediately after surgery. Patients often enjoy immediate relief from weight-related illnesses such as sleep apnea, type 2 diabetes, high blood pressure, heartburn and incontinence.
Am I a candidate?
Candidates for bariatric surgery typically have a Body Mass Index or BMI of 35 or more, though more data is accumulating that surgery benefits people with even lower BMI also. A normal BMI is between 18.5 and 25. Calculate your BMI . Other factors are taken into consideration, including the patient’s physical and mental health and ability to follow a strict diet and exercise program. Patients interested in this procedure should schedule a consultation with their physician.