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Bariatric Surgery Main
How do I know if weight loss surgery will be successful for me?How effective is weight loss surgery? How do I know if I am eligible for weight loss surgery? What are the risks of weight loss surgery? Will my health insurance pay for surgery? Why should I choose a multidisciplinary program? If I am interested in weight loss surgery, what is my first step? What should I bring to my first appointment with the surgeon? How long will I have to stay in the hospital after surgery? How big will my pouch be? Will my pouch eventually stretch, and if so, will that affect by success at maintaining weight loss? Is it possible to dine out and stick to your diet after your gastric bypass surgery? Can I get pregnant following gastric bypass surgery and is it safe? What if I have excess skin? What is the value of the a Support Group? Will I have to take vitamins? Should I exercise after weight loss surgery?What should I know about Addiction Transfer after Bariatric Surgery?
Weight lost after surgery is dependent on several factors, including:
Clinical studies show that following surgery most patients lose weight rapidly and continue to do so for approximately 18 to 24 months. Within 1 year, most patients can expect to lose about 65% of excess weight. And, the long-term success of weight loss surgery is defined as loss of 55% or more of excess body weight and maintenance of that loss for at least 5 years. Bariatric or weight loss surgery is recognized as the only effective means of long-term weight loss for patients who have repeatedly failed multiple, conventional weight loss attempts.
Bariatric surgery is an elective procedure for clinically morbidly obese people for whom substantive long-term weight loss is desired, but other weight loss approaches have failed.Dr. Thomas Brown, Medical Director for the Bariatric Surgery Center of Excellence at Presbyterian/St. Luke's Medical Center in Denver believes it is important to follow the guidelines supported by the National Institutes of Health to help determine a patient's eligibility for weight loss surgery. Factors considered for those who are potential candidates for surgery include people who:
All major surgery comes with risks, and the risks are different for each patient. At the Bariatric Surgery Center of Excellence at Presbyterian/St. Luke's Medical Center in Denver, our Medical Director, Dr. Tom Brown — and our entire team — are committed to quality outcomes and patient safety. We passed a rigorous review by the American Society of Bariatric Surgery (ASBS). ASBS has purposefully identified qualified hospitals and surgeons who have demonstrated a high standard of care in bariatrics. If you are considering bariatric surgery, it is critical to choose a Bariatric Surgery Center of Excellence to minimize the risk of complications and to ensure potential for long-term success. Our surgeons have better outcomes than most medical centers because we are a Center of Excellence. During your first appointment, your surgeon will explain your individual risk level.
Some insurance companies do have exclusions in their policies for weight loss surgery. An exclusion means that they will not pay for the surgery even if it is proved medically necessary. However, there are some insurance companies that will pay for a portion of the surgery. We can help you determine what your benefits are. Because we need to prove that surgery is medically necessary, we will put together a packet of information to submit to your insurance company. This packet will include your history and physical, nutrition consult, psychological evaluation, blood work, chart notes from your primary-care doctor, and any diet history information you give us.
Team approach to treatment. At the Bariatric Surgery Cener of Excellence at Presbyterian/St. Luke's Medical Center in Denver, people who are likely candidates for laparoscopic bariatric surgery will undergo a thorough team evaluation prior to any treatment. Under the Medical Direction of Dr. Tom Brown, Bariatric Surgeon, we strive for the most successful outcomes possible, ensuring our patients undergo a multidisciplinary medical evaluation prior to being accepted and scheduled for surgery. In addition, patients will have extensive follow-up by both the surgeon and other health professionals as they progress. Such an approach is associated with long-term successful weight loss. Surgical evaluation-a surgeon will discuss with the patient whether or not they meet the National Institutes of Health (NIH) requirements for undergoing the surgical procedure and whether they are a satisfactory operative risk. Nutritional evaluation-a nutritionist will help the patient decide whether they have sufficient motivation towards weight loss to make the necessary lifelong changes in eating habits and exercise that must compliment the surgical procedure. There is also a need for close nutritional monitoring during rapid weight loss, as certain vitamins and minerals are poorly absorbed and need to be supplemented. Psychological evaluation-there are two reasons for preoperative evaluation-to identify those in whom surgery would be contraindicated and discuss what adjustments might be needed before surgery is indicated, and to identify those in whom surgery is likely to be a success. The psychologist will discuss with the patient issues that are not unique, but certainly common, among many obese adults such as frustration, food cravings and obsessions, self-esteem or confidence issues, anxiety, and depression, and how surgery may realistically impact their life. Intensivist consult-it is important for the patient to have a thorough medication evaluation to ensure that the patient is medically ready for surgery. Bariatric surgery requires a long-term commitment to positive change on the part of the patient; eating habits, physical activity habits, and overall lifestyle habits will undergo significant modification. Clearly, the patient must be prepared and ready for such a challenge. Using such a team approach to bariatric surgery increases the likelihood of success in achieving desirable and realistic weight loss, as well as improvement and satisfaction in daily life for the patient long-term. We also provide and encourage involvement in a support group to assist patients in continuing to maintain their modified lifestyle they have chosen.
First, we would like to talk with you and get to know you. Creating a positive relationship with our patients is very important to us. You should establish a relationship with our team by completing the online contact form. One of our patient support staff will contact you within two weeks.
