This is week two of a three-week series on gastric surgery.
So you have been thinking about gastric bypass surgery. You not alone. It is big business and it is growing every year. Over 200,000 people chose this route to a lower body mass index (BMI) in 2008. That’s a big jump from 16,000 in the early 90s. And many of these people had diabetes.
Two powerful issues, need and efficacy, are driving this bus. 1.) Over two thirds of Americans are overweight or obese and 2.) the surgery is effective. No other weight loss option can boast the long-term success rates of going under the knife.
People who select bariatric surgery can lose up to one-half of their pre-surgery weight over a two-year period. And many of those who started the surgery on insulin saw their blood glucose values normalize almost immediately post recovery.
But with a more robust achievement rate comes a higher risk ratio. Although most go well, this type of bowel surgery is a major operation with the potential for long lasting consequences. Patients can experience nutrient deficiencies, infections, poor wound healing and, in a very small number of cases, chronic hypoglycemia.
And most importantly for the bypass procedures, there is no easy method of changing your mind.
How you eat and what you eat is going to shift is radically post surgery.
You can expect to follow a high protein, low fat, low concentrated sweets diet. Initially, your food will be in liquid form progressing over several weeks to small quantities of solid foods. You will also be limited to how much and how often you can eat, precautions that prevent vomiting and overstretching of the gastric pouch.
It is also common to experience some minor changes in body habitués. Initially following surgery you may have mood changes, feel cold or tired and develop minor hair loss and dry skin due to the body’s metabolism slowing down from the rapid weight loss.
And there’s more to this than just a nutritional change. So drastically altering the way you eat can affect your social dynamics with family and friends, especially if food has played an important role in your relationships. Maybe in the past you and your friends would get together for pizza and a movie, complete with popcorn and candy. This routine would have to change a bit to accommodate your new lifestyle.
About 10 percent of people experience nausea, vomiting and diarrhea in the first month post-surgery. And 3 percent have more serious complications such as blood clots, wound re-opening, ulcers and heart attacks. In a small number of cases the surgery itself is fatal.
(Of note, more patients who choose to take bypass type vs. banding procedures generally have more complications.)
First and foremost the surgery is for people who are significantly overweight. According to The National Institutes of Health (NIH) you should have a BMI of greater than 40 (approx 100lbs overweight for men and 80lbs overweight for women) to be a good candidate. The BMI recommendation drops to 35 if you have obesity related diagnoses such as diabetes or hypertension.
In addition you should:
- Have made other attempts and failed at traditional weight loss strategies in the past. Weight loss diets do work for some people and they are a much less radical choice.
- Be psychologically prepared for the rigors of the process and the need to make significant lifestyle changes in order to make the surgery effective and maintain the weight loss.
Bariatric Surgery can control your diabetes, your blood pressure and make it a whole lot easier for you to get around. This makes it very appealing to patients and their health care providers. But since it can have serious complications, it is important make sure you are a good fit and are ready to make the lifestyle changes it requires. .