If you are very overweight and have struggled to lose weight through diet and exercise, weight loss surgery may be right for you. Weight loss surgery changes the way your body handles food, which can help you lose weight and keep the weight off longer and more reliably than other weight loss methods.
Weight loss surgery may incorporate one or both types of surgical procedures to help you lose weight. The risks and long-term effects of weight loss surgery will depend, in part, on which strategies are used. Restrictive procedures, such as lap band surgery, will make it difficult to overeat, but doesn’t drastically limit the types of foods you can eat. Gastric bypass, which is a combination of restrictive and malabsorptive procedures, limits how much you can eat and requires patients to avoid foods that are high in fat or sugar.
Weight loss surgery helps people to change their diet and eating habits, which often results in a dramatic weight loss. Most patients continue to lose weight for up to two years after their surgery and are able to maintain a healthy weight longer than people who lose weight through diet and exercise*.
As a result of losing weight, patients who suffer from obesity-related medical problems will often experience relief from their symptoms after weight loss surgery*. Even patients with chronic conditions, such as diabetes, have seen an improvement in their well being and a reduced need for medication after having surgery.
The risks associated with weight loss surgery will vary depending on your current health and lifestyle, and the type of procedure you choose.
If you are a man who is 100 or more pounds overweight, or a woman who is 80 or more pounds overweight, you may be a candidate for weight loss surgery. You may also be a candidate if you are less overweight but suffer from at least one obesity-related medical condition, such as diabetes or sleep apnea. As of 2011, the FDA approved the use of lap-band surgery, a restrictive weight loss surgery, for people with a body-mass index of 30 or higher who also have one co-morbidity.
Weight is not the only factor to consider before choosing weight loss surgery. A candidate should also have tried to lose weight in the past without surgery and be able to demonstrate that they are willing and able to make long-term changes to their diet and exercise habits.
When you see Dr. Choi at our Fort Lauderdale office, he will do a physical examination and review your medical history to determine if you are a candidate for weight loss surgery. You may also undergo a psychological exam and further physical testing. Your medical team will also work with you to ensure you’re aware of the potential benefits, risks and long-term lifestyle changes associated with weight loss surgery.
*Sleeve Gastrectomy as bariatric Procedure
*Lee WJ, Chong K, Ser KH, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg 2011;146:143– 8
Dr. Choi has over 23 years of healthcare experience.
Dr. Michael Choi, D.O. is affiliated with Broward Health Imperial Point and Memorial Hospital Miramar.
After surgery, most patients return to work in one or two weeks. You will have low energy for a while after surgery and may need to have some half days, or work every other day for your first week back. Your surgeon will give you clear instructions. Most jobs want you back in the workplace as soon as possible, even if you can’t perform ALL duties right away. Your safety and the safety of others are extremely important – low energy can be dangerous in some jobs.
Many patients are worried about getting hernias at incisions. That is almost never a problem from work or lifting. Hernias are more often the result of infection. You will not feel well if you do too much.
Right away! You will take gentle, short walks even while you are in the hospital. The key is to start slow. Listen to your body and your surgeon. If you lift weights or do sports, stay “low impact” for the first month (avoid competition, think participation). Build slowly over several weeks. If you swim, your wounds need to be healed over before you get back in the water.
The general answer to this is yes. Make sure to tell your surgeon and anesthesiologist about all prior operations, especially those on your abdomen and pelvis. Many of us forget childhood operations. It is best to avoid surprises!
Sometimes your surgeon may ask to see the operative report from complicated or unusual procedures, especially those on the esophagus, stomach, or bowels.
There are loan programs available to cover the cost of health expenses such as metabolic and bariatric surgery. Appeals to insurance companies or directly to your employer may reverse a denial of coverage. Metabolic and Bariatric surgery is a health expense that you can deduct from your income tax.
If you are not able to qualify for a loan, the Obesity Action Coalition (OAC) produces a helpful guide titled “Working with Your Insurance Provider – A Guide to Seeking Weight-loss Surgery.” This guide can help you work with your provider and advocate for your surgery to be covered. You can view the OAC guide on their website.
Yes and no.
Most people think of a “diet” as a plan that leaves you hungry. That is not the way people feel after surgery. Eventually, most patients get some form of appetite back 6-18 months after surgery. Your appetite is much weaker, and easier to satisfy than before.
This does not mean that you can eat whatever and whenever you want. Healthier food choices are important to best results, but most patients still enjoy tasty food, and even “treats.”
Most patients also think of exercise as something that must be intense and painful (like “boot camp”). Regular, modest activity is far more useful in the long term. Even elite athletes can’t stay at a “peak” every week of the year. Sometimes exercise is work, but if it becomes a punishing, never-ending battle, you will not keep going. Instead, work with your surgeon’s program to find a variety of activities that can work for you. There is no “one-size-fits-all” plan. Expect to learn and change as you go!
For many patients (and normal weight people, too) exercise is more important for regular stress control, and for appetite control, than simply burning off calories. As we age, inactivity can lead to being frail or fragile, which is quite dangerous to overall health. Healthy bones and avoiding muscle loss partly depends on doing weekly weight bearing (including walking) or muscle resistance (weights or similar) exercise.
As you lose weight, you may be able to reduce or eliminate the need for many of the medications you take for high blood pressure, heart disease, arthritis, cholesterol, and diabetes. If you have a gastric bypass, sleeve gastrectomy or a duodenal switch, you may even be able to reduce the dosage or discontinue the use of your diabetes medications soon after your procedure.