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Published on December 14, 2018

Bariatrics: When to Consider Weight-Loss Surgery, Surgical Options and Life After Surgery

Bariatrics: Considering Weight Loss Surgery, Surgical Options and Life After Surgery

In this Fox 8 House Call series, Cone Health experts discuss bariatric topics, including:

When to Consider Weight-Loss Surgery

If you’re one of the many people who has already tried every diet and exercise plan imaginable to try to lose weight, but nothing has worked long-term, it may be time to consider weight-loss surgery. Sometimes, in spite of our diligent efforts, we may not be able to achieve long-term results by ourselves. In cases of severe obesity, bariatric surgery can serve as a tool toward achieving significant, long-term weight loss.

First, eligibility guidelines for surgery must be considered. Bariatric surgery involves a major life change; therefore, several factors are considered when determining eligibility, including:

  • A body mass index (BMI) of (a) at least 40, or (b) a BMI of 35 with 2 comorbidities (serious obesity-related diseases such as sleep apnea, diabetes and hypertension).
  • No severe psychological or medical conditions that would make surgery a high risk.
  • No drug or alcohol dependency, unless involved in a recognized treatment program with 1 year of sobriety.
  • Being psychologically stable with realistic expectations.
  • Being at least 18 years old.

Individuals who are interested in learning more about weight-loss surgery and getting started in the process are encouraged to attend 1 of Cone Health’s bariatric seminars. These seminars provide information about the risks and benefits of weight-loss surgery, the costs and a pathway to help guide you through the process to make a lifestyle change. These seminars are offered online, as well as in person. To register for either seminar, visit http://www.conehealth.com/bariatrics.

Once a weight-loss surgery candidate is medically verified, dedicated bariatric program coordinators help guide patients through insurance matters; referring and setting additional medical appointments, such as psychological and nutritional counseling; offering additional preoperative educational classes and holding patient support groups.

Each patient can expect to have a psychological examination, gastrointestinal testing and other lab tests done to make sure they’re ready for surgery. Some patients will also undergo supervised weight loss or testing with other specialists if they have other conditions, such as heart disease. Bariatric surgery can be an effective step toward losing weight and improving your entire well-being. Yet in order to be effective, it requires a full commitment toward a lifestyle change. Incorporating movement is an important part of any healthy lifestyle, whether that’s going to a traditional gym or participating in dance classes. To help patients incorporate movement into their lives after surgery, Cone Health offers the BELT program (Bariatric Exercise & Lifestyle Transformation) for 16 weeks after surgery.

Dawn Williams-James, MSN, RN-BC, is the bariatric nurse coordinator for Cone Health.

Surgical Options

The type of weight-loss surgery a patient chooses to have needs to be a well-informed, well-thought-out decision based on their individualized needs and goals. The two main types of surgical weight loss offered by Cone Health are sleeve gastrectomy and Roux-en-Y gastric bypass. With both of these procedures, patients can lose from 100 to 130 pounds, depending on their original size. Not only can weight-loss surgery serve as a tool in losing weight, it can help patients achieve overall well-being by improving, and sometimes curing, comorbidities such as diabetes and obstructive sleep apnea.

LAP-BAND® adjustable gastric banding is also available, but has become less popular in the last few years since the other procedures have been proven to help with other chronic diseases, such as diabetes, and provide more significant weight loss.

The sleeve gastrectomy has become the most common procedure and involves removing approximately 80% of the stomach, limiting it to the size of a cup of food. The portion removed produces hormones that increase hunger, so the result is a reduced desire to eat.

LAP-BAND® adjustable gastric banding involves the placement of an adjustable silicone band around the upper part of the stomach to create a small pouch, which can hold only a small amount of food. With the adjustable band, most patients can expect to lose 50 to 70 pounds over a 2-year period.

In the Roux-en-Y gastric bypass procedure, an upper stomach pouch about the size of an egg is created. This primarily restrictive procedure limits the food intake, also bypassing the first 3 feet of the small intestine to reduce calorie absorption. Gastric bypass also causes changes in the body’s gut hormones, which has been proven to be extremely beneficial for type 2 diabetic patients—making fairly prompt, helpful changes in managing their condition.

All operations are performed using minimally invasive techniques, which involve less pain, faster recovery and improved cosmetic outcomes.

Individuals who are interested in learning more about weight-loss surgery and getting started in the process are encouraged to attend one of Cone Health’s bariatric seminars. At “Bariatrics: Surgical Options for Weight Loss,” an informational seminar held at Wesley Long Hospital and Alamance Regional Medical Center, individuals considering bariatric surgery can learn more about the different procedures and the major lifestyle changes that must accompany the process. The informational seminars are now offered online, as well as in person.

Eric Wilson, MD, is a board-certified general surgeon in Greensboro and a member of the Cone Health Medical and Dental Staff.

Life After Surgery

Bariatric surgery can be an effective step toward losing weight and improving your overall well-being. In order to be effective, it requires a full commitment to a lifestyle change.

Roxana started to become health conscious a few years ago when she began working for Cone Health. As she started to explore her weight-loss options, she found a lot of support in her co-workers, friends and family. Without them cheering her on, it would’ve been easy for her to get discouraged. Some people will tell you that bariatric surgery is the easy way out, but it requires a lot of hard work. Roxana was able to tune all of the negative thoughts out because of the motivation from her support system at work and at home. It took a year from her first seminar until she made the decision to move forward with bariatric surgery. She had her surgery in September 2017.

For the first month after surgery, patients are on a liquid diet as they recover. Once they start to get back to normal, they slowly incorporate other foods and exercise into their routine. Surgery is just a tool, not a quick fix. Patients have to work at it each day, but with the support provided by family, friends and the team of doctors, nurses, therapists and other providers at Cone Health, they can learn healthy habits that keep you on track.

Working at night changed Roxana’s daily schedule a lot and affected her eating habits significantly. Since her surgery, she’s been trying to plan ahead to fit in 3 meals a day, even on days she works. Along with nutritional changes, she’s also made time for more movement in her life. Before, she’d always tried to stay active but hadn’t been able to exercise consistently. When she committed to surgery, she started to work out again and it helped her stay motivated to exercise now. Cone Health offers many different exercise classes for employees, and Roxana is lucky enough to have a fitness center right down the hall from where she works that she uses during her breaks.

It’s still hard for Roxana to stop thinking of herself as a bigger person, but it’s been very rewarding for her to see her progress. Before, she could not run a mile, but now she can comfortably. One of the things she was looking forward to the most was being confident enough to wear a swimsuit in public again.

If you or a loved one is interested in weight-loss surgery, talk to your primary care physician to see if it’s right for you. Cone Health’s Bariatric team is committed to educating and helping individuals in the community achieve long-term weight loss and overall health improvement.

Luke Kinsinger, MD, is a board-certified general surgeon in the Triad and a member of The Cone Health Medical and Dental Staff.

Roxana Brand receives care from Kinsinger at Cone Health.

Fox 8 House Call

Fox 8 House Call

Cone Health experts appear Monday, Wednesday and Friday at 8:30 a.m. on the Fox 8 morning news.