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Life After Bariatric Surgery

    • Bariatric surgery can greatly improve the health of people who are severely obese and have tried unsuccessfully to lose weight on their own. More than 200,000 bariatric procedures are performed in the United States every year with a high success rate. Around 80 to 95 percent of patients lose 60 to 70 percent of their excess body weight and maintain this loss.

      By reducing their weight, many patients experience extensive health benefits because maintaining a healthy weight reduces the incidence of high blood pressure and cholesterol, arthritis, sleep apnea, type-two diabetes, certain cancers and heart disease.

      But surgery alone isn’t enough. A successful outcome involves more than an operation – it requires making major lifestyle changes for the rest of one’s life.

      “Surgery is a wonderful tool and can be life-changing, but it is not a magical wand,” explains Ajay Upadhyay, M.D. , FACS, FRCS, general surgeon and medical director of the Metabolic & Bariatric Surgery Program at Alta Bates Summit Medical Center. “To achieve a successful outcome after surgery, patients must adhere to a comprehensive follow-up program that includes periodic health checkups, dietary counseling, support groups and exercise.”

    • What is Obesity?

    • Obesity is a widespread, chronic disease that undermines the health of patients. Physicians often use body mass index (BMI) to define obesity, which is an individual’s body weight (in pounds) divided by height (in inches) squared. Approximately nine million American adults are severely obese, which means they have a BMI over 35.

      “People with a BMI under 30 can usually lose weight through exercise or medication,” Dr. Upadhyay says. “However, most with a BMI over 35 are unable to lose weight by traditional methods and keep it off, so surgery is often necessary.”

      Doctors frequently recommend surgery for patients with the following BMIs who have tried to lose weight unsuccessfully on their own:

      • BMI over 40
      • BMI of 35 who also have a medical disease related to obesity

    • What Does Surgery Involve?

    • “Compared to a decade ago, bariatric surgery is much safer and more effective,” observes Dr. Upadhyay. “The development of a minimally invasive surgical technique called laparoscopic surgery has greatly improved bariatric procedures. Because laparoscopic bariatric surgery only involves a few small incisions, post-surgery recovery is minimal and most patients stay in the hospital one or two nights.”

      Some common procedures include:

      • Gastric Bypass: Stomach is stapled to form a small pouch and a small section of the small intestine is attached to the new stomach pouch so less food is absorbed.
      • Laparoscopic Adjustable Band: An inflatable adjustable band is placed around the upper part of the stomach that is adjusted to reduce stomach size and limit food intake.
      • Laparoscopic Sleeve Gastrectomy: This procedure involves removing 75 to 85 percent of the stomach, creating a small sleeve about the size and shape of a banana that limits food intake.

      Although there are many different types of procedures, most work by reducing the stomach dramatically – sometimes to the size of an egg. After the surgery, patients eat much smaller portions of food, but feel very full and satisfied, which facilitates weight loss. Because patients are eating less, they must make sure that they are consuming foods rich in key nutrients. Meeting regularly with a dietary nutritionist is important.

    • Life After Bariatric Surgery

    • Bariatric surgery is most successful when patients make major changes in their lifestyles and commit to those changes for the rest of their lives. Studies show that patients are more likely to make behavioral changes when they know that their doctor will be checking on their progress at regular follow-up appointments.

      “Patients should regularly follow up with their primary care physician and surgeon, who can make sure there are no medical complications,” notes Dr. Upadhyay. “They should also take vitamin supplements and exercise to maintain weight loss and muscle mass. Without proper after care, 10 to 15 percent of bariatric surgery patients may regain the weight they lost.”

      Programs that provide comprehensive services are more successful at treating a chronic and complex medical condition like obesity. Alta Bates Summit Medical Center offers a comprehensive bariatric surgery program that has been certified as a Center of Excellence based on its expert medical practitioners, successful treatment outcomes and premier range of comprehensive services both before and after surgery.

      To help you achieve a healthy weight and lifestyle, our program includes regular follow-up appointments with physicians, dietary education and counseling, monthly support groups, and psychological counseling. Patients considering bariatric surgery should discuss the options with their doctor, who will determine the best procedure based on a patient’s medical condition, weight and risk profile.

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