Understanding Weight Loss Surgery

Weight loss is a must for those who are obese. There are various ways and means for losing the weight. Weight loss surgery is one of the best options for those people who are obese. The people whose body mass index are more than 35 and have health complications because of their excess weight are advised for weight loss surgery.

Weight loss surgery is the only options at times, when there is a medical emergency in which one needs to reduce weight at once. Of course there are few complications and risks that are involved in weight loss surgery; nevertheless weight loss surgery is very effective and simple.

One has to be little careful after the weight loss surgery in order to avoid possible complication. But by far the weight loss surgery is the quickest way of losing weight. The person needs to follow the advices of the surgeon to the core otherwise he can become overweight or obese after some time.

As far as weight loss surgery is concerned the most important thing is that one should have the complete in formation about the all possible surgical options. one need not to go anywhere as he can get all relevant information from the surgeon himself about the various surgical options, the procedures of the selected weight loss surgery, the merits and demerits of the weight loss surgery and the post operative care required.

One you have decided to go for weight loss surgery, please get cleared all the doubts by questioning the surgeon. Never hesitate to ask the question even if it appears so silly to you.

There is nothing wrong in getting opinion from the other doctor who is highly experienced like the surgeon who is going to operate you. Try to get the names and addresses of the patients who had undergone weight loss surgery, in order to share their experience, whether it is bad or good.

In addition to getting in formation from the surgeon and the patient, one can also get information regarding weight loss surgery from internet. Another excellent source to get information about weight loss surgery is ASBS [American society for bariatric surgery].of course the weight loss surgery results in instant weight loss there are various complications and risks involved.

The key in weight loss surgery is that before accepting or opting for surgery the patient needs to be very well informed about the weight loss surgery as he needs to sign “informed consent”.

“Informed consent” is an important document that needs to be signed by the patient before weight loss surgery. As per this consent the parents agrees to the surgery after knowing the possible risks and complications.

If the person has complete information about the weight loss surgery, he will not have unwanted fears when he encounters the signs and symptoms of the possible post operative complications that arise due to weight loss surgery and can get in touch with the physician the moment he notices the signs and symptoms. Hence there is nothing wrong in opting for weight loss surgery if the doctor advices you to go for one.

Are You a Candidate for Weight-Loss Surgery?

In recent years, weight-loss surgery has emerged as an incredibly effective tool in helping patients manage obesity and make healthy lifestyle choices. However, weight-loss surgery is not for everyone, so you should understand the key factors used to determine if you are a good candidate for weight-loss surgery, like the LAP-BAND System.

While there are several medical factors that can determine whether or not you are eligible for weight-loss surgery; if you qualify, your commitment to the long-term weight-loss process will greatly impact the results. You may want to consider some of these issues on your own, but meeting with a weight-loss surgeon will help you gain an understanding of both the procedure and the lifestyle changes required afterwards.

Body mass index

The body mass index (BMI) requirements for weight-loss surgery were originally set by the National Institutes of Health (NIH) and have been in place since the 1990s. As a result, weight-loss surgeons will look for patients with a BMI of at least 40 or a body weight at least 100 pounds over ideal weight. Patients with a BMI between 35 and 39 may also be considered for weight-loss surgery if suffering from at least one health condition related to obesity, including, but not limited to, diabetes, hypertension, sleep apnea, high blood pressure, depression and high cholesterol.
BMI is the most commonly used method of determining an individual’s level of obesity. By using theBMI calculator provided by NewHope Bariatrics, you can see where you fall amongst the following BMI classifications:

o Healthy Body Weight – BMI from 18.5 to 24.9

o Overweight – BMI from 25.0 to 29.9

o Obese – BMI from 30 to 34.9

o Severely Obese – BMI from 35 to 39.9

o Morbidly Obese – BMI 40 and above

Failure of traditional weight-loss methods

Before agreeing to operate, weight-loss surgeons also need to determine if their patients have attempted to lose weight on their own. In most cases, surgeons will require that patients have tried traditional diet and exercise regimens prior to considering weight-loss surgery and documented the results. And in some cases weight-loss surgery patients have participated in medically supervised weight-loss programs. Weight-loss surgeons use this information to determine if their patients are committed to weight loss and lifestyle changes.Documentation of weight-loss efforts is also important when approaching the funding of weight-loss surgery. Like weight-loss surgeons, insurance providers typically require prospective patients to provide proof of repeated efforts to lose weight without surgical intervention.

