Obesity is a chronic disease that significantly impacts overall health and quality of life, leading to a variety of metabolic and physiologic disorders, including diabetes, cardiovascular disease, dyslipidemia, and obstructive sleep apnea. Bariatric surgery, also known as metabolic surgery, can be a life-changing process for individuals struggling with obesity. Kaiser Permanente offers a comprehensive Bariatric Surgery Program with a multidisciplinary approach to obesity treatment. This article provides detailed information about Kaiser Permanente's bariatric surgery program, including the types of procedures offered, the comprehensive support system, and what to expect before and after surgery.
Kaiser Permanente's Multidisciplinary Approach
Kaiser Permanente's Bariatric Surgery Program is committed to partnering with weight loss surgery patients to maximize their chances for success while minimizing the risks. The program emphasizes that bariatric surgery is just one tool to help patients reach their long-term goal of sustainable weight loss. A team of surgeons, bariatricians, case managers, dietitians, and mental health practitioners provide consultative services both before and after surgery. The program includes nutritional and exercise instruction, as well as access to support groups.
Specialized multidisciplinary bariatric care is concentrated at five Kaiser Permanente hospitals, designated as centers of expertise. These centers are located in Fremont, Fresno, Richmond, South Sacramento, and South San Francisco. The experienced surgeons and bariatricians at these centers perform a high volume of bariatric surgeries and procedures, which results in superior outcomes for patients. Kaiser Permanente doctors also work at all Kaiser Permanente hospitals throughout Northern California, ensuring that patients are never too far from the care they need.
Accessing the Program
The first step in accessing Kaiser Permanente's Bariatric Surgery Program is to attend the Provider Seminar. This 90-minute information session provides an overview of surgical options and allows prospective patients to ask questions. Kaiser Permanente also offers newsletters with guidance and education for individuals who have undergone bariatric surgery for weight loss. The program strongly encourages all bariatric patients, both pre- and post-surgical, to participate in support groups for ongoing support and education.
Types of Bariatric Surgery Offered
Kaiser Permanente offers various types of bariatric surgery, each designed to help people lose weight by making changes to the digestive system. These surgeries work through three main mechanisms: restriction, malabsorption, and hormone changes. Most bariatric surgeries use restriction, which involves making the stomach smaller, thereby limiting how much a person can eat. Some surgeries also alter the digestive tract, affecting how the body absorbs food. The intestines are rearranged and reconnected in these surgeries, making them more complex.
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Two common types of bariatric surgery offered by Kaiser Permanente are gastric bypass and sleeve gastrectomy.
Gastric Bypass (Roux-en-Y Gastric Bypass)
A gastric bypass, also called Roux-en-Y gastric bypass, is a surgery that helps individuals lose weight by reducing the size of the stomach and altering the connection between the stomach and the intestines. During the surgery, the doctor separates the upper part of the stomach from the rest of the stomach, forming a small pouch. This new pouch will hold the food you eat. The doctor then connects the new stomach pouch to the middle part of your small intestine. After the surgery, the food you eat will go from the small pouch to the middle part of your intestine, bypassing the rest of the stomach and part of the small intestine.
The surgery is typically performed laparoscopically, involving tiny incisions on the abdominal wall through which a small camera and thin instruments are inserted to perform the operation. The abdomen is filled with a gas to create space for the surgeon to operate. Most people stay in the hospital for one or more days after the surgery and can return to work or their usual routine in about 2 to 4 weeks.
After a gastric bypass, food may empty into the small intestine too quickly, leading to dumping syndrome. This can cause diarrhea and make you feel faint, shaky, and nauseated. Because the surgery bypasses the part of the intestine where many minerals and vitamins are most easily absorbed, patients may not get enough iron, calcium, magnesium, or vitamins. It is crucial to work with a dietitian to plan meals and ensure adequate nutrient intake to prevent vitamin and mineral deficiencies.
Sleeve Gastrectomy (Gastric Sleeve Surgery)
Sleeve gastrectomy, also called gastric sleeve surgery, is a procedure that involves removing a significant portion of the stomach to help with weight loss. The surgery limits the amount of food your stomach can hold. The surgery is usually done through several small cuts in the belly, called incisions. The doctor will separate the upper part of your stomach from the rest of your stomach, forming a small pouch.
