Ask the Expert: Is Weight Loss Surgery Right For Me?
Posted Jan 19, 2017
by Dr. Alexandre Figueiredo
Medical Content Manager
Weight Loss surgery defines a group of medical procedures that reduce the size of various parts of the digestive tract to help patients lose weight.
Weight loss surgery may be a long-term and effective solution for those patients who were not able to lose weight with traditional diet and exercise programs. Weight loss surgery is usually prescribed to patients with severe obesity whose Body Mass Index is over 30. Body Mass Index measures body fat based on a person's height and weight. For more information on how to calculate your BMI, read our Bariatric Surgery Guide. This is a free resource offering a detailed overview of the different bariatric procedures.
In this blog post, we are going to understand who is eligible for weight loss surgery, what actions should be taken before and after the procedure, and what benefits this treatment has. Dr. Grzegorz Kowalski from KCM Clinic in Poland is going to help us shed some light on this procedure.
Dr Grzegorz Kowalski, Md, PhD
Dr. Kowalski’s medical experience covers laparoscopic general surgery, bariatric surgery, and endocrinology. He currently practices at KCM Clinic in Jelenia Gora.
Dr. Kowalski, who is the best candidate for bariatric surgery?
Qualification criteria vary by country. Generally, patients with the following criteria are eligible for weight loss surgery:
BMI is ≥ 40, or the patient is more than 100 pounds overweight
BMI is ≥ 30-35 and the patient presents at least two obesity-related co-morbidities such as type 2 diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders. Additionally, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
What's the most important thing you wish patients understood about bariatric surgery?
Before going under the knife, we recommend our patients to lose weight, and for 2 main reasons:
Patients who lose weight before surgery are more likely to lose even more weight after surgery.
Patients who lose weight before surgery are less likely to experience complications during surgery.
The average operating time for patients who lose 5% of their weight before surgery is 36 minutes shorter than for those who did not. In other words, lower weight makes it easier for the surgeon to perform the procedure. Less operating time equals lower risk of complications. Research identified a direct correlation between pre-op weight loss and complication rates for gastric bypass patients and sleeve gastrectomy patients: the more weight patients lost before a gastric bypass surgery, the less likely they would experience complications.
Undergoing weight loss surgery marks the beginning of a new life: the operation is just the start of a new lifestyle the patient is strongly encouraged to implement. Poor lifestyle and food habits take time to change, and weight loss surgery will not work over the long term if patients don’t start making a healthier lifestyle their own.
We understand that weight loss surgery needs a strong commitment on behalf of the patient. What if this is not the case?
Let’s imagine a marathon runner: would he/she ever attempt to run a marathon without months of preparation, hard work and commitment? Of course not! The same happens with bariatric surgery patients: they should never undergo surgery unless they have prepared for it extensively, both on a physical and a psychological level.
The same happens once the procedure is done: if patients go back to their old habits after surgery, they may not only gain back the weight they lost but also experience a relapse in their obesity-related health problems.
The sooner patients start preparing for bariatric surgery, the more likely they will be able to get confident with their new lifestyle for a long-term weight loss and health improvement.
What happens after surgery?
Bariatric surgery is a major event in a patient’s weight-loss journey, but I would rather describe it as a new beginning.
Obesity is a lifelong disease and there is no operation, diet or medication that can by itself offer a permanent cure. Surgery with good aftercare and moderate lifestyle changes can give wonderful long-term results.
In the weeks following surgery, patients will have a plan to follow, including nutrition and workout guidelines. For starters, these may include a liquid diet, which is very important in the early stages. Later on, the diet may include soft or pureed foods, and eventually more regular food. While healing in the first few months, it is extremely hard to get enough fluids. Most surgeons advise patients to consume fluids daily to avoid dehydration, constipation, and kidney stones. Patients will also need to maintain a lifelong habit with daily supplements, including: multi-vitamins, vitamin D, calcium, iron, and vitamin B12.
Healthy lifestyle choices improve quality of life after surgery. Protein-rich foods are important: patients are advised to assume 60-100 g proteins daily, depending on their medical condition, type of operation and activity level. We warn patients to avoid excessive carbohydrate intake, such as starchy food (bread, pasta, crackers, refined cereals) and sweetened food (cookies, cakes, candies, or other sweets). Limiting carbohydrates to 50 grams per day, or less, helps avoid rebound hunger problems which may lead to weight regain.
What are the benefits of weight loss surgery?
As already mentioned, weight loss surgery has proved to be very effective in helping achieve long-term weight loss. When compared to diets, or with treatments with tablets to help weight loss, weight loss surgery has had more positive outcomes in terms of weight loss in obese people. In fact, weight loss surgery may be the most effective treatment for patients who are very obese. Weight loss surgery-related benefits include:
Type 2 diabetes may be completely reversed in many people who had weight loss surgery, or, in others, control over their diabetes may be greatly improved. Studies have shown that, in seriously obese people, having weight loss surgery may help them live longer. The reason behind this being less risk of stroke, heart attacks, some types of cancer, and liver disease that are not connected with alcohol.
Studies have also shown that people who had bariatric surgery are less likely to develop high blood pressure in the future than those having conventional weight loss treatments.
We would like to thank Dr. Kowalski for his precious contribution!
Dr. Kowalski also contributed to another article, “Bariatric Surgery: How do I choose the right doctor?”, with useful information about what to look for in a surgeon for your weight loss procedure.
If you are interested in a bariatric surgery, contact us! We are available 24/7 to connect you with the best clinics worldwide!
About KCM Clinic
KCM Clinic offers a wide array of procedures, ranging from diagnostics and gynecology to ophthalmology and weight loss. Actively involved in a scientific exchange with specialists at Sanford Health in the USA and Germany, KCM Clinic is ISO-certified.
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