Obesity is a chronic, lifelong condition affecting a significant portion of the adult population in the US. In Los Angeles, various surgical options are available to help individuals achieve significant weight loss and improve their overall health. Bariatric surgery is a safe and effective long-term treatment for obesity and its related metabolic complications. This article explores the different weight loss surgery options available in Los Angeles, providing valuable information for those considering this life-changing step.
Understanding Bariatric Surgery
Bariatric surgery, or weight loss surgery, encompasses a range of surgical procedures designed to help individuals with severe obesity lose weight. These procedures work by altering the digestive system, either by limiting the amount of food the stomach can hold or by reducing the absorption of nutrients. Bariatric surgery is often recommended for individuals with a Body Mass Index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health issues such as type 2 diabetes, heart disease, high blood pressure, fatty liver disease, sleep apnea, and gastroesophageal reflux disease (GERD).
Types of Bariatric Surgery Procedures Offered in Los Angeles
Gastric Sleeve Surgery (Sleeve Gastrectomy)
Gastric sleeve surgery, also known as sleeve gastrectomy or vertical sleeve gastrectomy, is a restrictive procedure that induces weight loss by limiting food intake. During this laparoscopic procedure, a large portion (approximately 75-80 percent) of the stomach is removed, leaving a narrow, tube-shaped stomach resembling a banana. This new, smaller stomach restricts the amount of food a person can eat, leading to weight loss.The surgery also modifies the size of the stomach, such that the organ decreases the absorption of calories and food. This type of surgery may result in risks, such as the leaking of digestive juices and partly-digested food.The new stomach is smaller and does not create the same appetite-increasing gut hormones, such as ghrelin, as the regular stomach. Unlike gastric bypass surgeries that require intestinal re-routing, sleeve gastrectomy is a less complicated procedure.After sleeve gastrectomy, some patients may suffer from heartburn. In these situations, one would need the help of an experienced bariatric surgeon to revise these outdated or detrimental procedures.
Advantages of Gastric Sleeve Surgery:* Significant weight loss (typically 60-80% of excess weight within the first year).
- Reduced appetite due to decreased ghrelin production.
- No intestinal re-routing.
- Shorter operative time compared to gastric bypass.
Gastric Bypass Surgery
Gastric bypass surgery is a very common and effective weight loss procedure. During gastric bypass surgery, the surgeon creates a small stomach pouch and reroutes a limited amount of the intestinal tract. This restricts food intake, making patients feel full quicker, and reduces the absorption of calories. Gastric bypass surgery reduces the stomach size and reroutes a limited amount of the intestinal tract. As a result, food intake is limited, patients are “full” quicker, and what is consumed is not fully absorbed.
Advantages of Gastric Bypass Surgery:* Significant and sustainable weight loss (typically 70-80% of excess weight within the first year).
- High remission rates for type 2 diabetes.
- Effective in treating GERD.
Lap Band Surgery (Gastric Banding)
Lap band surgery, or gastric banding, is a laparoscopically performed medical weight loss procedure. A gastric band is a long-term implant placed around the upper part of the stomach to create a smaller pouch. This restricts the amount of food a person can eat, leading to weight loss.A gastric band is intended to be a long-term implant; however, it is important not to assume that a band will be a permanent device. Some patients go through weight loss surgery and find themselves needing to reposition, replace or remove the band sometime during their life.The Lap Band is a laparoscopic adjustable gastric band device that constricts your stomach, leaving a smaller space behind. This helps you lose weight quickly and in the long term.
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Advantages of Lap Band Surgery:* Reversible and adjustable.
- Lower risk of nutritional deficiencies compared to other bariatric surgeries.
- Less invasive than gastric bypass or sleeve gastrectomy.
Duodenal Switch
The duodenal switch procedure causes weight loss by limiting the amount of food that can be ingested and significantly restricting the number of calories absorbed by the body. Technically, this is accomplished by both the reduction of the stomach volume and a very extensive intestinal bypass.
