Surgical Weight Loss Tips

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What are some behavior changes needed after surgery?

Behavior Modifications Needed After Bariatric Surgery

Surgery is only a tool to assist you in becoming healthier; the rest is up to you. Think of surgery as a new beginning which, like it or not, will require a lot of work. Don't approach surgery with the attitude of “After surgery I'm going to take it easy and watch the weight fall off." This type of attitude will lead to poor results and could potentially cause a relapse. Yes, there are those who continue to eat what they wish and stretch their stomach pouches to accommodate more food. Surgery doesn't guarantee success.

One important consideration after surgery is learning how to deal with your emotions. This may be more difficult than you think. For some, food is a trusted friend. Bariatric patients can become depressed and may require behavioral counseling.

In addition to eating smaller portions and more frequent meals, you must also change how you eat. Liquids are not to be consumed during or up to one hour after meals. Having liquids increases the amount of food you can eat with meals. Foods are to be chewed thoroughly, about 20 to 30 times per bite. Eliminating distractions, like watching TV or eating in your car, can prevent you from overeating.

Exercise will help you maintain or lose weight, as well as create muscle tone. The inital weight loss with surgery allows you to become more physically active. The more you lose, the more active you can become. Your goal should be to work out for 45 minutes to an hour on most days of the week.

Will I be required to take vitamins and minerals?

Bariatric Surgery: Importance of Protein, Vitamins and Mineral

When your stomach only holds one cup of food, it can be a challenge to get all the nutrients you need for optimal health. A week after your operation, you will probably be asked to start taking a chewable daily multivitamin. You will continue this for the rest of your life. Approximately one month later, calcium in the form of calcium citrate with vitamin D will be added to your nutritional regimen. Other vitamins and minerals often needed are iron, B12 and folate. These will be determined based on lab values from your routine check-ups.

Since you only eat about ten bites of food per meal, you must make them all count. It is critical to consume food containing high amounts of protein first at each meal. A minimum protein goal is 60 grams or about 240 calories from protein per day. Protein allows you to preserve muscle mass and maintain hair and nail growth. Good sources of protein include:

  • Meats and beans
  • Fish, including tuna
  • Cottage cheese
  • Eggs
  • Tofu
  • Yogurt and other lowfat milk products.

What does Weight Loss Surgery Cost?

What Does Weight Loss Surgery Cost?

The three principal costs associated with weight loss surgery are the hospital facility, surgeon's fee and anesthesia. These fees will differ based on where you live. The highest costs are found in the Northeast and West Coast. The expertise of the surgeon will also affect the cost of your surgery. Top surgeons command higher fees as they have more experience and generally produce better results.

The average cost for liposuction is based on the number of areas treated and the size of the areas treated. For instance, liposuction performed on the abdomen or hips can cost up to $4,000, while the fee for three areas ranges from $6,000 to $8,000.

The complexity of the surgery and recovery time are also factored into cost. Since there is more than one technique and recovery related issues, the price can quickly increase. The average cost across the country for bariatric surgery ranges from $17,000 to $30,000. There are several added costs with these procedures, including dietary counseling, vitamin and mineral supplements, behavior modification and exercise classes.

One positive aspect of bariatric surgery is that health insurance can help you cover the cost of the procedure. Your doctor must provide the insurance company with documentation that the surgery is medically necessary. The amount of coverage varies between insurance companies. You may need to be persistent since it's common to be denied coverage at first. It is unlikely that the additional expenses after surgery will be covered by insurance.

What can I eat after bariatric surgery?

Nutrition for Bariatric Patients

Over the years, general nutrition guidelines have been developed, but presently no standardized diet for post-bariatric surgery patients exists. Most weight loss surgery centers have registered dietitians who, along with your doctor, help you understand your dietary needs. Typically, you will progress from liquid to pureed food over several weeks. An example of food choices one month post-operation include cheese, eggs, low fat tuna, and/or chicken blended until smooth. Cooked seedless vegetables and soft seedless fruit are also introduced at this time. By about three months, solid cuts of meat and fresh vegetables are added to your diet as tolerated.

Initially, your new stomach pouch will only hold one ounce of food. The pouch eventually expands to hold about one cup of thoroughly chewed food (a normal stomach can hold up to four cups). You should eat small frequent meals throughout your day rather than large meals that your stomach cannot accommodate. Because your stomach is so small, you will be asked not to drink liquids during or up to one hour after your meals. In general, your goal is eat 800 to1000 total calories per day.

Since you can only consume about 10 bites of food, it is very important to make those bites count. Avoid empty calories that are found in high fat foods, sodas and sweets. Your new stomach won't be able to tolerate a large amount of junk food. Overeating junk foods increases the likelihood of “dumping syndrome.” The nasty side effects of dumping include nausea, vomiting and diarrhea. Most doctors will let you make the last bite of food your choice, so it is possible to have a bite of chocolate now and then.

What are the risks of weight loss surgery?

Surgical Risks

There are associated risks with every surgical procedure, with less invasive procedures inherently carrying fewer risks. Advances in medicine have made serious complications from liposuction quite rare -- less than half of one percent. The risk of surgical complications increase as more areas are treated and larger amounts of fat are removed. Common side effects of liposuction include bruising, fluid oozing from the incision site(s), swelling, numbness and general discomfort during the healing process. Serious side effects can happen, too. These include infections, excessive fluid loss potentially causing shock, nerve damage, puncture of vital organs and development of fat clots or blood clots possibly causing death.

