Most patients who research bariatric surgery realize that the two most performed bariatric surgeries in the United States are the gastric sleeve or sleeve gastrectomy, and the Roux-en-Y gastric bypass. There’s a good reason for these procedures being so prevalent. Both are proven with plenty of data behind them, and both allow patients to lose a significant amount of weight and improve or eliminate many of the diseases associated with excess weight and obesity. With such similarities, you might ask what the difference is and why you would choose one over the other. There are subtle differences between the two procedures, and we will discuss those in the article below. While your research may point you in one direction, it’s important to remember that a consultation with a qualified bariatric surgeon is the only way to know which procedure is best for your situation.
While many of us do not think much about the gallbladder, and we don’t need it to live, it represents an organ in the human body responsible for over 1 million surgeries every year. Many millions of Americans have gallstones – tiny, calcified pebbles in their gallbladder that sit there and don’t cause much trouble. Some patients can also have a large gallstone that can be alternately symptomatic or asymptomatic. However, when any stone blocks the outflow of bile into the stomach or gets lodged in the bile duct, it can be excruciating and even debilitating, with pain and discomfort occurring soon after a meal.
The class of drugs known as GLP-1 receptor agonists like Wegovy and Mounjaro have been held up as possible solutions to the worsening obesity crisis in the United States and around the world. These drugs are incredibly effective in well-selected patients. However, the hype has been such that many patients now believe that medication is all they need to lose their excess weight and hit their weight loss and disease resolution goals. Many patients look for this medication without considering whether they may be better suited to bariatric surgery. With that said, there is an excellent case for bariatric surgery for many patients who are currently taking Wegovy, Mounjaro, or other GLP-1 drugs off-label for weight loss. In this article, we dive into what these medications are and what they are not, where the effectiveness of medication ends, and where the usefulness of bariatric surgery begins.
What you drink after your surgical procedure makes a big difference in your eventual results and how you feel. Of course, we advocate for all patients to drink plenty of water and indulge occasionally in drinks that are low in calories and sugar (and complement the post-op diet nicely). However, the question of beer does sometimes pop up, mainly because many patients will have been used to enjoying a beer during a football game or at dinner, and it may be their preferred alcoholic beverage. With that said, while moderation is key, and most bariatric programs don’t want to limit their patients’ enjoyment too much, the simple fact is that beer is one of the more problematic beverages after surgery. Let’s dive into why:
Though it’s a different specialty, bariatric surgeons always take note of guidance from the American Heart Association or AHA. We do so because many metabolic disorders we treat are reflected in longer-term heart disease. When patients experience significant excess weight issues, especially obesity, the heart takes the brunt of the problem. For example, patients who are obese tend to have accelerated atherosclerosis or narrowing of the arteries due to plaque buildup along their walls. Type two diabetes is also a widespread consequence that can constrict arteries and cause cardiovascular issues and problems with virtually every organ in the body.
So, we listen when the AHA provides guidance on the diets they think are best for heart health. This is precisely what was published in Circulation recently. After reviewing comprehensive studies on diets, the AHA released its list of best diets, giving each a percentage score and grouping them into three distinct tiers.
Years, or even decades of excess weight, have likely made you question yourself, beat yourself up, and create a mental environment of negative self-worth. It sounds extreme when you read it on paper, but everyone does it to some degree or other, no matter how fit, intelligent, or beautiful they may be.
These years of beating yourself up and putting yourself down don’t just go away when you lose weight, even if your negative self-talk was very much weight related. Our minds are very flexible, and adaptability allows for significant changes that are needed to reverse some of these thoughts and actions. For example, think of a habit. Getting into a routine is often straightforward but surprisingly difficult to remove yourself from. As such, anyone who tells you that positive self-talk is all you need to get back on track doesn’t understand how the brain is wired for the challenges one faces after bariatric surgery.
You might wonder why every clinician you meet emphasizes drinking enough fluid after your bariatric procedure, and ultimately it comes down to one fundamental reason. Dehydration is a leading cause of hospital readmission after bariatric surgery. Drinking water after weight loss surgery may seem relatively straightforward. It can be difficult, even for a patient with an average size stomach, let alone someone whose stomach has been surgically reduced to just a few ounces.
Along with getting enough water, we must take physical and psychological cues from our bodies to know if we are drinking at the right time. While you may read the guidance of drinking 64 ounces or 8 cups daily, the amount you need will vary dramatically, depending on your exercise patterns, the temperature outside, and more. For most active post-bariatric patients, it may be closer to 80 ounces per day. Let’s delve deeper into what you should consider when determining how much water you need:
Obesity is linked to an increased prevalence of gastroesophageal reflux disease (GERD) – a chronic and persistent form of acid reflux. GERD can lead to severe complications, such as Barrett’s Esophagus, which increases the risk of esophageal cancer. In this article, we will compare LINX, fundoplication, and gastric bypass as treatment options for GERD.