Overall Health and Lifestyle

While there are many health conditions that may increase the urgency of weight-loss surgery, weight-loss surgeons will require all patients to meet certain lifestyle requirements as part of the program. To ensure that patients undergoing weight-loss surgery are able to experience long-term success and improve their overall health, surgeons will look for patients that avoid smoking, drinking and the abuse of drugs. If considering weight-loss surgery, it is important to eliminate these habits prior to beginning the process. After surgery, patients will be expected to avoid smoking and illicit drug use, while alcohol consumption should occur on a limited basis.

Commitment

Lastly, it is very important that all prospective weight-loss surgery patients be committed to permanent lifestyle changes. After ensuring that patients understand both the risks and rewards inherent in weight-loss surgery, some insurance providers will require psychological evaluations. As weight-loss surgery is not a magic bullet to erase obesity, it is important for all patients to understand the role that better eating habits and exercise play in the recovery process. Additionally, most weight-loss surgery procedures will require patients to meet regularly with doctors, attend support groups or meet with medical specialists to help support specific areas of follow-up care. The decision to have weight-loss surgery should not be taken lightly, and hence, doctors and insurance providers will insist that any patient undergoing the procedure is fully committed to each part of the lifelong process.

If you are trying to determine if you are a candidate for weight-loss surgery, you should consider your BMI and your past experiences with traditional weight-loss methods. If you feel you meet the criteria outlined here, you should then carefully consider both the potential benefits and responsibilities of weight-loss surgery. Though you may be unsure if weight-loss surgery is right for you, a consultation with a weight-loss surgeon will provide extensive insight into your condition and information about life after the procedure. In the end, if you are a good candidate for the procedure and feel prepared for the necessary lifestyle changes, weight-loss surgery can be the first important step towards a longer and healthier life.

Laparoscopic Weight Loss Surgery – Common Questions and Answers

Why consider Laparoscopic Weight Loss Surgery?

In the United States, obesity has become a common problem. In a report released in 2009 by the “Trust for American’s Health” and the Robert Wood Johnson Foundation called, “F as in Fat”, studies show that two-thirds of adults are overweight or obese, and nearly one-third of children and adolescents are also considered overweight or obese.

And it doesn’t stop there. According to the Center for Disease Control and Prevention, England ranks in at 3rd, and Australia and New Zealand top the scales at the #7 and #8, respectively.

Treating obesity can be a long and difficult process, made even more so when the patient doesn’t have a correctable endocrine problem.

The first line of defense is usually a recommendation of more exercise and a low-calorie, low-fat, balanced diet. Most doctors do not recommend ‘fad diets’ – also known as ‘crash diets’ or diet drugs as their effects are short lasting and may cause additional long-term complications.

However, as is shown by the results in the report above, diet and exercise alone are sometimes not effective.

Laparoscopic weight loss surgery is becoming a treatment of choice for doctors whose patients are morbidly obese.

What is morbid obesity?

A person is considered ‘morbidly obese’ when they weight 100 pounds (or more) over their ‘ideal body weight’, or when a calculation of the body mass index (BMI) is greater than 35 – 40.

Want to calculate your own BMI (Body Mass Index)?

Grab a calculator (or a pen and paper if you’re good at math), and start by multiplying your weight by 705. Divide that number by your height in inches. (Someone who is 5;7′ inches is 67 inches tall, as an example.) Now divide that number by your height again. The number you end up with is your BMI.

Health Problems Associated with Obesity

Obese or morbidly obese people are at increased risk for diabetes, hypertension, heart disease, hyperlipidemia, sleep apnea (temporary stopping of breathing during sleep), and osteoarthritis, to name just a few.

If diets and exercise have failed, ask your doctor if you’re a candidate for laparoscopic weight loss surgery

Your doctor can test your BMI and talk to you about your general health condition, and carefully assess your need for surgery. He can also explain the procedure and answer all your questions about having laparoscopic weight loss surgery.

Will my insurance company cover this procedure?

In recent years, research has clearly shown a link to obesity and many health problems, such as diabetes, heart disease and stroke. We also know that obese individuals are at risk for having a shortened life span and a lesser quality of life.

Many insurance companies now recognize obesity as a substantial health risk and will cover laparoscopic bypass procedures.

To determine if your insurance company will cover this type of medical care, contact them.

What’s the biggest advantage of laparoscopic weight loss procedure?

Also known as laparoscopic bypass procedure, the most important benefit to patients is significant weight loss during the first year after surgery. (Imagine being able to lose 50, 60, or even 80 pounds in only 12 months?)

