If you have struggled with weight loss your whole life, you know how easy it is to feel powerless. But you are strong. Obesity is a chronic and progressive disease that can affect multiple organs in the body. People with clinically severe obesity are at a greater medical risk for serious health conditions or premature death. The good news is that significant weight loss can improve these conditions or reverse them completely. CoxHealth offers various services and experienced specialists to provide options and resources that help you achieve your desired lifestyle.
Understanding Bariatric Surgery
Weight-loss surgery, also called bariatric surgery, is a treatment option for severe obesity. It’s often done as a laparoscopic surgery, with small incisions in the abdomen. It’s advised for people who have tried other weight loss methods, such as diet and exercise, without long-term success.
Criteria for Bariatric Surgery
Criteria for people considering surgery for obesity or bariatric surgery often includes having a body mass index, or BMI, of 40 or greater. Your doctor may also advise it if you have a BMI between 35 and 40 and a health condition such as sleep apnea, high blood pressure, heart disease, or type 2 diabetes.
Surgical Options at CoxHealth
Our comprehensive weight-loss program offers options based on individual needs combined with local, ongoing support. The SBL Bariatric Program offers two surgical options: laparoscopic sleeve gastrectomy and gastric bypass. In addition to advanced bariatric surgery, CoxHealth is proud to offer medical weight loss services as part of a comprehensive approach to obesity care.
Laparoscopic Sleeve Gastrectomy
A laparoscopic sleeve gastrectomy involves restricting the size of the stomach by stapling and dividing it vertically. The portion of the stomach that receives food is shaped like a very thin banana or sleeve. Sarah Cox decided to move forward with a sleeve gastrectomy, a surgery that decreases the size of the stomach, limiting the amount of food that can be eaten.
Read also: Inspiring Health Transformation
Gastric Bypass (Roux-en-Y)
A gastric bypass reduces the size of the stomach to roughly the size of an egg and the small intestine is divided. Roux-en-Y gastric bypass (RYGB) is a type of weight-loss surgery. This surgery reduces the size of your upper stomach to a small pouch about the size of an egg. The surgeon does this by stapling off the upper section of the stomach. This reduces the amount of food you can eat. The surgeon then attaches this pouch directly to part of the small intestine called the Roux limb. This forms a “Y” shape. The food you eat then bypasses the rest of the stomach and the upper part of your small intestine. This reduces the amount of fat and calories you absorb from the foods you eat. It also reduces the amount of vitamins and minerals you absorb from food.
The Journey of Sarah Cox: A Sleeve Gastrectomy Success Story
Sarah Cox, Otsego, spent years of her life struggling with her weight. “I’ve gained and lost weight my whole life. I’ve tried everything-name a diet, I’ve done it,” Sarah shared. Like many, the Covid-19 pandemic caused Sarah to pack on even more pounds. She was stress eating, had lost the motivation to exercise and was dealing with the anxiety of the pandemic in unhealthy ways. After a few months, her clothes didn’t fit and seeing her face on-screen during video calls made her feel worse about herself.
Sarah’s mom had bariatric surgery years ago, so Sarah was familiar with the process but had many questions of her own. Her online research led her to Ridgeview’s Bariatric & Weight Loss team. When she called and spoke with Kristyn Baker, bariatric managed care specialist, she immediately felt a weight lifted off her shoulders. “I felt reassured about my decision to pursue weight loss surgery and I looked forward to my consultation with Dr. Baker.”
At Sarah’s consultation, Jeffrey Baker, MD, bariatric surgeon, discussed all of her options. Sarah appreciated how personable he was, and they quickly made the connection that Dr. Baker delivered her youngest son. “Dr. Baker was very clear on the process and knowledgeable about which option was the best choice for me,” Sarah said. “I left excited, informed and I completely trusted his judgment.”
During the month leading up to her surgery, the bariatric team educated and prepared Sarah for surgery and what to expect afterward. She learned more about what types of food she should be eating, and what her body needed in terms of nutrition and activity-igniting Sarah’s desire to make some real changes.
Read also: Bariatric Surgery for Seniors: Is It Right for You?