With bariatric surgery, the list of serious complications grows. It is possible that death may result from surgery and the risk is approximately 1 in 300. Therefore, you should carefully weigh the benefits and risks of surgery. After surgery, many patients report mild to severe nausea, vomiting, bloating and diarrhea. It is very common for these side effects to occur due to the small stomach pouch being overly stretched by food that isn't chewed well. Complications from gastric bypass surgery can range from abdominal hernias, infections and rupture of the staple line to nutrient deficiencies and stretched stomach pouches. The most frequent post-operative complications for Lap-banding include nausea, vomiting, heartburn and stomach-band outlet obstruction. With any of these bariatric procedures, complications can require hospitalization and/or re-operation.

How does liposuction work?

Understanding Surgical Procedures for Weight Loss

Most liposuction procedures are performed in an outpatient setting. To complete the surgery your doctor will first make a tiny incision near your trouble area. Doctors are aware of scaring so they usually work hard to keep the incisions as inconspicuous as possible. Your surgeon will inject fluid into the area to be treated, this prevents extensive tissue damage. A cannula is inserted and with a vigorous push and pull motion fat is removed. If more sites are to be treated, your surgeon will suture the incision before moving on to the next area. Recovery time is usually pretty quick with liposuction. You will be asked to wear a form-fitting girdle for a short period after the surgery. Sutures are removed five to seven days after surgery. Patients typically return to normal activity in three to four weeks. Swelling peaks and begins to subside during the first week with total reduction occurring after several weeks. Bruises fade and ultimately disappear after about four to six weeks. You may still have numbness in the treated areas for some time, but it usually subsides after a few weeks.

The most common types of bariatric surgery are gastric bypass and lap-banding. Of the two, gastric bypass is the most invasive procedure. Both surgeries work by restricting the amount of food that can be held in the stomach. With gastric bypass, the stomach size is dramatically reduced by using a stapling procedure and re-attaching the small stomach pouch to the intestines. This procedure reduces the volume of food that can be eaten to about two tablespoons.

A newer more popular bariatric procedure is the Lap-band, which stands for Laparoscopic Banding. In this surgery, an adjustable band is placed around the upper portion of the stomach. No stapling is necessary to create a smaller pouch. The band can be adjusted to the amount of restriction needed to meet the goals of your weight loss. An attractive aspect of this surgery is that the technique can be reversed.

How do I find a good weight loss surgeon?

Finding a Surgeon

When considering weight loss surgery, it is critical to find a well-qualified surgeon. Be careful when choosing a surgeon because they aren't created equal; some are better than others. There has been an exponential rise in the number of surgeons, particularly bariatric surgeons, because insurance has begun to pay for the procedure. Be sure that you find a surgeon that is knowledgeable about your particular procedure. A more experienced surgeon translates into a lower risk of complications. Most doctors have websites you can browse to learn more about their credentials. If possible, find a surgeon that has performed a minimum of 100 procedures. It is especially important that you feel comfortable and trust your surgeon. During your consultation, inquire about the surgeon's experience and type of complications that have occurred in the past. Your surgeon should be board-certified by the American Board of Surgery and a member of the American Society of Bariatric Surgeons.

Am I a candidate for weight loss surgery?

Are You a Candidate for Surgery?

The best candidates for liposuction are those who need to lose small to moderate amounts of fat deposits. This is done by sculpting certain body parts. If you want slimmer hips and thighs, a flatter stomach or your double chin removed, then liposuction can help. Requirements include good physical and emotional health, skin elasticity and realistic expectations to achieve maximal benefit. As you consult with your physician, he/she will determine if you are appropriate for surgery.

Severe obesity is clinically diagnosed by either having a Body Mass Index (BMI) greater than 40 or being 100 lbs. overweight. Being this overweight is associated with many health-related problems. The most obvious is an increased risk of death directly related to increased weight. If you meet either of the two above criteria, you are a potential candidate for bariatric surgery. You must also have a strong desire for a permanent lifestyle change and substantial weight loss. Before surgery, you must have a clear and realistic understanding of the risks invloved and how your life will change after surgery.

Patients with a BMI of 35 to 40 may also be considered for surgery. Surgery may be necessary if you have life-threatening health conditions such as severe sleep apnea, diabetes mellitus or heart disease. If your weight interferes with your daily life or adversely affects employment or family functions, you may be considered for surgery. Your physician will make the final decision.

What type of weight loss surgery is right for me?

Surgical Weight Loss Options

There are a variety of surgical weight loss options, but the choices are based on your weight loss needs. The surgery performed is relative to the amount you need to lose; greater weight loss demands more invasive surgery. The least invasive type of surgery is liposuction, while the most invasive is a bariatric procedure, also known as a gastric bypass.

Liposuction is usually an outpatient procedure. This is a cosmetic procedure where excess fat is removed from specific areas of the body like the hips, buttocks, abdomen, flank (love handles) or chin by suction. Most insurance companies won't cover liposuction since it's considered cosmetic surgery.

Treatment using bariatric surgical procedures is often a last resort for severely obese individuals seeking weight loss. For the obese, who have been unsuccessful at weight loss, medical intervention is required. The good news is that due to the increased number of bariatric surgeries peformed in the U.S., more insurance companies are beginning to cover their cost. Bariatric surgery is the only established method of achieving successful long-term weight control for the severely obese. This type of treatment is not a cosmetic procedure. Bariatric surgery of severe obesity does not involve the removal of fat by suction, but involves reducing the size of the stomach pouch.

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