Another big benefit of laparoscopic bypass surgery is that with this significant weight loss, many of the medical problems you may face – such as diabetes, hypertension and coronary artery disease – can be easier to treat – or they could be eliminated altogether!

And the third biggest benefit is that by choosing laparoscopy, (which requires much smaller incisions than traditional abdominal surgery), most patients generally have less pain and scarring after surgery and recover more quickly.

Laparoscopy also reduces the risk of developing hernias, which are more common after traditional abdominal surgery.

Of course any surgery carries risks, and that’s why it’s very important that you speak with your doctor and understand all the facts before considering laparoscopic weight loss surgery.

What are the most common procedures for weight loss surgery?

There are three generally accepted procedures most commonly used today: laparoscopic isolated gastric bypass, adjustable gastric band, and sleeve gastrectomy.

In a “Roux-en-Y” gastric bypass, more than 95 percent of the stomach is “bypassed” and a tiny portion – (only about the size of an egg) remains functional.
In an adjustable gastric band procedure, the stomach is restricted or “cinched” by the placement of the band, which can be adjusted after surgery as needed for further weight loss. (This has become the most common procedure being carried out today.)
Sleeve gastrectomy is the removal of two-thirds of the stomach with a “bypass”

What is involved before, during, and after surgery?

Before surgery

Your doctor will naturally perform many tests before deciding if you’re a good candidate for laparoscopic weight loss surgery. Tests may include cardiovascular, pulmonary, and endocrine systems.

Most doctors also consider a psychological evaluation essential as well, to determine their patient’s response to weight loss and the resulting change in body image and permanent lifestyle changes that will be needed.

And basic nutritional counseling is also a must before laparoscopic weight loss surgery.

During surgery:

As mentioned before, one of the advantages of laparoscopic weight loss surgery is that it’s considered minimally invasive as compared to traditional methods of surgery. The general goal in a laparoscopic bypass procedure is to”shunt” or bypass a portion of the stomach. During your surgery, here’s what to expect:

Four to six small openings (each about the size of a dime) are made in the abdomen. These openings allow the surgeon to pass a light, camera, and surgical instruments into the abdomen.
The abdomen is inflated with carbon dioxide gas, so the surgeon can see your stomach and other organs better.
Surgical instruments (only about the width of a pencil) are placed into the abdomen to the surgery.

After surgery:

Most patients recover from surgery without any complications.
You can expect to be in the hospital usually only from 1 to 3 days.
Depending on the type of work you do, you may be off work for 2 to 4 weeks.
Once at home, you will need to follow very specific eating guidelines. Your dietician will help you understand what your new eating regime will involve and what you need to know.
Regular follow-up visits will be scheduled during the first year after surgery to check your overall physical and mental health, metabolism and nutritional status.
Many patients will need plastic surgery (abdominoplasty) 1 to 2 years after weight loss to remove the excess skin around the abdomen. (The longer you are overweight and the more overweight you are, the harder it can be for your skin to ‘shrink’ down to your new size and weight.)

If you’re overweight, and diets and exercise haven’t worked for you, talk to your doctor to see if laparoscopic weight loss surgery can help you to start a new healthier, happier life.

Weight Loss Surgery, Loose Skin, and Post-Bariatric Surgery

Got those Loose Skin Blues?

Massive weight loss is a huge decision, most of you reading have either gone through a massive weight loss or are contemplating going through a massive weight loss. One of the most common hesitations in losing weight is the resulting loose skin that occurs once your body has gone through a significant weight loss. It is common knowledge that losing weight = loose skin. Loose skin not only occurs with a massive weight loss but also with natural body occurrences such as pregnancy. This is because once your body stretches through weight gain or through pregnancy; your skin loses its elasticity. First patients come in to talk about weight-loss and bariatric surgery, how it works and your results. Many patients, however, decide they want to go the less expensive and natural way by strict diet and exercise but are concerned about the loose skin. Our doctors always tell patients to be realistic, being healthy is far more important than having loose skin. Even when you have loose skin after weight loss there are ways to remove it such as post-bariatric surgery which includes tummy tucks, breast augmentations, and thigh lifts. The loose skin, although it may not seem like it, is a proud reminder of how far you’ve come and if you take that extra step to remove the loose skin, your body will be an entire trophy dedicated to yourself. In this post, we will see why and where that extra skin came from and how to reduce or remove it.