Endoscopic Bariatric Procedures
Endoscopic bariatric procedures are minimally invasive treatments suitable for patients who may not qualify for traditional bariatric surgery or who have regained weight after a prior bariatric surgery. These procedures are performed using an endoscope, a long, flexible tube with a camera attached, to view and treat the areas within the gastrointestinal tract.
Types of Endoscopic Bariatric Procedures:
- Endoscopic Sleeve Gastroplasty (ESG): Involves using sutures to reduce the size of the stomach, similar to a surgical sleeve gastrectomy, but without the need for incisions.
- Gastric Balloon: A balloon device is placed inside the stomach and inflated, restricting how much a person can eat and promoting weight loss.
Bariatric Revision Surgery
In some cases, patients may need bariatric revision surgery. This is usually recommended when weight loss slows down or when there is a regain of weight after the initial surgery. Revisional bariatric surgery may be needed for a variety of reasons. One of the most common reasons a patient seeks revision for their original bariatric procedure is due to not meeting weight loss expectations. Like other diseases, obesity treatment is different for each patient. Some patients do not lose as much weight as desired or they may regain weight that was lost. Another reason for revision bariatric surgery is complications resulting from their procedure.
Considerations Before Undergoing Bariatric Surgery
Candidacy
Candidates typically have a BMI of 40 or higher or a BMI of 35 with obesity-related health conditions like diabetes or high blood pressure.
Pre-Surgical Consultations
Patients undergo pre-surgical consultations to prepare for the procedure. At La Peer, their Beverly Hills surgeons provide each of their patients with pre-surgical consultations to help prepare you for this time.
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Multidisciplinary Team Approach
Optimal results are achieved through a multidisciplinary team that includes bariatric surgeons, gastroenterologists, endocrinologists, dietitians, social workers, psychologists, psychiatrists and nurses.
Support Groups
Bariatric surgery programs often include support groups for patients, providing a platform for sharing experiences, celebrating successes, and offering support during challenging times. In a support group, you’ll find people who have similar wellness goals, want to celebrate your successes, and support you in challenging times.
Lifestyle Changes
Bariatric surgery requires a commitment to long-term lifestyle changes, including healthier eating habits and regular physical activity, for successful results.
Finding the Right Bariatric Surgeon in Los Angeles
Los Angeles is home to many skilled and experienced bariatric surgeons. When choosing a surgeon, consider the following:
Experience and Expertise
Look for a board-certified surgeon with extensive experience in performing various bariatric procedures. For example, Dr. Khalili has trained several surgeons who now lead their bariatric programs in the US, has truly proven his expertise in weight loss surgeries.
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Patient Reviews and Testimonials
Read reviews and testimonials from previous patients to get an idea of the surgeon's bedside manner, surgical outcomes, and overall patient satisfaction.
Comprehensive Care
Choose a surgeon who offers comprehensive care, including pre-operative evaluations, post-operative support, and access to a multidisciplinary team.
Facility Accreditation
Ensure that the surgical facility is accredited and equipped with the latest technology to ensure patient safety and optimal outcomes.
The Role of Cosmetic Surgery After Weight Loss
After the significant weight loss that takes place after gastric surgery, usually 15 to 18 months post-surgery, there is excessive skin remaining. Generally speaking, the skin does not retain its elasticity so when you lose weight, your skin does not shrink to fit your new body.Weight Loss Surgeon Dr. Moeinolmolki is an expert at bariatric surgeries (weight loss surgeries) and cosmetic body contouring. His expertise includes procedures like body lifts, tummy tucks, and liposuction.
Benefits Beyond Weight Loss
Bariatric surgery isn’t just designed to help you lose the excess weight quickly and effectively. Weight loss surgery has also been shown to be effective at resolving many obesity-related conditions like type 2 diabetes, heart disease, high blood pressure, and others. Many bariatric surgery patients also report taking fewer medications to treat their obesity-related conditions.