BARIATRIC TREATMENT

How Does Bariatric Surgery Affect The Digestive Process?

2011-10-14T07:31:00.000-07:00

How Does Bariatric Surgery Affect The Digestive Process?(2)

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After Surgery
During both main types of obesity surgery, the size of the stomach is reduced by up to 90 percent, to the size of an egg or even the size of a thumb. Typically, its capacity is 3-4 tablespoons of food. This stomach reduction drastically reduces the quantity of food which can be consumed in one sitting and speeds up satiety. During bypass surgery, the digestive tract below the stomach is also altered. After leaving the small stomach pouch, food is re-routed to bypass most of the duodenum and is directed into the final part of the jejunum. Because the food passes along a much reduced length of small intestine, and comes into contact with smaller amounts of digestive enzymes, fewer calories and nutrients are absorbed.
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Bariatric surgery

2011-09-24T07:18:00.000-07:00

Bariatric Surgery

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Bariatric surgery, or weight loss surgery, is a type of procedure performed on people who are dangerously fat (obesity), for the purpose of losing weight. This weight loss is usually achieved by reducing the size of the stomach with an implanted medical device (gastric banding) or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestines to a small stomach pouch (gastric bypass surgery).

Long-term studies show the procedures cause significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 23% from 40%.

The U.S. National Institutes of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI 35 and serious coexisting medical conditions such as diabetes. However, research is emerging that suggests bariatric surgery could be appropriate for those with a BMI of 35 to 40 with no comorbidities or a BMI of 30 to 35 with significant comorbidities.

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Does Bariatric Surgery Typically Lead to Major Weight Loss?

2011-09-14T07:32:00.000-07:00

Does Bariatric Surgery Typically Lead to Major Weight Loss?
Bariatric Treatment
Some patients who undergo bariatric gastrointestinal surgery lose more than 100 pounds in weight - some lose as much as 200 pounds weight. Typically, patients who undergo adjustable gastric banding procedures, such as Lap-Band lose less weight than those who have gastric bypass like Biliopancreatic Diversion (BPD) or Duodenal Switch (BPD-DS). Some patients reach a normal weight, while others remain overweight, although less overweight than before. However, in order to maintain this type of weight reduction, patients must follow carefully the post-operative guidelines relating to diet and exercise.
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Who Is A Candidate for Bariatric Weight Loss Surgery?

2011-08-14T07:34:00.000-07:00

Who Is A Candidate for Bariatric Weight Loss Surgery?

Some bariatric surgeons accept patients in their 60's, and some even operate on teenagers. But because bariatric surgery is a last-gasp treatment solution for obesity, to be used when conventional weight loss programs have been tried and failed, candidates must have severe obesity-related health problems.

* Typically, to qualify for bariatric surgery you must be 'morbidly obese', which usually means being overweight by 100 pounds (man) or 80 pounds (woman) with a Body Mass Index (BMI) of 40+.
* Alternatively, bariatric surgery may be appropriate if you are 80 pounds overweight (BMI 35+) and have a serious obesity-related condition like type 2 diabetes or life-threatening cardio-pulmonary problems such as severe sleep apnea or obesity-related heart disease.
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Is Bariatric Surgery Dangerous?

2011-07-14T07:35:00.000-07:00

Is Bariatric Surgery Dangerous?

Yes. Both types of bariatric surgery (gastric banding and gastric bypass) involve major operations lasting one to two hours (longer if performed laparoscopically) and patients typically need three to five nights in hospital. The first night following the operation is usually spent in a high dependency unit or intensive care environment.
(Note: After laparoscopic bariatric surgery, patients typically remain in hospital for 2-3 days, rather than the 4-5 days after open surgery. Patients typically return to work after 2-3 weeks, compared to 4-6 weeks after open bariatric surgery.)
The level of health risk varies according to patient condition, type of procedure and the experience of the surgeon. (Patients are five times more likely to die if the surgeon has less experience, per University of Washington Study.) But in general, bariatric surgeries carry all the possible health risks of any major medical operation.
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Do Bariatric Patients Regularly Suffer From Health Complications?

2011-06-14T07:37:00.000-07:00

Do Bariatric Patients Regularly Suffer From Health Complications?