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Like gastric bypass, sleeve gastrectomy is typically performed laparoscopically. Patients may experience belly pain and require pain medicine for the first week or so after surgery. Because the surgery makes your stomach smaller, you will get full sooner when you eat. Food also may empty into the small intestine too quickly, leading to dumping syndrome.
After a sleeve gastrectomy, it is essential to follow the specific instructions provided by your doctor regarding what to eat. You will start with only small amounts of soft foods and liquids, gradually adding solid foods back into your diet. Chewing food well and stopping eating when you feel full is crucial to avoid discomfort or nausea.
Preparing for Bariatric Surgery
Preparing for bariatric surgery involves a comprehensive evaluation and lifestyle changes to ensure the best possible outcome. Kaiser Permanente's multidisciplinary team will guide you through the process, providing the necessary education and support.
Pre-Surgery Recommendations
- Attend the Provider Seminar: Learn about your surgical options and ask questions.
- Get Moving: Start incorporating physical activity into your daily routine before surgery to make it easier to continue exercising afterward.
- Practice Healthy Eating Habits: Focus on eating nutritious foods and practicing portion control.
Post-Surgery Expectations and Lifestyle Changes
Bariatric surgery is a tool, not an instant fix. To achieve long-term success, it is crucial to commit to lifelong changes in how you eat and drink. Kaiser Permanente provides ongoing support to help patients make these changes.
Dietary Guidelines
- Follow Doctor's Instructions: Your doctor will provide specific instructions about what to eat after the surgery.
- Start with Liquids and Soft Foods: For about the first month after surgery, your stomach can only handle small amounts of soft foods and liquids while you are healing.
- Sip Water Throughout the Day: Try to sip water throughout the day to avoid becoming dehydrated.
- Add Solid Foods Gradually: Bit by bit, you will be able to add solid foods back into your diet.
- Chew Food Well: Be careful to chew food well and to stop eating when you feel full.
- Avoid High-Calorie Liquids: If you drink a lot of high-calorie liquid such as soda or fruit juice, you may not lose weight.
- Work with a Dietitian: Your doctor will probably recommend that you work with a dietitian to plan healthy meals that give you enough protein, vitamins, and minerals while you are losing weight.
Exercise and Activity
- Stay Active: Regular exercise is essential for maintaining weight loss and improving overall health.
- Start Slowly: Begin with gentle activities like aquatic therapy and gradually increase the intensity and duration of your workouts.
Emotional Well-being
- Acknowledge Your Emotions: It is common to have many emotions after this surgery. You may feel happy or excited as you begin to lose weight, but also overwhelmed or frustrated by the changes you have to make in your diet, activity, and lifestyle.
- Attend Support Groups: Kaiser Permanente strongly encourages all bariatric patients, both pre- and post-surgical, to participate in support groups.
Potential Risks and Complications
Any surgery has risks. Potential risks and complications of bariatric surgery include:
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- Narrowing of the connection between the stomach and the small intestine.
- Leaking from the stomach into the belly area.
- Gastroesophageal reflux disease (GERD).
- Dumping syndrome.
- Not getting enough of certain vitamins and minerals.
It is essential to discuss these risks with your surgeon and healthcare team to make an informed decision.
Long-Term Weight Management
Bariatric surgery is a powerful tool for weight loss, but it requires a lifelong commitment to healthy habits. It took you so long to get that big, itâs gonna take some time. Remember, if you only lose 1 pound in 1 week, youâre doing great. If you plateau, youâre doing fine. Donât be hard on yourself.
Key Strategies for Long-Term Success
- Eat Mindfully: Pay attention to your body's signals and stop eating when you feel full.
- Stay Active: Incorporate regular physical activity into your daily routine.
- Follow Up with Your Healthcare Team: Attend regular appointments with your surgeon, dietitian, and other healthcare providers.
- Seek Support: Participate in support groups and connect with others who have undergone bariatric surgery.
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