How We Burn Fat

As we all know, matter cannot be created nor destroyed, so when you exercise and diet fat is not simply “disappearing” off your body. What occurs is a form change, just like water and steam. The glucose and sugar that is harnessed from carbohydrates are the first fuel sources. Once the glucose runs out, fat takes over. Your body is a constant interconnected conveyor belt that removes essential nutrients from the fat and delivers them to specific body parts. Hormones that regulate our blood sugar levels activate an enzyme in fat tissue called lipase. Lipase ignites fat cells to release triglycerides, which is what makes fat cells fat. When they receive a signal from lipase to exit the fat cells, the triglycerides break-up into glycerol and fatty acids and then enter the bloodstream for use in your body. The process of breaking down triglycerides into reusable energy is called lipolysis which is shuffled and reshuffled to produce heat, water, carbon dioxide, and ATP. Since the fat tissue has lost some of its components, the cells shrink.

Why the Extra Skin?

When fat tissue is worked and the cells shrink, wouldn’t it make sense that your skin would shrink as well? Yes and no. In the cases of moderate weight loss, skin can certainly shrink back to fit the body’s new size because of its elasticity due to collagen in the skin. However, collagen does have its limits. Collagen fibers weaken with age and results in wrinkles. Rapid growth or weight gain also outpaces collagen production in the skin causing areas to over-stretch, leading to stretch marks commonly seen in pregnancy and adolescents going through puberty. In cases of massive weight-loss, the skin that has been stretched has lost its collagen strength making it very difficult if not impossible for the extra skin to shrink back to its former shape. Those undergoing gastric bypass surgery or bariatric surgery feel this pain. As the number of patients going through weight loss surgery increases, so do corrective surgeries for the unwanted and uncomfortable skin. This extra skin can actually be a serious problem and can actually cause infections, rashes and even back problems.

Post-Bariatric Surgery and Treatment Options

The most important determinant of how much loose skin an individual will have following weight loss is their age. Younger patients tend to have less loose skin than those who are older because of the strength of collagen in your skin. The next most important factor is the amount of weight loss. An individual who loses 200 lbs. is more likely to have excess skin than someone who has lost 80 lbs. There are other factors of who is more likely to have loose skin such as smoking, sun damage and skin color.

- Exercise: Exercise that includes increasing muscle town can tighten connective tissue. For patients who have undergone bariatric surgery are recommended to add a regular exercise regimen that is helpful to maintain ones weight and can also serve to tighten loose skin to some extent.

- Body Contouring Procedures: For those that are losing 80 lbs. to over 100 lbs. surgical procedures, known as post-bariatric surgery, are available to tighten skin and remove the extra pockets of skin that inhibit your body from being as toned and tight as the individual would like. Below are the most common procedures for massive weight loss patients.

Abdomen, Thighs and Buttocks- The abdomen is usually one of the greatest concerns for individuals following massive weight loss. In both men and women, excess fat is stored both in the abdomen and beneath the skin of the abdominal wall. Consequently following weight loss in those areas, extra skin appears. Large amounts of hanging skin can lead to the collection of moisture between the skin folds resulting in a condition called intertriginous dermatitis, which leads to irritation, redness and pain. Occasionally, the skin may even breakdown, bleed and become infected. With proper documentation, many insurance companies recognize this problem and provide full coverage from surgical removal through a tummy tuck or abdominoplasty. The abdominoplasty will solely remove the excess skin from your stomach which is ideal for women following pregnancy. However, for those who have undergone weight loss surgery or a massive weight loss, excess skin is not limited to the stomach but also results in the buttocks and thighs. Because of this, surgeons will perform a procedure specifically for weight-loss patients called a body lift. This involves an abdominoplasty, thigh and buttock lift all at one time. This addresses and removes loose skin and cellulite along the thighs and buttocks as well as the abdomen. Although the resulting scar is lengthy, it is confined to the waistline and is hidden by underwear, panties, or a bikini.

Breasts- Following a great weight loss, breast size and shape often change significantly in both men and women. Everyone worries about sagging breasts as we age but few know that massive weight loss greatly accelerates the process. As women advance from girls to teens to twenties and into their later years, the glandular portion of breasts is replaced by fat. The original glandular tissue is significantly more firm than fat and consequently the skin becomes unable to retract completely and produces severely ptotic or sagging breasts. This is called breast involution. There are many treatment options for women following weight loss. If a woman desires less sagging and wants to be larger, a breast lift or mastopexy is needed. Again, surgeons will tell you your options and also remind you to be realistic with or breast augmentation may be satisfactory. The problems in men are similar however treatment is slightly different. Men tend to have larger breasts when over-weight. Depending on a man’s age, degree of weight loss, and a few other factors he may result in large breasts, large and/or sagging breasts, or satisfactory breasts following weight loss. Large and/or sagging breasts in men is called gynecomastia. Here liposuction alone may be satisfactory, however this is not typical. Most men with both sagging and large breasts go through a two-staged procedure. The first stage is liposuction and is performed to remove excess fat and some glandular tissue. Over the next few months, the breast skin will retract slightly. Three to six months later, the patient will return to evaluate the situation and determine if the outcome is satisfactory. Delaying the second stage allows for significant skin retraction and if a skin tightening procedure is desired it is likely to require smaller incisions.