Traditional Treatments for GERD
Lifestyle interventions such as improved diet and exercise are the most effective ways to address GERD. However, many patients rely on proton pump inhibitors (PPIs) to reduce stomach acid production. While PPIs can alleviate GERD symptoms, they may also have long-term side effects, such as bacterial dysregulation and alkaline burns to the esophagus.
The gastric band (Lap-Band & Realize Band (no longer on the market)) was a revolutionary device introduced over a decade ago as the first bariatric surgery that was adjustable and fully reversible in cases of need. Unlike stapled procedures, which are a one-and-done solution, your bariatric surgeon could implant the band and adjust it quickly and easily by increasing or decreasing the volume of saline in the small pillows that make up the inner part of the band. By adding saline, the band could be tightened, and patients would, theoretically, eat less; removing liquid loosened it, allowing the patient to eat more and relieve issues associated with overtightening.
Recovering from weight loss surgery and beginning your new gym life can be daunting. Whether it’s your first time at a gym or you’re returning to a previous workout routine, it’s crucial to make the right decisions for your body as it adapts to new and old exercises. In this guide, we’ll explore how to ease back into a healthy lifestyle without pushing your limits.
As a postoperative bariatric patient, you will experience plenty of physical and emotional changes. One such change is musculature. Well-developed muscle offers several benefits. It helps maintain joints, bone, tendon, and nerve structure, and it also helps burn more calories at rest, which aids in weight loss. However, the restrictive nature of the post-bariatric surgery diet can make it difficult for patients to maintain that muscle mass, let alone build more.
Prepare Yourself for CHANGE in Every Aspect of Your Life.
This one word – change. At first, when you hear it in the context of bariatric surgery, you are just so focused on getting thinner and healthier that you’re simply thinking of the physical. However, this choice and the change it ushers in will also affect every part of your life/work balance, relationships, mental health, family relations, and friendships. Social dynamics change a lot as you see life through a different lens. Dealing with that feeling can be emotional. Thoughts will go through your head like:
This never happened to me before; more smiles, more friendly people, more willing to help. Why?
When we weigh ourselves or look in the mirror, we don’t dig much deeper than the number on the scale or the image staring back at us. This is human nature, and we all do it. Similarly, when we visit our primary care physician for a yearly physical, we might learn more about the effects of our excess weight on various metabolic markers, like cholesterol, blood pressure, and diabetes. But by worrying about numbers alone, we often ignore the less obvious issues, like where the fat has accumulated. Visceral fat, the bad fat that accumulates around the abdomen is a serious concern and one that has not yet been given the importance it deserves.
A fascinating fact about abdominal fat and waist size is that the latter can predict heart disease more accurately than the ubiquitous body mass index or BMI. Female patients with a waist size over 35 inches and males with a greater than 40-inch waist ratchet up to a significantly higher risk of heart disease and other obesity-related conditions. One of the reasons for this is the pro-inflammatory effect visceral fat has throughout the body.
One of the most upsetting things to see in a relationship is your partner struggling with their weight and continually yo-yo-ing up and down. Getting excited at the achievements but then falling into deep frustration and maybe even depression at every failure. While it can be difficult and frustrating to watch, it is something that most partners of those suffering from obesity must live with as they try to lose weight. Ultimately, the hormonal and metabolic barriers to losing a significant amount of weight are such that 90 to 95% of obese patients trying to lose weight with diet and exercise alone simply can’t do so.
Much like other chronic diseases, obesity does not just affect the person. The entire family often suffers, even if they are not obese. A spouse may not be able to have the emotional and physical relationship with their partner that they once had or hoped to have. Kids often lose out on their parent’s attention and physical presence because of their inability to perform certain activities due to weight or navigating the parent’s preoccupation with body image and the emotional roller coaster that comes with struggling with weight.
When we’re younger, we’re fearless. We don’t mind climbing trees, making friends with strangers, or telling our secrets to people we’ve just met. We open our eyes and hearts to new experiences and people and trust that everything will be okay. But, somewhere along the way, we learn that vulnerability can hurt and be uncomfortable.
Brené Brown, a renowned professor, lecturer, author, and podcast host – best known for some popular TED Talks, has focused her research on shame, vulnerability, and leadership. Ironically, all 3 of those things can relate to a person on a weight loss journey and the journey itself.