Dr. Michael Sutker is a general surgeon practicing in Dallas, TX. Dr. Sutker specializes in abdominal contents including the esophagus, stomach, liver, gallbladder, pancreas and often thyroid glands. General surgeons are able to deal with almost any surgical or critical care emergency, also involving the skin or soft tissue... more
The decision to undergo bariatric surgery is not an easy one.
Thinking about undergoing bariatric surgery or know someone who is? Here are some FAQs that might help.
When is someone eligible for bariatric surgery?
Since there are no two overweight people that are exactly the same, there is no general answer to this question. In general, someone is eligible to be considered for bariatric surgery if traditional efforts to lose weight, like diet and exercise, are unsuccessful and your BMI (body mass index) is 40 or higher. But, for some people who live with serious health conditions like diabetes or sleep apnea, they can be considered for bariatric surgery if their BMI is 30 or more. Those serious health conditions, coupled with obesity, put the patient in a much more dangerous situation.
Even when a patient meets the above requirements, their healthcare team must decide if the potential benefits of bariatric surgery are worth all of the health risks for their unique case. The patient’s healthcare team will then decide which type of surgery is the right choice.
What are the different types of bariatric surgery?
Nowadays, most surgeons in America and around the world perform bariatric surgery laparoscopically, which is extremely noninvasive compared to traditional, open methods. For patients, this means less pain, and a much quicker and more comfortable recovery. For surgeons, this means a much lower risk of complications during and after surgery.
- Gastric bypass: This operation separates the stomach into two. The top section of the stomach is smaller, and will collect the food you eat. It’s extremely small, and will be able to hold an ounce of food, typically. This leads the patient, of course, to eat less and therefore lose weight. The food then travels directly into the small intestine, leading the patient to absorb less calories.
- Lap band: This procedure doesn’t involve surgically separating the stomach into two. Instead, a band is placed around the upper part of the stomach, siphoning off a small pouch where food will go. The band can be adjusted nonsurgically. Like bypass, it restricts the amount of food you can eat, but it doesn’t restrict nutrient absorption.
- Sleeve gastrectomy: Here, the stomach is reshaped into a “sleeve” structure after part of it is removed. It is smaller, so it cannot hold as much food.
- Duodenal switch procedure: This one is a bit more complicated. A part of the stomach is removed, leaving behind a stomach pouch that is similar to the sleeve gastrectomy. Then, a portion of the small intestine is bypassed, allowing food to travel into the large intestine with reduced nutrient absorption. The combination of less food eaten and fewer nutrients being absorbed leads to weight loss.
What can be expected during recovery?
The specifics depend on the exact operation and the patient’s unique circumstances. But, in general, monumental lifestyle changes will be necessary and the patient must adjust to their new body accordingly.
Immediately after surgery, patients typically stay in the hospital for a few days if there are no other complications.
Once the patient returns home, they will basically need to re-learn how to eat. It is common for vomiting to occur frequently as the patient gets used to their new stomach. Eating too fast, eating too much, not chewing food properly, and even drinking with a straw can all lead to vomiting. Once the patient gets used to their new eating habits, the vomiting will stop.
Just as the mind must get used to a new stomach, so must the body. It’s normal to have different bowel habits and nausea during the initial stages of recovery.
It is crucial for patients to have frequent follow-up visits to ensure they’re getting the right daily nutrients for their unique body. It’s possible for patients to lose up to 40% of their excess weight by the six-month period!