Bariatric Surgery

Am I a good candidate for bariatric weight loss surgery?

Bariatric weight loss surgery is reserved for people who are obese and who have repeatedly tried to lose weight but failed. While for many people counting calories or increasing exercise is enough to lose weight, for others these methods just don’t work, for reasons doctors still don’t fully understand.

Generally speaking, surgeons reserve bariatric weight loss surgery for people who have a Body Mass Index (BMI) of 40 or more. (You can use a calculator to determine your BMI.) Surgeons will also consider the procedure if you suffer from a serious obesity-related illness such as life-threatening heart disease or severe sleep apnea.

Bariatric weight loss surgery should not be undertaken lightly or considered the “easy” way out because it carries the pain and risks of a major gastrointestinal surgery. But it is a proven procedure for highly motivated individuals who have a serious weight problem and have failed at other methods of losing weight.

What are the benefits of bariatric weight loss surgery?

Bariatric weight loss surgery has many benefits for the right candidates. It can improve:

• Quality of life by improving your ability to be active, to relate socially with others and to feel good about yourself
• Sleep apnea
• Gastroesophageal reflux disease (acid reflux or GERD)
• High blood pressure
• High cholesterol
• Type 2 diabetes

Why do I have to wait so long for bariatric weight loss surgery?

As a result of rationing of care by the Canadian public health system, a shortage of trained surgeons in this highly specialized procedure and restricted access to operating room times, there are currently very long waits for bariatric weight loss surgery. If the required wait is unacceptable to you, Timely Medical Alternatives can help you find a private clinic to expedite the surgery you need.

What will happen during bariatric weight loss surgery?

There are two main types of bariatric weight loss surgery: bypass and Lap-Band.

With the bypass procedure, the surgeon “staples” part of your stomach to make a smaller stomach pouch. This pouch is then directly connected to a lower portion of the small intestine, bypassing the duodenum. By making the stomach smaller and by bypassing the top section of the small intestine, the surgery will help you feel “full” faster and your body will be prevented from absorbing as many calories.

The most common type of bariatric bypass surgery is known as the roux-en-Y and it can be done via traditional or “open” surgery or by a laparoscope (a special and very small telescope used to examine the inside of the body.) Laparoscopic surgery usually means a shorter hospital stay and a faster recovery, but not everyone is a candidate for this technique. As well, another less common bypass option is the biliopancreatic diversion bypass. In this procedure, a portion of the stomach is removed. This is less commonly performed today. Your doctor will discuss all the surgical options with you.

Another alternative for bariatric weight loss surgery is the Lap-Band. This is a band or belt of silicone rubber that’s gathered around near the top of the stomach in order to reduce the amount of food it can hold. It effectively divides the stomach into two parts – somewhat like an hourglass, but with the top portion much smaller. It is adjustable and reversible although for some weight loss patients, it is not as effective as bypass surgery. Again, you should discuss your options with your doctor.

What are the possible complications of a bariatric weight loss surgery?

Bariatric weight loss surgery is considered a relatively high-risk procedure and there are a number of potential complications. For this reason, doctors rigorously screen potential candidates. They want to know that the risks of the surgery will be outweighed by the benefits you can expect. Risks include but are not limited to: blood clots in the legs; leaking at one of the staple lines in the stomach; pneumonia; narrowing of the opening between the stomach and small intestine; dumping syndrome (which leads to nausea, vomiting, diarrhea, dizziness and sweating.) and vitamin and mineral deficiencies. A risk of death has also been associated with the surgery.

At the same time, you should note that severe obesity in itself is considered a life-threatening disease. Your risk profile is unique. To get a true picture of what is best for you, it’s essential to talk to your surgeon in detail.

What happens after bariatric weight loss surgery?

Your recovery time will vary greatly, depending on your health and weight going into the surgery and on the type of surgery you have. Typically, you will not be allowed to eat for several days following the surgery, so that your stomach can heal. Then you will gradually add food into your diet in a controlled way for the following 12 weeks. You will be required to monitor your food intake for the rest of your life. As with any major surgery, you will be tired and may find moving difficult for the first six weeks. You should experience rapid weight loss in the first three to six months and, with proper attention to diet and exercise, should have lost about half of your excess weight within the first two years.

What are my expectations for success with bariatric weight loss surgery?

Some patients will lose as much as 200 pounds, but most others will have a more modest weight loss. Some will reach a normal weight while others will remain overweight – but less so than before. Some will regain the weight.

In order to maintain your weight loss, it’s essential to follow the diet and exercise plan that the surgeon will give you and to be psychologically prepared for the challenge. Many people also find joining a support group very helpful. As well, following the surgery, many patients will want plastic surgery to remove excess skin.