Obesity results from having an abnormally high proportion of body fat which exceeds the body’s skeletal and physical standards. Obesity develops into morbid obesity when an individual is 50-100 pounds or more over their ideal body weight and has a BMI (Body Mass Index) of 30 or higher. Morbid obesity includes one or more serious health conditions or diseases that are a direct result of the excess weight an individual carries, known as co-morbidities. BMI of 35 and higher with co-morbidities and 40 and higher with or without co-morbidities makes patients with morbid obesity a potential candidate for surgery.
Any surgical procedure involves a certain degree of risk, but modern bariatric surgery has an excellent safety record with patients rarely experiencing any complications. This is not to minimize the fact that this is still a major operation, which should be considered after all a careful and thorough evaluation.
Once a surgeon has determined that you are a candidate for weight loss surgery, it’s very important that you reveal all pertinent medical information to your surgical team. The bariatric surgeon will assess the risks involved with your particular surgery and take every precaution necessary to ensure your safety and to reduce the risk of complications.
Regardless of the type of weight loss surgery, it’s important that the decision to undergo surgery is carefully thought out. It’s imperative to weigh the risks of surgery with the long-term risks of remaining obese. Discuss any concerns you might have with your surgical team and your loved ones.
Pre operative diet has the benefit of shrinking the liver and reducing the fat in the abdomen, in certain patients this is beneficial and will be decided by your surgeon at the time of office visit. The length of the preoperative diet varies, and is something that you will need to discuss with your surgeon. Additionally, some insurance companies require a physician-monitored diet three to six months prior to surgery as part of their coverage requirement.
With any bariatric procedure performed laparoscopically you are expected to recover fully and return to any occupation within three to four weeks. If your job is physically demanding and requires heavy lifting or physical activity, a longer period off work may be necessary. If there are questions, patients should consult with their surgeons.
Walking is encouraged as early as the first evening after surgery and, on a regular basis thereafter to increase your physical activity level. Aerobic activities such as brisk walking, stationary biking, elliptical machines, etc. may be engaged almost immediately after surgery and are limited generally by the degree of discomfort that these activities cause. You may engage in swimming once your surgeon has determined that the wounds have healed sufficiently. Activities that are more strenuous or that involve lifting weights are generally discouraged for four weeks after surgery. This will vary by patient, and our Surgeons will create a personal plan which is right for you.
Vitamin and mineral supplements are necessary in the weight-loss period and certain vitamin/mineral supplements are needed life-long, depending upon the type of surgery you have. Insurance typically does not pay for vitamin and mineral supplements. However, you can pay for vitamins and minerals out of a flex medical account, which is a pre-tax account from your income that can be used for medical expenses.
Bariatric surgery is just a tool that will enable you to lose weight. Although surgery does produce changes in your body that help with the initial weight-loss, for maintenance of the weight-loss it is ultimately up to you to make lifelong changes in diet and lifestyle in order to be successful. This includes making right food choices, controlling portions, taking vitamin and mineral supplements as directed, getting plenty of fluid, rest and regular exercise. In addition, sufficient sleep and stress control may help to improve long-term weight-loss success and maintenance. Without these lifelong changes weight regain is likely to occur.
Our bariatric care team includes support from a monthly in-person support group, online support, personalized guidance from dietitians and lifestyle coaches.
With weight-loss you may be able to go off or reduce the dosage of many of the medications you take for obesity-associated co-morbidities, such as blood pressure, heart disease, arthritis, lipid abnormalities, and type 2 diabetes. If you have a gastric bypass, sleeve gastrectomy or a duodenal switch, you may even be able to discontinue using or to reduce the dosage of your diabetes medications in the early period following surgery.
For the first 18-24 months after weight loss surgery it is important that women of childbearing age do not conceive. Pregnancy can be taxing on the body and the potential for fetal damage increases. During this waiting period, it’s important to give the body time to heal and recuperate. For this reason, we will typically advise you to take every precaution necessary to reduce the chances of becoming pregnant for up to two years after your surgery.