What are the primary risks related to obesity?
According to the CDC, obesity-related risks include three diseases that are the leading killers of Americans: heart disease, cancer and cerebrovascular conditions, including stroke. Obesity also contributes to diabetes, the sixth-leading cause of death in America.
Surgery
How do I know if I qualify for weight loss surgery?
To be eligible, you must have a BMI of 40 or greater without comorbidities or a BMI between 35 and 40 with at least two co-existing comorbidities related to obesity. In addition, you must show that you have seriously tried to lose weight in the past; have no physical, mental or other problems that would make surgery unnecessarily risky; and be able to participate in your treatment and lifetime follow-up care.
Why do I need a psychiatric evaluation before surgery?
There are two reasons. First, because an evaluation is required by our program and may be required by your insurance company. Second, because we need to assess how well you understand the surgery and its risks and whether you have the ability to make the lifelong commitment required to maintain good health.
How long does the surgery take?
It depends on your physical condition and the type of procedure you have. In general, it can take anywhere from 30 minutes to 1.5 hours.
What kind of staples are used in the surgery?
They are made of stainless steel or titanium and are very small.
Will the staples set off metal detectors?
No.
How big will my stomach pouch be after surgery?
The pouch will hold about one ounce.
Do men and women respond differently to the surgery?
Not significantly. Both respond well, though men tend to lose weight faster than women.
How old do I have to be to have weight loss surgery?
The American Society for Bariatric Surgery and National Institutes of Health recommend patients should be at least 18, although some have been as young as 14. This is primarily because younger patients may not have matured physically to the point that their body can handle the procedure or emotionally to the point that they can make a decision this important.
Is there an age limit?
For our program, we will evaluate patients for a gastric bypass up to the age of 60. For patients between the ages of 60 and 65, we recommend the adjustable gastric band as there are fewer potential complications, and older patients do not handle complications well.
Can weight loss surgery help me live longer?
Yes. On average, weight loss surgery increases life expectancy up to 6.5 years. By comparison, heart bypass surgery increases life expectancy by about 3.5 years.
After Surgery
How long do I have to stay in the hospital?
Most patients leave one to three days after surgery. Our average length of stay is 1.82 days.
When can I go back to work?
The usual timeframe for returning to work is 10-14 days.
What kind of exercise regimen should I follow after surgery?
Exercise is an important part of your recovery. Patients begin walking the day of their procedure – they walk a little more the next day, a little more the day after that, and so on. As you get stronger, you should aim to reach 30 minutes of aerobic exercise every day.
How long should I wait before getting pregnant?
We recommend that you wait at least 18 to 24 months after surgery. By then, your body should be strong and stable enough to carry a properly nourished fetus. However, we strongly recommend that you consult your doctor if you are planning a pregnancy.
Can I take medications?
At first, your doctor may recommend taking pills in liquid or crushed form. After the first six weeks, most pills and capsules should easily pass through the stomach pouch.
Are there any limitations on the medicine I can take?
Diuretics and over-the-counter pain medicine should be avoided. Diuretics cause your kidneys to lose potassium, and most weight loss surgery patients already experience a reduction in potassium intake just because they are eating less. Over-the-counter pain medicines can cause ulcers in the small stomach and bowel. Always consult with your bariatric surgeon about the medications you are taking or wish to begin taking.
Can I start smoking again?
We recommend strongly that you do not. It increases the potential for lung problems after surgery, stalls the healing process, promotes infection and interferes with the blood flow to tissues that are healing.
When can I resume sexual activity?
Sexual activity can resume usually within 7-10 days, but it depends on how well and how fast your wound heals and on your threshold of discomfort from the surgery.
Should I worry about losing too much weight?
No. But if you are concerned about your weight loss, talk with your surgeon.
Will I lose my hair after surgery?
Some patients experience either hair loss or thinning, typically in the first four to eight months after surgery. In most cases, it comes back naturally. You can help prevent hair loss by getting enough protein with meals and by drinking sufficient fluids during the day.
When can I start driving again?
You should wait to start driving until your doctor clears you. Usually you'll be able to drive again one week after surgery.
Diet and Eating
When will my appetite return?
Every individual is different. Some people experience a return in appetite shortly after surgery, while for others, it takes longer. Usually, hunger returns three to six months after surgery.
How much water or fluids should I drink?
You should drink 64 oz. of sugar-free, non-carbonated, caffeine-free fluids per day; drink it slowly, in small sips.
Why do I have to drink so much?
As you lose weight, waste products accumulate. Some of these materials form crystals, which in turn can cause kidney stones. Drinking a lot of fluids helps you get rid of these substances and promotes healthier weight loss. It also helps fill you up, and thus reduces the urge to eat between meals.
How much protein do I need?
About 50 to 65 grams daily, but since how much you need depends on your specific body, we want you to continue your appointments with the program's registered dietitians for the first year after surgery. Our program must follow how you're doing to ensure the healthiest outcome for you.
What are the best sources of protein?
Chicken, turkey, fish, tofu, low-fat cheese and cottage cheese are just some of the protein-rich foods you can enjoy.
Can I have milk products?
It is probably best to avoid them. Milk has lactose – milk sugar – that passes undigested until it reaches the lower bowel. Bacteria then acts upon it, causing cramps, gas and diarrhea. Every person is different, and you'll have to see how your new system reacts. There are many lactose-free milk products available now at your local supermarket. MooTopia®, found exclusively at HEB, is a favorite of many patients.
Do I have to cut back on salt?
Not unless your doctor tells you to watch your intake.
Can I still eat spicy foods?
Yes, but wait until your surgeon gives his/her approval.
Can I drink alcohol?
We recommend waiting one year after surgery. Then, with your doctor's approval, you can enjoy a glass of wine or a small cocktail. But be careful – even the smallest amounts of alcohol will affect you quickly.
Will I need nutritional supplements like vitamins?
Yes. You must take a multi-vitamin twice daily for the rest of your life. Your surgeon may recommend other supplements such as calcium, iron, vitamin B-1, vitamin B-12 or a super B complex based on your routine lab results.
What foods should be avoided the first year after surgery?
- Lobster
- Shrimp
- Beef
- Nuts of any kind
- Popcorn
- Chips
- Foods high in fat
- Foods high in sugar
- Foods high in calories
- All carbonated beverages, including diet sodas
- Alcohol
Risks and Complications
What are some potential complications of weight loss surgery?
They include gallstones, liver problems, hernia, staples in the stomach pouch that pull loose, leakage, blocked bowel and other risks typically associated with any surgery.
What is dumping syndrome?
It is a condition faced by weight loss surgery patients that occurs when sugar or simple carbohydrates are dumped too quickly into the small intestine. It is caused by eating sugars that dump into your bloodstream. It may or may not produce cramping and diarrhea that may last up to an hour; often, the only way to ease the discomfort is to lie down.
It can also reduce blood pressure because of the rapid increase in blood sugar that causes your body to release too much insulin. Other common side effects of dumping include rapid heart beat, tachycardia, sweating, headache, fainting and weakness.
How can I avoid this condition?
To begin with, don't eat the foods that trigger it – especially sweets. Also, eat several small meals a day that are low in simple carbohydrates, and drink liquids between meals rather than with meals.
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