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It depends upon patient-condition, the complexity of the specific operation and the skill and experience of the surgeon. Recent research suggests that 4 out of 10 patients suffer complications within six months of surgery.
Of these patients, up to 20 percent required re-hospitalization to treat specific problems relating to their stomach bypass or gastric banding procedure. As well as perioperative and post-operative health problems, patients should expect to face a number of longer term physical and emotional problems.
To begin with, the recommended post-operative diet regime requires an immediate and drastic change of eating habits. Gastric bypass also necessitates nutritional supplementation for life. Secondly, after losing a significant amount of weight, patients typically experience a distressing amount of loose skin. Removal will require cosmetic/plastic surgery. Your surgeon and/or the staff at your obesity clinic will advise you about the specific weight-related health issues you are likely to face.
Bariatric Treatment

Are The Health Risks Of Bariatric Surgery Greater Than The Risks Of Obesity?

2011-05-14T07:38:00.000-07:00

Are The Health Risks Of Bariatric Surgery Greater Than The Risks Of Obesity?
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For most patients suffering from morbid obesity (BMI 40+), super-obesity (50+) or end stage obesity syndrome (BMI 60+), the big question is, do the benefits of bariatric surgery outweigh its risks? The answer is Yes.
Severe obesity is a chronic, frequently progressive, life threatening disease, and the known health risks associated with morbid obesity far outweigh the risks associated with surgery. Published studies indicate that someone who is 100 percent above his/her ideal weight has a risk of mortality ten times higher that of a person of normal weight. By comparison, the mortality rate for both vertical banded gastroplasty, adjustable gastric banding and roux-en-y gastric bypass is less than one percent.
Morbidity (ie. rate of disease) in the immediate post-operative period is roughly ten percent or more, although the combined risk of the most serious complications is less than three percent. In the later postoperative period, other health complications can and do arise, and may require corrective surgical treatment. Also, some patients are unable to comply with post-operative eating and exercise guidelines over the long term. But in general the overriding health benefit of bariatric treatment is now well established.
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Is Bariatric Surgery Covered By Health Insurance?

2011-04-14T07:40:00.000-07:00

Is Bariatric Surgery Covered By Health Insurance?

Health insurers are slowly beginning to accept that bariatric surgery can deliver powerful medical benefits that will save them money in the long run, especially where convention weight loss remedies have consistently failed to reduce obesity.
Therefore in several states, bariatric surgeries like gastric bypass and lap band are covered by most medical insurance plans. However, patients may need to work closely with their surgeon or clinic to submit the necessary forms to the health insurance company in order to receive authorization for weight loss surgery. This includes a Letter of Medical Necessity which typically (a) Patient's weight (BMI 40+ or 35+ with health complications),
(b) List of obesity-related medical symptoms (eg. type 2 diabetes, sleep apnea, raised blood pressure, high blood fats, insulin problems),
(c) How long patient has been overweight (at least five years),
(d) History of failed weight-loss programs, with details of type of program, whether or not medically supervised, amount of weight lost.
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Is Bariatric Surgery Effective?

2010-08-14T08:12:00.001-07:00

Is Bariatric Surgery Effective?

Given the serious, even life-threatening effects of severe clinical obesity, many medical experts support surgical methods to reduce morbid obesity, citing the relative ineffectiveness of conventional treatments such as diet, exercise and lifestyle counseling. However, others are concerned about the relative high rate of perioperative and post-operative complications of bariatric surgery, plus the difficulties experienced by patients in adapting to their new diet. Although research into surgical techniques, health risks and psychosocial factors is ongoing, the bottom line appears to be this:

* Bariatric procedures are serious operations with a risk of significant complications. Many gastric surgeries are irreversible. Thus before deciding, candidates should thoroughly discuss all their options with their doctor.
* Patients must have realistic and informed expectations about the impact of the bariatric surgery on their weight, body shape and eating habits.
* After bariatric surgery, it is vital to adhere strictly to the proper dietary and exercise guidelines.
* Participation in post-operative support groups is beneficial for many patients of bariatric treatment.
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What Do Doctors Think About Bariatric Treatment For Obesity?

2010-08-14T07:42:00.000-07:00

What Do Doctors Think About Bariatric Treatment For Obesity?

