How Weight Loss Surgery Works
Frequently Asked Questions
What is Weight Loss Surgery and How Does it Work?
- Weight loss surgery has been around for nearly 40 years, early operation for severe obesity was the intestinal bypass. This operation produced weight loss by “malabsorption” mechanism. Patients could eat large amounts of food, which would be poorly digested so that the body could not absorb the calories. Even though this surgery is no longer used in its original form, modified techniques of this surgery are being performed today. In addition to the malabsorptive component, a restrictive component was added, resulting in the patient left with the ability to consume and absorb small amounts of food.
- The surgical procedures that are used to promote weight loss are
- Roux-en-Y gastric bypass - The American Society of Bariatric Surgeons and the NIH consider this procedure to be the gold standard for surgical weight loss. This procedure surgically creates a small stomach pouch, bypasses the larger native stomach and the first segment of the small intestine called the duodenum, where most absorption takes place. The patient not only eats smaller amounts to food, but what they eat is not fully absorbed, thus creating large weight losses.
- Sleeve Gastrectomy - This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume.
- Gastric banding - a surgery that limits the amount of food the stomach can hold by having an adjustable silicone band being placed around the upper part of the stomach. This creates a new small pouch with the larger part of the stomach below the band. The pouch above the band can only hold a small amount of food so that you feel full sooner and the feeling lasts longer.
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Who is a Candidate for Weight Loss Surgery?
Although there may be some exceptions depending on each individual, the following criteria must be met before a candidate is accepted for a surgical weight loss procedure
- Demonstration of one or more supervised non-surgical weight loss attempts for 6-12 consecutive months within the last year. They can be from one of the following:
- weight reduction programs such as Weight Watchers or a registered dietitian
- a physician monitored medication program
- monthly visits with your primary care physician where diet is mentioned and weights are monitored.
- Willingness to make necessary changes needed
- Absence of medical problems that would make surgery/ anesthesia hazardous
- Must be over 18
- Must be at least 80-100 pounds overweight or have a Body Mass Index of 40 or greater
- Body Mass Index of 35-39 with documented medical problems such as hypertension, diabetes, joint problems, pulmonary function abnormalities or any other medical conditions that would be improved or alleviated by weight loss.
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Is Weight Loss Surgery Right for Me?
For those who remain severely overweight when non-surgical approaches have not been successful, or for people who have obesity-related diseases, surgery may be the solution. You should consider the following when making your decision to undergo weight loss surgery:
- The likelihood that you will be able to lose weight successfully with further non-surgical methods.
- How informed are you about the surgical procedures?
- How motivated are you to lose weight and improve your health?
- Your knowledge of how your life may change after the operation.
- Your knowledge of the potential for serious complications
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What are the Long Range Results of Surgery?
With the altered size of your stomach and by eating only the amount of food recommended in your diet, your daily food intake will be decreased. With this will come a weight loss the first twelve to eighteen months.
The rate at which you will lose weight will decrease gradually until you reach a stable healthy weight. Additional weight can be lost with a concentrated effort which includes incorporating exercise into your life.
Weight loss improves most obesity-related conditions, including diabetes, sleep apnea, joint problems and hypertension. Many patients can reduce the number of medications they must take or eliminate medications altogether.
Many patients also report a greater sense of self esteem. There are many factors that contribute to weight loss; among the most important are your age, gender and initial weight at the time of surgery. Your willingness to make the necessary adjustments in your present habits is essential to the ultimate success of the procedure.
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What are the Potential Risks?
- Any surgery entails a certain amount of risk, and complications cannot always be avoided. It should be noted that the risks/complications listed are rare, however, if they happen it may require a revisional surgery. Therefore, before making the decision to undergo surgery it is important to consider the following:
- With the gastric Lap Band System some risks/complications are:
- Gastric perforation or tearing in the stomach
- May not provide the necessary feeling of having had “enough to eat”
- Nausea and vomiting
- Outlet obstruction
- Pouch dilatation
- Band migration/slippage
- With the Gastric Bypass and Sleeve Gastrectomy some risks/complication are:
- Pulmonary embolism (blood clot in the lungs)
- Blockage where the tissues are sewn or stapled together
- Leakage from the staple or suture line
- Insufficient weight loss
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Will I Have to Do This Alone?
The answer is NO. At the New Jersey Bariatric and Metabolic Institute we offer a multidisciplinary team approach. You will have the support of not only the bariatric surgeon, but the clinical program director, bariatic navigator, psychologist, exercise physiologist and registered dietitian. In addition, there are monthly support group meetings in which people who are considering the surgery, waiting or have had the surgery attend. Experience tells us that those who attend the support group meetings are more successful because the environment of the groups helps improve your self-esteem while keeping you motivated.
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Is Weight Loss Surgery Covered by Health Insurance?
Many insurance companies do not cover these procedures. Insurance providers understand that severe obesity can contribute to multiple health problems. The knowledgeable staff at the New Jersey Bariatric and Metabolic Institute will work with you and your insurance company to help make the necessary financial arrangements.
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