Frequently asked question about Bariatric Surgery

Frequently Asked Questions About Morbid Obesity Surgery
Yes! Weight loss surgery improves fertility especially in women suffering from PCOD (Polycystic Ovarian Syndrome) and the ones who are having difficulty in conceiving. In fact, several women who are trying to conceive are advised to lose weight to increase the chance of conception and a healthy pregnancy.  
As you lose weight after bariatric surgery, you may be able to reduce or eliminate the need for many of the medications you take for high blood pressure, heart disease, arthritis, cholesterol, and diabetes. If you have a laparoscopic gastric bypass, sleeve gastrectomy or a duodenal switch, you may even be able to reduce the dosage or discontinue the use of your diabetes medications soon after your laparoscopic bariatric procedure.
Yes, it is possible to perform bariatric surgery in mild heart disease, but you may need medical clearance from your cardiologist. Bariatric surgery leads to improvement in most problems related to heart disease including:
  • High Blood Pressure
  • Cholesterol
  • Lipid problems
  • Heart enlargement 
  • Vascular and coronary heart disease
During the pre-anesthetic screening process, be sure to let your surgeon or nurse know about any heart conditions you have. Even those with atrial fibrillation, heart valve replacement, or previous stents or heart bypass surgery usually do very well. If you are on blood thinners of any type, expect special instructions just before and after surgery.
You will need to take a multivitamin for life especially after bypass surgery. You may need higher doses of certain vitamins or minerals, especially Iron, Calcium, and Vitamin D. You will also need to have at least yearly lab checks. Insurance almost never pays for vitamin and mineral supplements but usually does pay for labs. You can pay for supplements out of a flex medical account.
It can be a little risky to operate if you have uncontrolled diabetes. Be sure to follow any instructions from your laparoscopic surgeon about managing your diabetes around the time of obesity surgery. Almost everyone with Type 2 Diabetes sees big improvement or even complete remission after bariatric surgery. Some studies have even reported improvement of Type 1 Diabetes after bariatric procedures.
Twice to thrice in the first year and then once in every year for atleast 5 years you need to come to World Laparoscopy Hospital for consultation..
After obesity surgery, most patients return to work generally in one or two weeks. You will feel tired for a while after surgery and may need to have some half days or work alternate day for your first week back. Your laparoscopic surgeon will give you clear instructions depending upon the type of bariatric surgery performed upon you.
Generally, a hospital stay can be between three to four nights, unless there are situations demanding longer stay due to co-morbid conditions/high-risk patients and adverse events. 
It is 1.5 hours to perform Gastric Bypass procedure and requires three to four days hospitalization. 
One loses approximately 60 to 80 % of excess body weight at a pace of 6 kilograms weight loss every month. The weight loss is long term and sustained. 
There are two basic types of bariatric surgery -- restrictive surgeries and malabsorptive surgeries. Each helps with weight loss in different ways.

Restrictive bariatric surgeries (like adjustable gastric banding) work by physically restricting the stomach's size, limiting the amount of solid food you can eat. A normal stomach can hold about three pints of food. After weight loss surgery, a stomach may only hold one ounce of food, although over time it may be able to hold two or three ounces of food.

Malabsorptive bariatric surgeries (like gastric bypass) work by changing the way your digestive system absorbs food. This type of weight loss minimal access surgery is more complicated. The laparoscopic surgeon removes parts of your intestine, creating a shortcut for the food to be digested. This means that fewer calories get absorbed into the body. The combined malabsorptive/restrictive surgery also creates a smaller stomach pouch, which restricts the amount of food you can eat.
It entirely depends on the type of procedure. Roux-en-Y Gastric bypass and Mini Gastric Bypass is reversible; however, sleeve gastrectomy is irreversible. 
Yes! World Laparoscopy Hospital Accredited by National Accreditation Board for Hospitals and Healthcare Providers.
Yes, regular exercise is necessary for maintaining weight loss. 
• Eat small meals
• Eat a nutritious and balanced diet (high in protein and low in carbohydrates and fats).
• Exercise regularly.
• Regular follow up with your surgeon. 
The Pros:

• Weight loss is quick and sustained (long term).
• Because weight loss is quick, weight-related health problems such as diabetes, high blood pressure, high cholesterol, arthritis, sleep apnea, and heartburn improve quickly.

