Bariatric surgery helps severely obese patients lose significant amounts of weight but it does not cure obesity. Instead, it helps patients learn to eat smaller amounts of food and, in certain types of surgery, blocks calorie absorption. For long-term success, patients must change their lifestyles and eating habits to maintain a healthy weight. Some of the necessary changes are common to all bariatric surgery patients while others depend on the type of surgery performed.
How It Works
Some bariatric procedures restrict the size of the stomach while others combine restriction with malabsorption, according to Highland Hospital. Adjustable gastric banding or Lap Band surgery involves looping a hollow band around the upper part of the stomach, creating an egg-sized pouch. In the sleeve gastrectomy procedure, the surgeon permanently removes 85 percent of the stomach. The gastric bypass, a combination procedure, creates a small stomach pouch with staples and reroutes the digestive system to bypass part of the small intestine. In the biliopancreatic diversion, the surgeon performs a sleeve gastrectomy and also bypasses most of the small intestine, blocking calorie absorption and restricting intake.
Results
The rate of weight loss varies among the various procedures, but most bariatric surgery patients lose 30 to 50 percent of their excess weight within six months and 77 percent within the first 12 months, according to the American Society of Metabolic and Bariatric Surgeons. Bariatric surgery also causes improvement of obesity-related disease, such as Type 2 diabetes, high cholesterol, high blood pressure and sleep apnea. Compared to morbidly obese individuals who did not have surgery, bariatric surgery patients maintained greater weight loss 10 to 14 years after the procedure and had more improvement in their obesity-related diseases.
Nutrition
All bariatric patients must limit their portion sizes and select high quality food to optimize their weight loss. After the initial recovery period, you will eat a high-protein, low-fat, low-carbohydrate diet and avoid sugar, alcohol and carbonation. Protein needs increase after surgery, so to prevent loss of lean muscle mass, eat 60 to 80 g per day, according to Linda Aills, R.D., lead researcher in a study published in the September 2008 issue of "Surgery for Obesity and Related Diseases." Your surgeon may instruct you to take vitamin and mineral supplements, such as B12, iron, calcium and vitamin D, for the rest of your life as these nutrients can no longer be absorbed after certain types of surgery.
Exercise
Bariatric patients need regular exercise for weight loss and maintenance. Engage in a moderate physical activity, such as walking, cycling, dancing or gardening, for at least 30 minutes every day, says the University of Chicago Medical Center. Add conditioning and flexibility exercises, such as weight lifting, push-ups, yoga and stretching, two to three times a week to build muscles and improve range-of-motion. Exercise also helps you to relax and relieve stress. Incorporate exercise into your day and make it enjoyable by walking to do errands, playing sports, visiting a park or dancing.
Emotional Issues
Severely obese individuals have a higher incidence of psychiatric disorders, such as substance abuse, binge-eating disorder, post-traumatic stress disorder, depression and anxiety disorder, so surgeons screen their potential patients carefully, according to the Society for Gastrointestinal and Endoscopic Surgeons. Problems encountered after surgery may include difficulty coping with stress; grazing all day; relationship issues; a sense of loss because the individual can no longer use food for comfort; distorted body image, says the University of Wisconsin.
Risks
Smoking injures the intestines and stomach, according to Highland Hospital, and may cause bleeding ulcers. Aspirin and non-steroidal anti-inflammatory medications, such as ibuprofen, increase your chances of developing ulcers as well. Other long-term risks include gallstones, kidney stones, bowel obstruction and hair loss. Some patients decide to have plastic or cosmetic surgery to remove sagging skin from their arms, torsos and abdomens. Others need revision surgery if their pouches expand too much.
Expense
Bariatric surgery patients incur expenses to reach and maintain a healthy weight. You must purchase vitamin, mineral and protein supplements for the rest of your life, and will probably purchase fresher, more expensive food than you did before surgery. To facilitate weight loss, you may decide to join a gym or attend yoga classes and purchase exercise clothing and equipment. During the first year or two, you may need to purchase smaller clothing every month or two because of your rapid weight loss, as well as a complete new wardrobe when you reach your optimal weight. If you have plastic surgery to remove excess skin, you may need to pay some or all of the cost as well.
Member Comments