5 Surefire Ways to Derail Your Postop Bariatric Success

February 21, 2024

Woman with head on her knees wrapped in arms next to scale

Bariatric surgery, as a specialty, is unique, and bariatric practices work with patients on both the physical and psychological levels. Many bariatric surgeons claim they can predict whether a patient will be successful, and to some degree, they can. They’re not looking to see a patient fail; rather, it helps them manage patient selection and expectations before surgery. It also helps them identify and help their patients avoid the most common pitfalls that make bariatric surgery unsuccessful. Today, bariatric surgery performed by an experienced and knowledgeable weight loss surgeon is very successful, with historically low complication rates. As such, it often remains up to the patient whether they will take full advantage of the tool they have been given.

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Obesity & Enlarged Labia / Labial Hypertrophy

February 7, 2024

By now, it’s clear that obesity affects just about every part of the body and causes significant physical and psychological ramifications. We commonly discuss the most visible of these concerns, but discussing areas of the body that hide behind our clothes is also important. Often concerning and rarely talked about is the likelihood of labial hypertrophy or excess labial tissue caused by excess weight and obesity.

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Avoiding Reflux After Bariatric Surgery

January 24, 2024

Woman touching chest experiencing heartburn and reflux symptoms

Bariatric patients are among the most knowledgeable and well-read in all medicine. When speaking to patients, it’s often surprising and refreshing to hear how much they already know about their surgery of choice. During this research, the patient usually comes across the concept of reflux after their bariatric surgical procedure (usually gastric sleeve) and wonders if it could happen to them. The short answer is that we genuinely don’t know, but there are ways to reduce the risk, and we discuss them in this article.

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Pfizer Discontinues Twice Daily Weight Loss Pills in Clinical Trials

January 10, 2024

It was recently announced that Pfizer discontinued a clinical trial for a twice-daily oral weight loss medication developed as an alternative to weight loss injections. The promise of this medication was significant – Pfizer, for one, thought it was a $10 billion drug with greater potential in the future. More importantly for patients, however, there was the hope that it would offer those who did not want to inject themselves with GLP-1 receptor agonist medication, like Wegovy and Mounjaro, an alternative pill form.

However, much like the injected weight loss medications above, there were side effects. While the side effects were generally well tolerated by many patients in the injection trials, they were far less accepted in pill form. Most side effects were mild and gastrointestinal-related, but they were significant and persistent enough that many patients dropped out of the clinical trial.

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Do Surgeons Reinforce or Buttress the Staple Line During Bariatric Surgery?

December 20, 2023

surgeons handing off scalpel in operating room

One of the most exciting parts of being in the bariatric field is seeing the excellent and in-depth questions bariatric patients have. Weight loss surgery patients are some of the most educated on their procedures. As such, we’re often surprised by great and often very technical questions, one of which is whether bariatric surgeons use reinforcement or buttressing on the staple line during bariatric surgery.

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Comparing The Gastric Bypass to The Gastric Sleeve

December 6, 2023

woman holding diagram of intestines in front of body

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.

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Do Bariatric Surgeons Remove the Gallbladder During Bariatric Surgery?

November 22, 2023

operating room with surgeons around the table

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.

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The Case for Bariatric Surgery in the Day of Wegovy & Weight Loss Medication

November 8, 2023

diabetes injection held by person wearing glove

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.

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What Should Bariatric Patients Do if They’re Always Hungry After Working Out?

October 25, 2023

woman exercising on floor next to weights on yoga mat

It can sometimes feel like a chore. As a bariatric patient, not only do you have to limit your diet and the calories you consume, but you must also go and work out. Sometimes, especially when motivation is waning, keeping this kind of schedule can be challenging, to say the least; even more challenging, however, is getting to the gym and doing your workout, yet feeling hungry afterward. Before we get into how to manage this, you need to know that this is normal. When our bodies work hard, we crave what we need to recover: restorative nutrition. However, uncontrolled eating after a workout needs to be limited. Let’s talk about how to do it.

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Why Beer May Be the Worst Drink After Bariatric Surgery

October 11, 2023

beer glasses lined up full on counter

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:

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How an AHA Statement on Diets Affects Bariatric Patients

May 25, 2023

assorted wines and other mediterranean diet foods on table with ocean view

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.

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Three Tricks to Reducing Negative Self-Talk After Bariatric Surgery

May 11, 2023

woman looking at herself in the full length mirror while standing

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.

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Rethinking How You Consume Your Daily Water

April 27, 2023

Woman sitting down drinking a glass of water

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:

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Understanding GERD Treatment Options: LINX, Fundoplication, and Gastric Bypass

April 13, 2023

Woman holding her chest from GERD symptom pain

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.

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Gastric Band Failure. Will It Happen, and What to Do?

March 30, 2023

person holding cut out of digestive system, stomach and intestines

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.

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