The Cons:
• The surgery may result in dumping syndrome, which occurs when food moves too quickly through the stomach and intestines. Dumping syndrome can cause sweating, dizziness, nausea, and severe diarrhea. Dumping syndrome happens in response to a carbohydrate-rich diet. However, this can be easily avoided if you follow small dietary modifications suggested by the nutritionist.
• Staple line leak. 
The Pros:
• Eliminates the portion of the stomach that produces the hunger-stimulating hormone (Gherlin).
• Dumping Syndrome is not observed.
The Cons:
• A gastric sleeve is irreversible.
• There are chances of weight regain in case the patient does not adhere to a healthy lifestyle.   
During your counseling and evaluation, the doctor will explain the risks pertaining to each individual. It varies patient to patient.
As you start losing weight after bariatric surgery, you will likely be thrilled with your new appearance. However, many people who lose a lot of weight often find their skin looks loose and baggy especially if your age is more. You may want plastic surgery can be performed to remove this excess skin.
A typical weight loss surgery at World Laparoscopy Hospital can run from $5,000 to $10,000. It can be paid by the insurance company but every insurance company is different, but before agreeing to cover the surgery, most insurance companies want documentation of the patient's struggle with obesity. They want a primary care doctor's records indicating that the patient has tried to lose weight through diet, exercise, and psychological counseling. Also, the medical causes of obesity must be ruled out. It pays to ensure that your doctor documents your efforts early on, so surgery is an option later.
Most women are much more fertile after bariatric surgery, even with moderate pre-op weight loss. Menstrual periods can become regular after bariatric surgery and you can get pregnant when you least expect it!
It will depend on the type of surgery and the type of your work. You must plan to take out 7-10 days from work if recovery is uneventful. 
You will take initially gentle, short walks during the first few postoperative days. The key is to start slow. You should watch the response to your body and your laparoscopic surgeon. If you lift weights or do sports, stay “low impact” for the first month. Build slowly over several weeks. If you swim, your wounds need to be healed over before you get back in the water.
Weight loss surgery is not for everyone. The laparoscopic surgeon generally recommends bariatric surgery only for people who:
  • Have a body mass index (BMI) of 40 or more
  • About 100 pounds overweight for men and 80 for women
  • Have a lower BMI (35 to 40), but also have serious health problems related to obesity such as heart disease, type 2 diabetes, high cholesterol, or severe sleep apnea
The common procedures we perform are:
• Gastric Bypass
• Sleeve Gastrectomy
• Minigastric bypass 
Of the people diagnosed with type-2 diabetes, about 60 percent are also diagnosed as obese. This fact provides an interesting clue to the link between diabetes and obesity. Understanding what causes the disease will hopefully allow us to prevent diabetes in the future.

Being overweight places extra stress on your body in a variety of ways, including your body’s ability to maintain proper blood glucose levels. In fact, being overweight can cause your body to become resistant to insulin. If you already have diabetes, this means you will need to take even more insulin to get sugar into your cells. And if you don’t have diabetes, the prolonged effects of the insulin resistance can eventually cause you to develop the disease.

The good news is type 2 diabetes is largely preventable. Research studies have found that lifestyle changes and small amounts of weight loss in the range of 5-10% can prevent or delay the development of type 2 diabetes among high-risk adults. Lifestyle interventions including diet and moderate-intensity physical activity (such as walking for 150 minutes per week) were used in these research studies to produce small amounts of weight loss. The development of diabetes was reduced 40% to 60% during these studies that lasted 3 to 6 years. Preventing weight gain, increasing activity levels and working toward small amounts of weight loss if you are overweight can have a big impact on the likelihood that you will develop diabetes in the future. Managing your weight is the best thing you can do to prevent the development of diabetes. 
 
Yes, after gastric bypass surgery, you will require a lifetime of vitamin supplementation. After the sleeve it is not that much important.
After bariatric surgery, Some hair loss is common between 3 and 6 months following surgery. The reasons for this are not totally understood. Even if you take all the recommended supplements, hair loss will be noticed until the follicles come back. Hair loss is almost always temporary. Adequate intake of protein, vitamins, and minerals will help to ensure hair re-growth and avoid longer-term thinning.
No. You can opt for many healthy alternatives like foods and drinks at social functions with the help of your nutritionist.

 

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