Many of the current standards and guidelines for performing bariatric surgery were set in 1991, by a Consensus Panel of physicians, sponsored by the National Institutes of Health (NIH). In particular, they established the body mass index (BMI) as the basis for selecting candidates for surgical bariatric treatment, to which was added the presence of severe comorbid conditions.
The panel also stated the necessity for patients to receive multidisciplinary care by a team of doctors and therapists, to handle their weight-related co-morbidities, and emotional needs. Bariatric operations were viewed as a means of enabling patients to change their lifestyle and eating habits, in order to reduce and manage their obesity.
Since 1991, there have been significant developments in the field of gastric reduction surgery, especially laparoscopy. As a result, a new Consensus Conference, sponsored by the American Society for Bariatric Surgery (ASBS), was held in 2004, which updated the evidence and the conclusions of the NIH consensus panel.
They concluded that:
(1) Bariatric surgery is the most effective treatment for severe clinical obesity.
(2) Stomach bypass is one of four types of surgical treatment for morbid obesity.
(3) Laparoscopic surgery is as effective and as safe as traditional open surgery.
(4) Bariatric patients should receive comprehensive pre-op assessment, and multi-disciplinary post-op support, in order to achieve the best weight loss results.
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How Does Bariatric Surgery Affect The Digestive Process?

2010-08-14T07:29:00.000-07:00

How Does Bariatric Surgery Affect The Digestive Process?
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Before Surgery
Food is chewed in the mouth, then swallowed, passing through the esophagus to the stomach, (roughly the size of a melon) where stomach acids dissolve it into smaller particles. The liquid (chyme) then passes into the small intestine where enzymes and bile continue the digestive process. The first section is the duodenum, the shortest section. Here, calcium, iron and a few vitamins are absorbed. The second and third sections are the jejunum and ileum, both about ten feet in length. Here, the bulk of food nutrients (vitamins and minerals) and calories are absorbed.
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bariatric-surgery

Introduction to Bariatric Weight Loss Surgery

2010-08-14T07:27:00.000-07:00

Introduction to Bariatric Weight Loss Surgery
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Bariatric surgery is a term derived from the Greek words: weight and treatment. Bariatrics concerns the causes, prevention and treatment of severe overweight, a condition known as obesity. Bariatric operations are major gastrointestinal procedures which alter the capacity and/or the anatomy of the digestive system. Some bariatric procedures are performed using general anesthesia via a midline abdominal incision.

Some bariatric surgeons also use laparoscopic surgical techniques, involving smaller instruments connected to cameras through which they view the operational site. The two types of bariatric surgeries are (1) restrictive - like Lap Band®, and (2) combined restrictive and malabsorptive - such as Roux-en-Y gastric bypass. The first type of surgical procedure simply reduces the size of the stomach, using staples and/or a band, resulting in a drastic reduction in the quantity of food it can ingest. The second reduces stomach capacity and bypasses the upper part of the small intestine, causing a reduction in the number of calories and nutrients which the body absorbs.

Stomach bypass operations differ in both how the stomach is sectioned (stapling, banding or gastrectomy), and how much of the duodenum and jejunum are bypassed. Currently, most obesity clinics and bariatric centers favor the Lap Band adjustable gastric banding procedure and the Proximal Roux-en-Y Gastric Bypass. Obesity experts estimate that patients undergoing gastric bypass and gastric bands will exceed 175,000 in 2007.
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Eating after bariatric surgery

2010-08-14T07:21:00.000-07:00

Eating after bariatric surgery
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Immediately after bariatric surgery, the patient is restricted to a clear liquid diet, which includes foods such as clear broth, diluted fruit juices or sugar-free gelatin desserts. This diet is continued until the gastrointenstinal tract has recovered somewhat from the surgery. The next stage provides a blended or pureed sugar-free diet for at least two weeks. This may consist of skimmed milk, cream of wheat, a small pat of margarine, protein drinks, cream soup, pureed fruit and mashed potatoes with gravy.

Post-surgery, overeating is curbed because exceeding the capacity of the stomach causes nausea and vomiting. Diet restrictions after recovery from surgery depend in part on the type of surgery. Many patients will need to take a daily multivitamin pill for life to compensate for reduced absorption of essential nutrients . Because patients cannot eat a large quantity of food, physicians typically recommend a diet that is relatively high in protein and low in fats and alcohol.
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