Bariatric Surgery

Obesity is a chronic disease and must be recognized as a serious disease with weight-related complications such as elevated blood sugars, increased blood pressure and cholesterol, infertility, some types of cancer, sleep apnea, joint and back pain. “Bariatric” is a term that describes the branch of medicine that deals with the causes, treatment and prevention of obesity. Bariatric surgery and weight loss surgery are often used interchangeably when discussing obesity treatment options.

Bariatric surgery has been shown to be the most effective method for individuals to lose a significant amount of weight and to maintain a lower healthy body weight. The decision to undergo bariatric surgery is not an easy one. Bariatric surgery is only a “tool” to promote weight loss, while behavior modification and a personal commitment to lifestyle change depends on the individual patient. Healthy eating and exercise behaviors are part of any medical treatment plan for obesity. However, the patient is ultimately responsibility for carrying out the long-term commitment to behavior change for weight loss and weight maintenance.

Benefits of Bariatric Surgery

The benefits of weight loss and bariatric surgery cannot be overstated. Some of these many benefits include improvement or elimination of many obesity related diseases such as high blood pressure, high cholesterol, type 2 diabetes, gastroesophageal reflux disease (GERD) and obstructive sleep apnea. Hormonal imbalances often improve and can decrease infertility concerns. As co-morbidities improve, patients enjoy lower costs of medical care with decreased medication use and fewer medical appointments.

Many patients also experience a greater feeling of self-worth and a lower risk of anxiety and depression. This often leads to more social and work opportunities for the individual. Increased physical mobility is associated with improved family and employment productivity, reinstating self-esteem and self-confidence.

Bariatric surgery also comes with risks inherent to any surgical procedure. Surgical risks are discussed with during the pre-surgery visits with our bariatric team, so patients should be prepared to ask their questions at scheduled appointments.

Types of Surgery

Gastric Bypass (Roux-en Y Gastric Bypass)

Once the most commonly performed bariatric surgery in the United States, the Roux-en Y gastric bypass remains the ‘gold standard’ procedure. The average weight loss is between 65 to 80% of excess body weight, in addition to significant improvement of obesity-related diseases such as type 2 diabetes. The gastric bypass combines restriction of food intake with malabsorption of food calories.

Gastric Sleeve (Sleeve Gastrectomy)

The sleeve gastrectomy is currently the most popular bariatric surgery in the United States. Surgeons and patients appreciate the simplicity of the procedure as well as the effectiveness both in weight loss and disease resolution. The gastric sleeve procedure eliminates approximately 70 to 80% of the existing stomach to reduce the amount of food the patient can eat during a meal. Weight loss is slower compared to the gastric bypass; however, patients do experience an average of 60 to 65% reduction of excess weight.

Intragastric Balloon

The most recently approved weight loss device in United States is the intragastric balloon. We offer patients the single gastric balloon. It is a large durable balloon about the size of a grapefruit, which is filled with a saline solution. The gastric balloon occupies approximately 1/3 of the stomach capacity, which helps to prevent over eating. This procedure is appealing for patients who do not want surgery, and for those who have a smaller amount of weight to lose over a shorter period of time. The gastric balloon is FDA-approved for individuals with a of BMI 30 to 40.

Duodenal Switch

Revision surgery is often related to the duodenal switch. Approximately 80% of the existing stomach is removed, in addition to re-routing the small intestine, causing a malabsorption effect. The duodenal switch is a complex surgery that is most commonly performed as a bariatric revision procedure.

Bariatric Surgery FAQs

How much time off should I plan before returning to work?
We recommend one or two weeks depending on the type of work. Start slowly with half days and build up to a full working day. Safety of the patient is the most important during the healing process.
When should I start exercising after surgery?
Immediately! Start slow with short walks. Other “low impact” activities and lifting ‘light’ weights can be started in the first month. Build slowly over several weeks. Swimmers need to wait until their wounds are healed before getting back in the water.
If I had a prior abdominal surgery, can I still have laparoscopic surgery?
All patients need to discuss their past medical and surgery history with our bariatric surgeon. Any unusual or complicated procedures involving the gastrointestinal track (esophagus, stomach, intestines) may require extra pre-operative imaging or tests.
Am I at higher risk for surgery if I have type 2 diabetes?
Surgery risk depends on the patient’s overall health. Patients with long-term well- controlled blood sugars are likely to have relatively lower surgical risk.
Can I have laparoscopic surgery if I have heart disease?

We will work with your cardiologist to determine medical clearance for bariatric surgery.  It is important for all patients to bring in their current medication list to be reviewed during their pre-op visit. If a patient is on blood thinners of any type, expect special instructions just before and after surgery.

What about pregnancy after bariatric surgery?
We recommend waiting 12 to18 months after surgery before becoming pregnant. Our bariatric surgeon can answer these questions during follow up appointments.
Do I still need to take my medications after bariatric surgery?
Yes, unless our bariatric surgeon or internal medicine physician changes or discontinues a medication. All patients should have their medications reviewed by our physicians when they return for follow up appointments at the bariatric clinic.