Obesity is a chronic disease resulting from multiple environmental and genetic factors. If you’ve been struggling with losing weight and keeping it off, bariatric surgery, also known as metabolic surgery, can offer you a tool to lose weight, maintain weight loss and reduce your risk of early death. It can also improve or resolve chronic health conditions such as Type 2 diabetes, hypertension and high cholesterol.
Tuesday F. A. Cook, MD, a board-certified bariatric surgeon with Adventist HealthCare Adventist Medical Group in Fort Washington, Maryland provides more information on which patients qualify, procedures available and what you can expect after weight-loss surgery.
Qualifications for Surgery
Weight-loss surgery is an excellent option for people who are diagnosed with obesity and struggling to maintain a healthy weight. According to Dr. Cook, you may be a candidate if you:
Have a body mass index (BMI) 40 or greater, that is, more than 100 pounds overweight
Have a BMI of 35 or greater with weight-related conditions such as diabetes, high blood pressure or sleep apnea
Are unable to achieve and maintain weight loss through diet and exercise alone
You will also meet with a team of professionals including a registered bariatric dietician, behavioral health specialist, exercise physiologist and bariatric surgeon to prepare you for life after weight loss surgery.
Depending on your medical problems, you may need to see additional medical specialists to optimize your health preoperatively. “Your team of healthcare providers are here to work with you to ensure that you’ll use this tool to achieve success,” says Dr. Cook.
Finding the Option Best for You
Together, you and your surgeon will review your health history and determine which operation is best for you.
Sleeve Gastrectomy: This operation removes about 80% of your stomach. The remaining stomach is smaller and restricts the amount of food you can eat at once, making you feel full sooner. By removing the stomach that produces the most “hunger hormone”, the surgery reduces food cravings, improves blood sugar control and helps maintain a healthy weight.
Roux-en-Y Gastric Bypass: By dividing the stomach and small intestine, food enters a small pouch, decreasing your portion size. The meal then bypasses a segment of the stomach and small intestine, causing your body to absorb fewer calories. The impact on hormones and metabolic health often results in the improvement of adult-onset diabetes before any weight loss occurs. Patients experiencing heartburn may also see improvement in symptoms.
Adjustable Gastric Band: A small, adjustable silicone band is placed around the upper part of the stomach creating a small pouch above the band. Through adjustment of your band via access to a port underneath the skin with a needle, the meal portion size can increase or decrease. The impact on obesity-related diseases and long-term weight loss is less than with other procedures.
What to Expect After Surgery
Depending on the type of operation, you’ll spend one to two nights in the hospital and will have minimal pain. Initially, you will need to follow a specific diet that will be gradually advanced the further out you are postoperative.
“Immediately following surgery, the most important thing is to remain hydrated and walk,” states Dr. Cook. “For maximum success, each patient will need to stick to the guidelines they were taught before their operation and continue to follow up closely with their bariatric surgery team.”
Most weight loss is experienced in the first few months and continues for 12 to 18 months after surgery. “Around 90 percent of patients lose 50 percent of excess body weight and keep this extra weight off long-term,” says Dr. Cook. Your surgeon can help you determine a more accurate range depending on your starting weight and the type of surgery you undergo.
Today’s weight-loss operations are safe and performed using minimally invasive techniques. “This allows for patients to have a better experience with less pain and complications, as well as a faster return to normal activities, says Dr. Cook. As with any procedure, there are potential risks that may vary with each patient. One way to ensure your safety is to keep follow-up appointments with your medical team. This way, they can monitor your progress and make sure you are doing well from a surgical and nutrition standpoint.
Dr. Cook adds, “Weight loss surgery is as safe as gallbladder surgery. This operation doesn’t just treat obesity; it treats over 20 other medical conditions, including infertility associated with weight. Bariatric surgery greatly reduces the risk of death from cancer and has been shown to lower a person’s risk of death from any cause by over 40 percent.”
Achieving Lasting Success
Bariatric surgery can provide excellent, long-term success. However, it requires making ongoing lifestyle changes since it is only one aspect of counteracting obesity.
“Surgery is only a tool and patients must be willing to continue their behavior modifications long term,” says Dr. Cook. “If these lifestyle changes aren’t followed, patients could regain the weight. If that happens, we are always here to help as it’s a lifelong journey we take together.”