You also can attend a free Bariatric Surgery information session about our program and our weight loss surgery options. We will also schedule you for evaluations with a surgeon, a dietitian, and a mental health professional. All seminars on LAP-BAND System and Gastric Bypass are held at Presbyterian/St. Luke’s Medical Center,1719 East 19th Avenue, Denver, CO 80218 in Colorado Room North near the Denver Medical Library on the first floor. Please call the office to register for one of our weight-loss surgery seminars (303-861-4505).
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When you come to your first appointment, please bring the following information:
Your hospital stay will depend on the type of weight loss surgery you have. Generally, hospital stays are between one and three days.
The newly created pouch will be about the size of your thumb, with the capacity to comfortably hold about 2 ounces. With time, the pouch will enlarge to 6 to 8 ounces, but it must be carefully managed so that it does not enlarge too much too soon. That's why it is important to follow your dietary and nutrition guidelines that we carefully outline for you.
Soon after surgery, the average patient can eat approximately ½ to 1 cup of well-chewed food without discomfort. Patients must always eat slowly, reduce meal size, and avoid overeating or drinking excessive fluids.
However, it is expected that your pouch will stretch to 6 to 8 ounces at 1 year to 18 months. It is important to follow the dietary guidelines we provide for you and develop good eating habits to optimize weight. Failure to follow these guidelines can defeat the purpose of surgery.
Dining out can be a challenging event after your gastric bypass surgery. However, eating out is a reality for most us today. In fact, more than half of Americans eat out daily. Why is it so difficult to stick to your low fat diet when you dine out?
The answer is simple. Most restaurants serve large portions, tempting foods, and prepare the dishes with fattening oils, butter and sauces. In fact, some of the entrees at restaurants have more than 1,000-2,000 calories and 50-100 grams of fat per serving!
The dining out experience can cost you plenty of calories, fat and "weight loss frustration"! This may cause you to give up the healthy eating altogether. However, DO NOT LET IT RUIN YOUR HEALTHY GASTRIC BYPASS MEAL PLAN! And, we have plenty of tips and advice on how to successfully "dine out" without compromising weight loss.
Yes, pregnancy can be very safe following surgery. It is recommended that a woman wait until she is 1 year to 18 months post-operative before getting pregnant to assure that her weight has stabilized.
If a gastric bypass patient does become pregnant, it is important that labs are monitored regularly to ensure that vitamin or mineral deficiencies do not occur. A prenatal vitamin along with 1500 mg of Calcium needs to be taken daily to prevent neurological or skeletal defects to the fetus. Make sure that your surgeon is aware of your pregnancy so that they can make the appropriate referrals.
As you start losing weight, you may notice excess skin. The amount of excess skin you experience is due to your weight loss, age, and smoking habits. Sometimes, patients choose to have plastic surgery to have this skin removed. We have a surgeon who works very closely with our patients regarding plastic surgery.
Each month (the 3rd Wednesday of each month), the Bariatric Surgery Center of Excellence at Presbyterian/St. Luke's Medical Center holds a support group for its patients. It generally follows an education seminar on a topic of interest to most bariatric surgery patients (Dealing with New Body Image, Role of Plastic Surgery, Physical Therapy/Exercise Advice).
It is facilitated by bariatric surgery professionals-our nurse practitioner is the facilitator, and our dietitian and psychologist are frequent participants. It is a wonderful opportunity for our patients to gain insight and guidance as they journey through this major change in life.
Participation in our bariatric surgery support groups is strongly encouraged. Support groups are a valuable aid in learning and feeling comfortable with medications in your daily habits and lifestyle. Talking and sharing with other patients helps you realize any limitations you may feel, and that these limitations likely pale in comparison to those experienced by the person who continues to be morbidly obese.
Bring your family and friends as well, as support groups can be a great source of support and encouragement to them as they assist you in achieving your goals.
Yes, but the number depends on your weight loss procedure. The gastric bypass (RYGB) and duodenal switch (DS) procedures require a lifetime of vitamin supplementation — usually three supplements daily. The Lap-Band® requires a multivitamin everyday.
Regular exercise is extremely important for maintaining your weight loss. Your bariatric surgery team will help you with the types of exercise you should be doing, and how soon after surgery you should start doing them.
FAQ: I keep hearing about people who have bariatric surgery but then become compulsive shoppers, alcoholics or sex addicts. What is this?A: The phenomenon of substituting a compulsive behavior for another which is no longer available is called Addiction Transfer.
FAQ: How does a surgical procedure cause this?
A: The surgical procedure itself doesn’t. The problem occurs when patients who have used overeating as a coping skill are no longer able to do so because of their bariatric surgery. Unaware of what is going on, and stripped of their usual defenses, they find themselves increasingly distressed and begin to substitute a different behavior such as drinking, drugs, sex, gambling or spending to make themselves feel better.
FAQ: Is this a problem for all bariatric patients?
A: No, but it is something that every bariatric patient needs to be aware of. Patients who are at high risk are those who have a personal or family history of any type of addiction and those who have a history of clinically diagnosable eating disorders or eating to deal with emotional discomfort.
FAQ: What can be done about addiction transfer?
A: Awareness is extremely important. If patients can identify themselves as high risk early on, then they can begin working with a professional counselor to deal with underlying problems. Dealing with triggers to compulsive behaviors and developing healthy coping skills for emotional distress is essential. If signs of a problem are already evident, or even if there is just a question about what is normal or not, patients should not wait to seek professional help.
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