What happens after surgery?
For RNY Gastric Bypass and Sleeve Gastrectomy Patients:
Immediately you will notice a difference in the amount and type of food you can eat. You will receive nutritional counseling to help show you the dos and don’ts. Since the amount of food you can eat will be much less, it becomes very important to eat the right types of food to be sure your body gets enough nutrients. Daily vitamin and mineral supplements will be necessary.
Exercise is important. Most people find that as the weight comes off after surgery, it becomes easier to exercise. Then, as they exercise more the weight comes off even more. It’s like a reverse snowball effect: as a snowball rolls downhill it goes faster and grows bigger – but instead of a snowball getting bigger, it is you getting smaller and healthier! We recommend that our patients exercise at least 30 minutes a day at least 5 days a week.
It is reasonable to expect to lose about 60 percent of your excess body weight after surgery, although this can be much higher or lower depending on compliance with proper diet and exerc ise. Most patients stabilize at their new lower weight between 1 and 2 years after surgery, although dramatic weight loss can often be seen within the first few weeks to months.
Weight-related medical problems may be alleviated or eliminated after surgery. Such conditions include diabetes, high blood pressure, sleep apnea, gastroesophageal reflux, and weight related depression. Significant weight loss may also decrease your risk of heart disease and some types of cancer.
Weight loss surgery is not without risk. The risks of surgery must be weighed carefully against the benefits of weight loss. Any major surgery carries risks of anesthesia, bleeding, infection, blood clots, pulmonary embolism – any of these can be minor or very serious including death. In addition, gastric bypass and sleeve gastrectomy surgery carries specific risks, including but not limited to: hernia, gallbladder problems, bowel obstruction, and leak or narrowing along the staple lines or at the anastamoses (where the bowels are hooked back together in the gastric bypass).
Life long supplementation of vitamins and minerals must be taken to prevent nutritional deficiencies such as anemia and osteoporosis. Women of childbearing age must avoid becoming pregnant during the first 1-2 years after gastric bypass surgery. Nutritional deficiencies during the rapid weight loss period after surgery could harm the developing baby. At Atlanta Bariatrics, you and your doctor will carefully review the risks weighed against the benefits of surgery for your particular situation.
For LAP-BAND and Band plication Patients:
It is very important to follow the eating and drinking instructions starting right after the operation to allow the new stomach structure to heal completely and in the right position. The LAP-BAND is usually left empty or only partially filled for the first 4 to 6 weeks after surgery. After that time you will begin a schedule of adjustments.
LAP-BAND adjustments are performed without surgery in the office using a thin needle to inject or withdraw saline from the band via the access port. We have an ultrasound machine we use in the office to make the process smooth and easy. Being able to adjust the band is a unique feature of the LAP-BAND system and is a normal part of the follow-up. This feature lets your surgeon find the right level of restriction to meet your individual needs. When your band is properly adjusted, you should not feel hungry between meals, and you should feel full with a limited amount of food.
You will notice a difference in the amount and type of food you can eat. You will receive nutritional counseling to help show you the dos and don’ts. Since the amount of food you can eat will be much less, it becomes very important to eat the right types of food to be sure your body gets enough nutrients.
Exercise is important. Most people find that as the weight comes off after surgery, it becomes easier to exercise. Then, as they exercise more the weight comes off even more. It’s like a reverse snowball effect: as a snowball rolls downhill it goes faster and grows bigger – but instead of a snowball getting bigger, it is you getting smaller and healthier! We recommend that our patients exercise at least 30 minutes a day at least 5 days a week.
It is reasonable to expect to lose about half of your excess body weight after LAP-BAND surgery. Most patients lose about 1 – 2 pounds per week when the band is adjusted optimally. Most patients stabilize at their new lower weight between 3 and 5 years after surgery. Weight loss can occur much faster if plication is performed.
Weight-related medical problems may be alleviated or eliminated after weight-loss surgery. Such conditions include diabetes, high blood pressure, sleep apnea, and weight related depression. Significant weight loss may also decrease your risk of heart disease and some types of cancer.
Weight loss surgery is not without risk. The risks of surgery must be weighed carefully against the benefits of weight loss. Any major surgery carries risks of anesthesia, bleeding, infection, blood clots, pulmonary embolism – any of these can be minor or very serious including death. In addition, gastric banding carries specific risks, including but not limited to: band slippage, band erosion, or mechanical malfunction of the port. At Atlanta Bariatrics, you and your doctor will carefully review the risks weighed against the benefits of surgery for your particular situation.
What to Expect
The health benefits of losing weight are countless. Most patients will lose between 50-70% of their excess weight. The exact amount of weight that is lost will depend on compliance with dietary and exercise guidelines after surgery and follow-up in the program. The time over which the weight loss occurs depends on the procedure that is chosen. The risks of many of the serious diseases associated with obesity decline dramatically as weight loss occurs and many conditions can be reversed. Many of the medications required for the diseases can be stopped or the dosages lowered.
In many of the conditions such as diabetes, there is no medical intervention that can achieve the profound effects as obtained in bariatric surgery. In addition, the quality of life is improved. Patients often remark how they are now able to do things that non-obese individuals may look at as trivial. Long-term maintenance of the weight loss has been documented in dozens of studies with follow-up as long as fifteen years out from surgery. Some medical conditions that greatly improve after surgery include:
• Diabetes - More than 80% of Type II diabetics have complete resolution of their diabetes, and many others have greatly improved control. This usually occurs within a few weeks of surgery for gastric bypass patients, and slightly longer for Lap-Band patients. Patients are able to come off their medications including insulin injections and have normal blood glucose and Hemoglobin A1C levels.
• Hypertension/High blood Pressure – Over 70% of patients are able to come off all of their anti-hypertensive medications. Many other patients are able to significantly reduce the number or dosages of their medications.
• High cholesterol – Over 80-90% of patients will develop normal cholesterol levels within two to three months after gastric bypass, with significant improvement seen for Lap-Band patients as well.
• Sleep apnea syndrome/Hypoventilation – The large majority of patients have improved breathing at night and overall decreased shortness of breath following weight loss. Sleep apnea is resolved in over 85% of patients. Patients feel refreshed and usually no longer require accessory breathing apparatus after weight loss.
• Degenerative Joint Disease – Patients who have significant joint pain which limits their activities find after surgery they can now participate in many activities and social events, even sports. Lower back pain and disc disease is often relieved and overall improvement is usually seen with as little as 25-30 pounds of weight loss. If nerve injury or structural damage had already occurred, the complete relief of pain cannot be expected.
• Acid reflux – Bariatric surgery is an excellent method of treating acid reflux disease. Relief is usually noticed within a few days of the surgery.
Other conditions which have been shown to greatly improve after surgery include asthma, stress urinary incontinence, polycystic ovary syndrome and many others. Many of the conditions improve as quickly as a few months after surgery.
