Bariatric Care Center California

The sole purpose of bariatric surgery is to lose weight. Weight loss can be usually achieved by reducing the size of the stomach by either removing a portion of the stomach with either biliopancreatic diversion with a duodenal switch or sleeve gastrectomy or with an implanted device called gastric banding. Gastric bypass surgery is also a method that involves restriction and re-routing the small intestines to a small stomach pouch.

Studies proved that these procedures can significantly reduce long-term weight loss. Due to this, patients have recovered from several diseases like diabetes and reduce the risk of cardiovascular diseases.

Research has shown that most people who are overweight experience depression and also other mental health problems. Patients with these problems who want to consider bariatric surgery are needed to have a complete mental evaluation before the surgery. But, the history of depression may not prevent the surgery from taking place.

Bariatric patients who suffer from depression can experience health problems and quality of life improvements when compared to non-depressed patients. Use of antidepressants by patients who had depression decreased it by about 20 percent one year after the surgery and remain at that level after three years of follow-up.

Anxiety and depression are common among people with chronic conditions like type-2 diabetes and obesity and these conditions can sometimes interfere with treatment.

In recent years most people are undergoing weight loss surgery. Women undergoing the surgery are increasing, particularly during their childbearing ages. The most common weight loss surgery that women are considering is sleeve gastrectomy.

Sleeve gastrectomy is the weight loss procedure in which the surgeon staples the stomach across the top and leaves a small pouch that can hold only a small portion of the food. After that the surgeon cuts a part of the intestine and sews it onto the pouch. This surgery restricts your ability to absorb calories from the food.

Effects of weight loss surgery on your pregnancy:

Early reports suggest that weight loss surgeries can cause more complications during pregnancy such as bleeding in the stomach or intestines, anemia, incomplete growth of the baby in the uterus. But, according to the recent studies, weight loss surgery helps to protect obese women and their babies from several health complications during pregnancy. They include:

• High blood pressure
• Gestational diabetes
• Cesarean delivery
• Overweight babies

Also reports said that weight loss surgery may boost a woman’s fertility. Women who have fertility problems due to obesity when undergo weight loss surgery can ovulate regularly for the initial time in years. Women who have PCOS may also observe great change in their fertility after undergoing the surgery.

Here are few things for women who are considering weight loss surgery and planning for pregnancy in future:

• Women who have undergone bariatric surgery should weight 18 months before getting pregnant. After having the surgery a woman’s body goes through several stressful changes and major nutritional disturbances that can cause problems to a growing baby.
• Weight loss surgery is not suggested for every woman who wants to become pregnant in near future. It is only for women who are extremely obese and have health problems due to overweight.
• After the surgery, you need to monitor your nutrient intake closely.
• You should know that your risk of complications drops but they don’t go away.
• You are more likely to have a cesarean.

Before undergoing the surgery, talk to a bariatric surgeon and also a medical professional who deliver your baby.

Sleeve gastrectomy is a restrictive weight loss procedure. It is restrictive in the sense that ‘restricts’ the amount of food the stomach can hold. In this procedure, stomach is reduced to 25% of the original size and a major portion of the stomach is removed. The open edges are attached leaving a small sleeve or tube, which is shaped like banana. Hence, the name sleeve gastrectomy.

The surgery is performed laproscopically involves stapling of the stomach upon removal of the left side of the stomach. Stapling of the stomach is done by harmonic stapling device. The surgery is performed by making a curve on the stomach. Surgery of the stomach is completed laproscopically and is irreversible.

Sleeve gastrectomy is performed on patients with BMI (Body mass index) more then 40, who are exceptionally considered as obese. Patients with high BMI rate are at increased risk of bariatric surgery. Hence, surgeon recommends the first part of sleeve gastrectomy to be performed in two stages. The first stage of surgery called as sleeve gastrectomy, helps to reduce weight for the first year earlier to second stage of surgery called as duodenal switch or gastric bypass surgery. For remaining weight loss, bypass is suggested. Complications related to weight loss are very less as the patient losses weight from sleeve gastrectomy. Therefore, the risks are very low associated with second surgery to do bypass. If patient losses weight by sleeve gastrectomy then the second stage of surgery is not required.

Sleeve gastrectomy advantages:

·         The surgery is done laparoscopically

·         The procedure performed is simpler compared to gastric bypass

·         The recovery time is very shorter

·         Pyloric part of stomach is left integral owing to dumping syndrome

·         The operative time is very less than bypass surgery

·         Foreign bodies are not used in this surgery

·         Less pain, fewer incisions

·         Condensed stomach volume enhances the sense of fullness

·         Functioning of stomach is normal only when a small quantity of food is allowed.

·         Hunger invigorating hormone is detached from the stomach portion

·         For morbidly obese sleeve gastrectomy is a safer procedure

Sleeve gastrectomy disadvantages:

·         Leakages and hemorrhages are seen sometimes, because of intra-abdominal pressure as a portion of stomach is removed and the edges are stapled. These kinds of leakages can be easily treated further.

·         Irreversible

·         Hernia is one of the possible complications. Therefore, surgery is required to treat the condition. Fifteen percent of the cases are seen.                                     

·         A hollow tube as passage linking the walls of the abdomen and stomach is called gastric fistula created by surgery. This is another possible complication.

·         Gastro esophageal reflux the irritation caused due to acids in the stomach, which leads to heartburn. It is uncomfortable as it is caused due to the changes in the shape of the stomach.

Bariatric weight loss surgery is not a quick fix. It is a continuing journey to weight loss through lifestyle alterations. Following the surgery, difference in your body makes it physically easier to adjust with your eating and lifestyle habits.

Life after the bariatric surgery brings a drastic change in your life. Weight loss surgery is not a cure for obesity, but it is a process to help you lose weight for living a longer, healthier and more fulfilling life. Success of the surgery mainly depends on your ability to follow the guidelines for exercise, diet as well as lifestyle changes.

Medications after the surgery

After the surgery, you can’t take whole pills. You need to make adjustments to your medicine regime at the time of your operation, so that you can safely continue taking the comparable daily dosage. To prevent ulcers, your doctor will recommend a daily acid reducer like cimetidine or ranitidine. Avoid consuming non-steroidal anti inflammatory drugs such as ibuprofen, Celebrex, aspirin, Motrin, Naprosyn, and Advil. These medications can cause ulcer formation. After undergoing the surgery, it is more difficult to diagnose and treat ulcers.

Your doctor will recommend a daily dosage of multivitamin and minerals supplement containing a minimum of 400 mcg of folic acid.

Returning to work

Ability to returning to your daily activities will depend on your physical condition and the type of surgery you had. Most of the people who experienced bariatric surgery will return to their work within one to three weeks after the surgery. Patients who had open surgery will return to work after six weeks.

Pregnancy and birth control

Pregnancy places added demands on your body and the possibility for fetal damage make this a most considerable necessity. Women who want to use birth control should consider the most effective forms for first 16-24 months after the surgery.

Follow-ups after bariatric surgery

We all know the short-term effects of bariatric surgery very well, but there are still questions to be answered about the long-term effects on your body system and nutrition. Nutritional deficiencies that occur over the course of many years need to be studies and mostly depend on your diet after the surgery. You need to take regular visit to your doctor for anemia, vitamin B12, folate and iron levels.

Support groups

Support groups can provide patients a chance to discuss their personal and professional problems. Keep contact with a weight-loss or bariatric support group. The key is to maintain a well-balanced diet and moderately strenuous activity.