The Bottom Line?

Being healthy has far greater importance than excess skin. Although, having excess skin can lead to some serious issues there are non-surgical ways of preventing infections such as keeping your excess skin dry. For those who are able and want to remove the excess skin, post-bariatric surgery is for you. It is important to remember that these procedures should only be considered after ones weight has stabilized; especially after weight loss surgery. This can range from 7-18 months after weight loss. The most important factor in finding a plastic surgeon who can perform these procedures is that they must be board certified. If your plastic surgeon’s website or office does not advertise that they are board certified you must RUN! For everyone who has heard horror plastic surgery stories, this is probably where it started, having a surgical procedure done without a board certified surgeon. Use ASPS (The American Society of Plastic Surgery) to find a board certified surgeon near you.

Questions to Ask When Considering Weight Loss Surgery

The idea of having a surgery to help reduce weight holds a lot of appeal for people suffering from obesity. And surgery has often worked out where other conservative techniques of weight loss like exercise and diets have failed.

But obesity surgery by itself is not a magic wand. It can be considered a very effective tool for you to lose weight. It is very important to have complete knowledge of and realistic expectations from bariatric surgery. Hence, we have compiled a list of questions that you can ask your doctor or health professional before deciding on weight loss surgery:

Why should I go for weight loss surgery?

No doctor will usually suggest weight loss surgery as the first option. If he or she does, then it should ring alarm bells. If you have a BMI more than or equal to 35 with obesity-related conditions, you can be a candidate for weight loss surgery.

Can bariatric surgery be performed in a minimally invasive way?

Yes, minimally invasive weight loss surgery is possible. And it carries many benefits to the patient like less pain, speedier recovery, etc. But be it open or laparoscopic surgery, certain risks remain. Also, some patients, like morbidly obese patients, may not be considered eligible candidates for laparoscopic surgery.

What are the risks involved?

Be it lap band, gastric bypass, gastric sleeve, or duodenal switch surgery, they all come with risks and possible complications. A clear understanding is a must before deciding on surgery.

How quickly will I lose weight and will I put the weight back on again?

Patients lose weight rapidly up to two years after surgery. But if you eat deep-fried or high-calorie foods or eat more than you are supposed to, the weight can come back.

I have some health conditions related to my obesity. Will surgery still be an option for me?

You will be subjected to a detailed heart and lung evaluation before this question can be answered. Patients with obesity-related health conditions are advised to actually lose some weight before surgery.

Which weight loss surgery is best for me?

The lap band surgery is considered the safest among weight loss procedures, but it requires a high level of patient motivation and compliance for success. The Roux-en-Y surgery is most frequently performed and is advised for patients with a BMI of 35-55. The duodenal switch procedure has many possible complications but has long-term weight loss benefits. Ultimately, it’s up to you to choose the weight loss procedure that best suits you.

Will I have to change my lifestyle after the surgery?

Yes, drastically. As we said earlier in the article, weight loss surgery cannot work miracles for you if you don’t co-operate. Throughout your life after bariatric surgery, you will need to pay a lot of attention to what you eat and take nutritional supplements.

Will my mental state be checked prior to surgery?

Yes. You will be put through a psychological screening to see if you suffer from depression or other emotional conditions. If yes, you will need to address those problems before undergoing surgery.

How long will I be in surgery?

1-3 hours or 4-6 hours, if additional procedures are done.

How long will I have to stay in the hospital?

3 days, if everything works out normally. But, if complications develop, hospital stay can be a month or more.

What am I supposed to eat after the operation?

Liquid food is recommended for 2 weeks. You can then slowly graduate to regular food in the next three months. A healthy diet has to be followed according to the instructions of your nutritionist.

What is the recuperation period for weight loss surgery?

It could be 3 days or 6 weeks, depending on how active you were before surgery and what type of procedure you had. You can safely assume that you will need about 2-4 weeks off from work. Those who undergo lap band surgery get back to work within a week.

Do my family and friends also need to understand this surgery?

It’s good if they make an effort to understand the procedure as they can help you with the follow-up program.