Is Weight Loss Surgery for Me?

By Sara Hodon

How many times have you tried to lose weight the old-fashioned way, through diet and exercise, only to fail miserably time after time?  If the weight is not going away and it’s starting to affect your overall health, it may be time to consider bariatric, or weight loss, surgery.

Weight loss surgery is not a “quick fix” for folks who want to lose a few pounds. It is a serious medical procedure that changes a patient’s entire anatomy, and is different from an operation such as liposuction. “Liposuction and tummy tucks are cosmetic procedures. Patients will lose some weight just from the fat being removed,” explains Dr. Leonardo Claros, MD, bariatric surgeon at St. Luke’s University Health Network. “Bariatric surgery is an option for the rest of the patient’s life to keep them from gaining weight. There are misconceptions about these surgeries – liposuction or tummy tucks will not fix the weight problem.”

According to Dr. Artun Aksade, bariatric surgeon at Easton Hospital, weight loss surgery should not be the first option for obese patients, although it’s usually the most effective one. “Studies have shown that patients who are morbidly obese have about a 5 percent chance of success with conventional weight loss methods. That’s a 95 percent chance of failure in the long term,” he explains. He says that most patients that come to his office have tried other weight loss methods a number of times, all without lasting results. The ideal candidate for bariatric surgery should have a body mass index (BMI) of 40, or 35 if they also have a medical condition directly related to their weight, such as diabetes or high blood pressure. If their BMI is 40 or greater, they automatically qualify for surgery.

Choosing the best procedure is not a decision to rush into. First and foremost, research the surgeon. “A patient needs to look into the expertise of the surgeon and the commitment of the hospital they choose,” Dr. Aksade advises. “The patient should feel comfortable with their surgeon and choice of surgery. It’s important to ask questions of the surgeon – their training level, et cetera. You should have someone who is fellowship trained. When the due diligence is complete and you’re comfortable with your choice of surgeon, the next step is to learn more about the different procedures available. The most common are laparoscopic roux-en-Y gastric bypass, in which a small pouch is created at the top of the stomach, causing the patient to be physically unable to consume a large amount of food or absorb a large number of calories; laparoscopic adjustable gastric band, where a silicone band is fitted around the stomach and creates a small pouch and opening for food to pass through, which severely limits the amount of food the person can eat; and the laparoscopic sleeve gastrectomy, where 75 to 80 percent of the stomach is removed entirely, and the remaining portion of the stomach is not re-routed to the small intestine, as it is with the band and gastric bypass procedures. Both St. Luke’s and Easton Hospitals hold informational programs a few times a month for patients who are seriously considering weight-loss surgery. At these sessions, patients can meet with dietitians, past patients, insurance representatives, social workers, and other individuals who can help them adjust to their new lives post-surgery. St. Luke’s Hospital requires their bariatric patients to attend these sessions. After the informational programs, the patients should have their choices of procedures narrowed down, and will then meet with their surgeon. “The patient might decide that one procedure might be best, but we’ll discuss their medical conditions and learn that another one might be better,” Aksade says. “Even though they’ve learned a lot by this time, they should still keep an open mind.”

The surgeries themselves are fairly simple. All three procedures are done through the navel, so there is a small incision and very little scarring. Recovery time varies depending on the type of procedure. “Gastric bypass is usually one  to two days, banding is one day, and the gastrectomy is a day and a half,” Aksade says. The patient may want to ease back into regular activities, but Aksade says they should be completely back to normal within 10 days. Dr. Claros of St. Luke’s University Health Network says the same, adding “Over 90 percent of our patients go home the next day. We have fast track bariatric surgery – we’ve been doing it for a long time and have seen excellent results. Some recover in a few days, others a few weeks.”

Bariatric surgery carries a small risk of complications, just as any other procedure. But Dr. El-Shahr also of St. Luke’s University Health Network, says that most side effects result from patient non-compliance. “If they aren’t following their diet, they may have nausea or vomiting. If they aren’t taking their medication, they can develop an ulcer. If they aren’t taking their vitamins, they may experience hair loss. More serious conditions like an infection or a hernia are possible, but extremely uncommon. It’s very unlikely for a patient to develop complications.”

Although bariatric surgery has become commonplace, it’s important to research the physician and learn about your options so you can choose the right type of procedure for you.

Sources:

Dr. Artun Aksade, M.D.
Bariatric Surgeon
Easton Hospital

Dr. Leonardo Claros, MD
Dr. Maher El-Shahr, MD
Bariatric Surgeons
St. Luke’s Hospital, Fountain Hill

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