Sarah had surgery in March 2021, a day before her 38th birthday. She was eager to wake up on her birthday as a “new person.” The surgery was a success, and post-surgery, Sarah continues to see the bariatric team. Two years post-surgery, Sarah has lost more than 100 pounds and she continues to keep it off-to which she credits the entire bariatric team. “I love the team. I never have to worry about getting the support I need-from the exercise physiologists, dieticians, psychologists, and so many others,” She said. Sarah felt well prepared and educated before and after surgery. “I wish I had the surgery sooner,” Sarah shared. “It’s not a quick fix. It’s a big change, but so worth it.”
Sarah now enjoys playing catch and chasing after her two young boys on the football field, which she says she wouldn’t have been able to do prior to surgery. “Even walking around at the park with the boys, I would have to take breaks before because my back or knees were hurting.
Medical Weight Loss Services
Medical weight loss uses evidence-based tools - such as FDA-approved medications, dietary counseling, and behavioral support - to help you achieve sustainable results. At our practice, we’re committed to providing comprehensive weight loss treatments, tailored to each patient’s unique needs. We practice a multidisciplinary approach to treating obesity with both medical and surgical options. Our program provides personalized care beyond just the procedure for lasting results.
The Importance of a Comprehensive Approach
Losing weight is a lifelong commitment, and CoxHealth Weight Loss and Advanced Surgery Center offers a variety of support services to help before, during, and after your goals are met. Our board-certified surgeons specialize in bariatric surgery and are members of the American Society for Metabolic and Bariatric Surgery. CoxHealth meets all criteria as a Comprehensive Center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program to deliver safe, high quality bariatric patient care.
Liposuction: An Additional Body Contouring Option
While dieting and exercise are the keys to weight loss, they are not always the best option for targeting specific problem areas on the body. Lipo procedures are commonly performed to improve body contours.
Read also: Healthy Cooking with Maneet
The Liposuction Procedure
Liposuction is performed using a thin hollow tube known as a cannula. The cannula is inserted under the skin using small incisions around the area of the body where the excess fat is located. Dr. Cox moves the cannula around the area to loosen any excess fat from the body. Liposuction can be performed as a stand-alone procedure but is also commonly used in conjunction with other surgical procedures.
Ideal Candidates for Liposuction
The liposuction procedure is appropriate for patients with stubborn excess fat in many areas of the body. Candidates are healthy and are at a stable body weight. Lipo is perfect for patients who want to enhance their body aesthetics. It is suitable for patients who could not successfully get rid of their excess body fat through traditional weight-loss methods like diet and exercise. While liposuction does involve the removal of fat, the amount of fat removed is minimal and the procedure is not a substitute for weight loss surgery. Liposuction does not do anything to correct loose skin.
Recovery After Liposuction
The procedure and recovery is very well tolerated and most patients typically can return to work within one week. There may be some bruising and swelling around the surgery site for a few days after the procedure. Recovery instructions will be provided to ensure a safe and comfortable healing process. Physical activities will be limited for the first few weeks, depending on the areas of the body that were contoured.
Gastric Bypass: Benefits and Risks
Gastric bypass can help a person lose about 100 pounds of excess weight. It may also improve, or in some cases even reverse type 2 diabetes. It can also improve or stop heartburn and reflux. Weight-loss surgery can also lower the risk for high blood pressure or improve it for people that already have it. A gastric bypass can also help with sleep apnea, and certain other health problems such as high cholesterol.
Potential Risks and Complications
Bleeding, infection, and blood clots in your legs are possible side effects that may occur after any surgery. General anesthesia may also cause breathing problems or other reactions. You may also have leaks from the stomach pouch or the Roux limb.
Possible problems over time may include:
- Low levels of vitamins if you don’t take supplements daily for the rest of your life (in some cases, even if you do take supplements)
- Low levels of iron and calcium
- Trouble getting enough protein
- Dumping syndrome. This can cause nausea, fast heartbeat, belly (abdominal) cramping or pain, fainting, and diarrhea after eating.
- Narrowing of the sites where intestines are joined (stenosis or stricture)
- Dangerous internal hernia, in which the small intestine can be trapped and blocked
- Hernia at the port sites
- Poor healing of the incision sites
- Need for additional surgery
- Failure to lose enough weight
- Weight regain, if you snack on high-calorie foods and don’t exercise
- Loss of too much weight too quickly. This can cause sagging skin that may need to be removed surgically.
