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Vital Signs: Bariatric journey requires dedication, but rewards can be great

Vital Signs: Bariatric journey requires dedication, but rewards can be great

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“My life has changed so much for the better since my bariatric surgery!”

“Weight loss surgery helped me control my diabetes and high blood pressure. I’m off all of my medications!”

“This was the best decision I could have ever made. I wish I had done it sooner.”

These are just some of the typical responses I hear from my long-term bariatric patients, and it is one of the main reasons why I chose to become a bariatric surgeon.

Bariatrics is the field of medicine that focuses on multiple therapies that allow an individual to achieve weight loss. As important as it is to have a positive body image, the more important reason for undergoing weight loss and metabolic surgery is the dramatic, positive impact the surgery has on a patient’s overall health and well-being.

Obesity and obesity-related illnesses are among the leading healthcare costs in the United States. Untreated, they can lead to disability and even death. Complications arising from obesity include coronary artery disease, diabetes, obstructive sleep apnea, peripheral arterial disease, stroke, cancer, fatty liver disease, gallbladder disease and chronic musculoskeletal issues.

A patient can qualify for metabolic surgery if he or she meets certain body mass index (BMI) requirements. All patients with a BMI greater than 40 — or greater than 35 with at least one significant co-morbidity (complication) — qualify to enroll in most bariatric programs.

Multidisciplinary approach

Being a successful bariatric patient requires a desire to live healthier, and an understanding that surgery is only one tool among many that make weight loss possible.

To be successful, patients must commit to lifestyle changes that include dietary and exercise habits, consistent follow-up with their support groups and care teams, and lifelong adherence to their goals. Bariatric surgery involves many healthcare providers—the surgeon, nutritionists, endoscopists, psychiatrists, nursing staff and patient navigators—who form a team that helps the patient achieve his or her health and weight-loss goals.

Weight-loss surgeries

Currently, two of the most commonly performed procedures are the Roux-en-Y gastric bypass and sleeve gastrectomy. They are performed laparoscopically with four or five tiny incisions.

The bypass has long been the “gold standard” operation in bariatrics. It’s the measure used to determine how successful other procedures can be. This operation involves stapling the top of the stomach into a small pouch and then connecting a portion of the intestines to the pouch.

In contrast, the sleeve gastrectomy is performed by stapling along the entire length of the stomach to form a thin tube and then removing the excess stomach. Both have excellent benefits when it comes to weight loss and co-morbidity resolution.

The bariatric team will review a patient’s medical history and discuss the risks and benefits of each procedure in deciding which procedure is most appropriate for the individual patient.

The recovery period

When considering bariatric surgery, many patients are concerned about the recovery. Thankfully, bariatric surgery has an overall low complication rate, and our patients do quite well. Most patients are discharged from the hospital within one or two days after surgery.

Patients typically follow a liquid diet for the first two weeks before advancing to softer and then gradually more solid foods. We also have our patients get out of bed right after surgery, which makes their transition to regular physical activity much easier.

No magic bullet

Bariatric surgery is not a quick fix for obesity and related health problems. The bariatric journey requires a large amount of dedication from the patient and will require lifelong monitoring and adjustments to allow for continued success. Happily, most patients achieve that success.

As part of the Sentara Bariatric team, I find it truly rewarding to help guide patients to a healthier future by providing the safest, most effective weight-loss care possible.

VITAL SIGNS This column, which promotes community health, is sponsored by Sentara Martha Jefferson Hospital, Region Ten Community Services Board, Thomas Jefferson Health District and the University of Virginia Heath System.

Dr. Timothy Snow is a bariatric surgeon with Sentara Martha Jefferson Medical & Surgical Associates.

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