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Obesity FAQ

1. What is Obesity Surgery?
2. How does Obesity Surgery aid weight loss?
3. What results can I expect from obesity surgery?
4. How long are you in the hospital?
5. How long are you off work?
6. How long does the actual surgery take?
7. Will my insurance cover it?
8. How big do I have to be?
9. Do you throw up all the time after bypass?
10. Do you have diarrhea all the time after bypass?
11. Do you have to eat baby food all the time?
12. Is the surgery very dangerous?
13. Can it be reversed if it doesn't work out for me?


1. WHAT IS OBESITY SURGERY?

TWO PRIMARY SURGICAL PROCEDURES APPROVED FOR MANAGEMENT OF MORBID OBESITY (NIH 1991)

ROUX-EN-Y GASTRIC BY-PASS - involves construction of a small (1/2 - 1 oz.) stomach pouch whose outlet is a y-shaped limb of small bowel of varying lengths

VERTICAL BANDED GASTROPLASTY - consists of a small (1/2 ounce) pouch of stomach with a reinforced, restricted outlet (opening) to the remaining stomach

There are several other types of restrictive or malabsorptive procedures performed including:

LAPAROSCOPIC BANDING- involves placing a silicone band with an inflatable balloon around the stomach. This will restrict the outlet. This is still considered investigational. It has not been released by the FDA for general use.

BILIOPANCREATIC DIVERSION - involves resecting a portion of the stomach and bypassing approximately one half of the small intestine. This includes a significant malabsorption component.


2. HOW DOES OBESITY SURGERY AID WEIGHT LOSS?

RATIONALE FOR WEIGHT LOSS WITH RESTRICTED GASTRIC PROCEDURES

Limited storage capacity and narrow outlet produce early satiety.

Overdistension causes distress and vomiting, promoting a change in eating behavior. This alone is not intended to promote the change in eating behavior. This may require counseling and training in behavior modification.

RATIONALE FOR INCREASED WEIGHT LOSS WITH ROUX-EN-Y GASTRIC BY-PASS OVER VERTICAL BANDED GASTROPLASTY

It combines the restriction or limited storage capacity with:

  • Selective malabsorption (primarily for sugar, simple starches, and fats)
  • Dumping syndrome (intolerance to concentrated sweets);
    this will not affect all patients.


3. What results can I expect from obesity surgery?

Approximately 50-100 % of roux-en-y gastric by-pass patients experience significant weight loss (50-100 % loss of excess weight) and improvement in overall health. Fifty percent of patients should be able to keep 50% of their lost weight off at five years.

Weight loss is reported to be higher with roux-en-y gastric by-pass compared to restrictive procedures alone. Surgery is the most effective means available for successful long-term weight loss. Significant weight loss generally occurs, with the lowest weight occurring in 12 to 24 months.

Some degree of weight regain is common by 2 to 5 years after operation. It can occur anytime, even years later. This is influenced by eating behavior and lack of a regular exercise program.

Most patients report improvement in mood and other aspects of psychosocial functioning following surgical treatment.


4. How long are you in the hospital?

We target to have you out 3 days after surgery. Three to five days is a realistic time frame, however most patients are out in 3 days.


5. How long are you off work?

If you have a sedentary job you may return at two weeks. You should not lift anything over 15 pounds for 6-8 weeks from surgery.


6. How long does the actual surgery take?

Generally 1-2 hours. revision procedures will take longer.


7. Will my insurance cover it?

Once we receive your obesity data, we send a prior authorization letter to your insurance company to see if they will cover. This is at no charge to you and you are not out time or money to find this out. There are a number of insurance companies that will cover weight loss surgery. A lot depends on your comorbidities and prior dietary attempts.


8. How big do I have to be?

At least 100 pounds over your ideal body weight.


9. Do you throw up all the time after bypass?

No. If you are following the rules, taking small bites, chewing, chewing, chewing, and taking your time you will be fine.


10. Do you have diarrhea all the time after bypass?

No. Some people are more sensitive to hidden sugars than others. if you turn out to be one of those patients, reading food labels can avoid that problem.


11. Do you have to eat baby food all the time?

Absolutely not. our patients eat a well balanced diet. they should avoid fried foods, junk, sweets and refined sugar. this is the life style that should be adopted.


12. Is the surgery very dangerous?

Any surgery is serious, the risks given to morbidly obese patients not having gastric bypass should be taken as seriously as risk with gastric bypass. Dr. Baker will make you very aware of the risk and potential complications during your intensive consult.


13. Can it be reversed if it doesn't work out for me?

The surgery can be taken down; however, your anatomy and gut function will never be the same. Patients thinking "oh, well, if this doesn't work or if I don't like my new lifestyle I'll just have it taken down", should not have the surgery done.

 

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