- Gallstones. This requires surgery to remove the gallbladder.
Preparing for Gastric Bypass Surgery
Your healthcare team will need to make sure that gastric bypass surgery is a good option for you. Weight-loss surgery isn’t advised for people who abuse medicines or alcohol, or who are not able to commit to a lifelong change in diet and exercise habits. Before having surgery, you’ll need to enroll in a bariatric surgery education program. This will help you prepare for surgery, and life after surgery. You’ll have nutritional counseling. And you may have a psychological evaluation. You’ll also need physical exams and tests such as an electrocardiogram (ECG), a chest X-ray, and sleep study. You will need blood tests. You may have imaging studies of your stomach, or have an upper endoscopy. If you smoke, you will need to stop several months before surgery. Your surgeon may ask you to lose some weight before surgery. This will help make your liver smaller, and make surgery safer. You’ll need to stop taking aspirin, ibuprofen, and other blood-thinning medicines in the days before your surgery. You shouldn’t eat or drink anything after midnight before surgery.
What to Expect During and After Gastric Bypass Surgery
The surgery usually takes several hours. You will have general anesthesia for your surgery. This will cause you to sleep through the surgery, and not feel pain. Your surgeon may use laparoscopy. They will make several small cuts (incisions) in your abdomen. The surgeon will then insert a laparoscope and put small surgery tools into these incisions. The surgeon will use a laparoscopic stapler to make a small stomach pouch with the upper part of your stomach. The surgeon then uses the stapler to divide the upper part of your small intestine into a tube with two ends. One end of the small intestine (the Roux limb) is brought up to the stomach pouch, and a small connection (anastomosis) is made between them. The other end of the small intestine is then connected to another part of the small intestine. Then your surgeon may test for leaks with a dye study or an upper endoscopy.
You may stay in the hospital for 1 to 2 days after the surgery. Talk with your doctor about wound care, safe pain medicines, and when you can start physical activity. Your doctor will tell you how often to change the dressing on your incision.
Post-Surgery Diet and Lifestyle
You will likely only have liquids for the first 1 to 2 weeks after surgery. Your doctor may slowly add soft food and then regular food to your diet about a month after surgery. You will be need to chew slowly and fully, and not to drink 30 minutes before or after you eat. Your initial weight-loss may occur quickly, so it's important to get all of the nutrition and vitamins you need as you recover.
Nutritional Considerations After Gastric Bypass
To prevent nutritional problems after gastric bypass surgery, many doctors advise:
- Daily multivitamins: You should take a daily multivitamin that contains 200% of the daily values.
- Daily calcium supplements: Multivitamins with calcium may not protect bone health. You may need 1,600 to 2,000 IU vitamin D and 1,600 mg calcium daily. Take a calcium supplement at least 2 hours after your multivitamin.
- Vitamin B-12 supplements: Doctors advise vitamin B-12 supplements for all people who have had weight-loss surgery to help prevent bone fractures. You can take this by mouth several times a week. Or you may have B-12 injections every month.
- Oral vitamin D supplements: You may need this if you have low levels. Your doctor may prescribe 50,000 IU of vitamin D taken by mouth once a week for 8 weeks. Some people need lifelong vitamin D supplements.
- Iron supplements: After gastric bypass surgery, the amount of iron in a multivitamin may not be enough to prevent anemia. You may need an additional 50 to 100 mg of elemental iron a day. Taking vitamin C will help your body absorb iron.
Because nutritional deficiencies can happen after this surgery, experts recommend that your blood be tested at least every 6 months for the rest of your life to ensure that you are getting the right amount of vitamins and minerals.
Long-Term Follow-Up and Support
Along with follow-up appointments with your doctor and surgeon, you will likely see a dietitian who will teach you how and what to eat with your reduced stomach size. You may also need to see a psychologist to help you deal with the feelings and concerns over your changed lifestyle.
Maintaining Long-Term Weight Loss
When committed to eating a healthy diet and regular exercise, people have the best long-term results. Lack of exercise, poorly balanced meals, constant grazing, eating processed carbohydrates and drinking carbonated beverages are some of the common reasons for weight regain. You should use the first year to develop good eating and exercise habits that will keep you from regaining weight.