Two surgical approaches
Most bariatric surgeries we perform are Roux-en-Y gastric bypass or sleeve gastrectomy. The hormonal changes that occur as a result of both operations allow a majority of our patients to tolerate small portions of food without experiencing the internal drive to overeat.
Weight loss is not the only measure of surgical success, however. In fact, Roux-en-Y gastric bypass is the gold standard operation for morbid obesity, and still the best operation for treating metabolic conditions such as diabetes, hypertension, and hyperlipidemia – increased levels of lipids (fats) in the blood, including cholesterol and triglycerides. A 2004 study from the Journal of the American Medical Association looked at 22,000 bariatric surgery patients who experienced an average weight loss of greater than 62 percent of their pre-operative body weight. Among the findings:
- Type 2 diabetes was eliminated in almost 80 percent of these patients
- 60-80 percent had complete resolution of hypertension and high cholesterol
- Almost 90 percent experienced completely resolved obstructive sleep apnea
Extensive patient support
Following bariatric surgery, patients typically have a nine- to 18-month window of time to incorporate lifestyle habits and lose weight. After that time, their potential for weight loss slows down considerably. The goal is to establish a new, healthy set point for their weight that they can maintain long term through diet and exercise.
- A comprehensive, multidisciplinary program to educate patients is essential for long-term success. The program should include:
- An initial appointment with the surgeon, which includes a full history/ physical and education about surgical options.
- One-on-one consultations with a dietitian, psychologist, and exercise physiologist, all of whom specialize in treating bariatric surgery patients.
- Post-surgery visits with the surgeon, dietitian, exercise physiologist, and psychologist.
- Support groups and exercise groups.
Patients should follow up with the surgeon and the weight loss team for the rest of their lives to ensure that they are staying on track and not experiencing any complications, such as mineral and vitamin deficiency. It is exciting to see patients transform from illness and inactivity to a vastly improved quality of life.
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