8 Common Myths of Weight Loss Surgery

Weight loss surgery is a popular treatment option for obesity and has shown to have many positive outcomes for a patient’s health, life expectancy, and overall quality of life. However, there are still some myths and misconceptions surrounding bariatric procedures that keep some patients from taking the step to begin their bariatric journey.

1. Weight loss surgery is really risky.

This is a commonly misunderstood perception. Weight loss surgery in an experienced surgeon’s hands has no more risk than other commonly performed abdominal surgeries. In fact, you are more likely to experience serious complications from a knee replacement than gastric bypass surgery.

2. People are always sick after weight loss surgery.

You should be able to eat normally and enjoy most foods without any problem. If a patient does experience frequent nausea and vomiting, there is usually a problem that can and should be addressed by your surgeon.

3. I will lose too much weight and look old.

This is rarely the case. Most of the time, patients lose the weight that their body needs to lose. Excessive weight loss occurs when an individual is not eating a healthy diet and is experiencing frequent nausea and vomiting that went on for too long before being addressed. Patients who eat a well rounded diet and exercise, look and feel healthy.

4. All my hair will fall out.

After weight loss surgery, a patient’s hair will thin during the first few months when they are rapidly losing weight. This is due to less caloric intake that a person might be consuming and possible nutritional deficiencies. This will stop after about 6 months post op and should grow back to normal after about a year.

5. I can’t get pregnant after weight loss surgery.

Losing weight is a great treatment for infertility. Women can become pregnant within a month or two after only losing a small amount of weight. Although pregnancy is healthy and normal and not complicated by weight loss surgery, we do encourage our patients to plan on not having children until they have lost the weight that they desire. We recommend that you wait more than 18 months.

6. I will have a lot of excess skin.

Significant weight loss will lead to some excess skin. Some people will have more than others. However it is better to be at a healthy weight with excess skin than it is to be overweight with no excess skin. Plastic surgery can be performed to address any problem areas. Exercise may be helpful too to improve your physical appearance in clothing.

7. I will regain all of my weight.

It is rare that an individual regains all of their weight back. However what is more common is that a patient regains 30 to 50% of the weight that they had lost. This is preventable however. This always occurs when a patient goes back to unhealthy eating habits that leads to the over consumption of carbohydrates. It is normal to gain back 5 to 10% of the weight that was lost. However if you regain more, it is likely to cause over-consumption of carbs. Even if someone regains more weight than we would like to see, they are almost always still healthier than where they started.

8. Bariatric surgery is the easy way out.

Any post bariatric patient will tell you that bariatric surgery is far from the easy way out. Yes, weight loss surgery will help patients lose a significant amount of weight, but it is only a tool in your toolbox. Successful weight loss comes with continued effort every day by making healthy food choices, making time to exercise, and often, overcoming food addictions or facing past traumas.

Weight loss surgery is a popular choice for any individual that is struggling with their weight, and offers assistance in helping patients regain their health and their quality of life. If you are considering bariatric surgery but are skeptical due to the above mentioned misconceptions, we encourage you to make an appointment with a bariatric surgeon to discuss your concerns and your health history more in detail.

Tips to Quit Smoking Before Weight Loss Surgery

Prior to having weight loss surgery, you will need to quit tobacco use if you are a smoker. Before and after bariatric surgery, tobacco use can increase your overall surgical risk, affect the healing process, and lead to serious health concerns.  

In general, smoking after bariatric surgery has a 30% increased risk of complications. Similarly, long-term smoking can decrease your ability to lose weight and increase the risk of future complications such as ulcers, blood clots, and pulmonary complications.

If you are a smoker and have ever tried to quit before, you know that the urges to smoke can be difficult to overcome. Before your bariatric procedure, you must quit smoking. Failure to do so may result in your surgeon canceling your surgery, or worse, serious health complications after your procedure. 

As a bariatric surgeon, I speak with many patients about breaking their habit of smoking and have compiled a list of the top tips to help you quit tobacco. The first step to breaking any habit, though, is to have the desire to quit. If you feel forced to quit and look at it as a temporary solution, you will likely not be committed long term. 

Weight loss surgery is known to increase your overall life expectancy by about 10 to 15 years, while smokers, on average, die ten years earlier than nonsmokers. Similarly, studies have found that nonsmokers have better success rates and fewer complications post-operatively than individuals who smoke after bariatric surgery. 

As you begin the journey to a healthier you, think about why you choose to lead a healthier life and follow these tips to quit your tobacco habit for good.  

  1. Throw away any boxes of cigarettes and ashtrays lying around.
  2. Find oral substitutes that can satisfy the urge to have something in your mouth, such as gum, straws, carrot sticks, and toothpicks. 
  3. Set a goal as to why you are quitting and establish a date for when you will start. 
  4. Make sure you have support. The more people who know you are trying to quit smoking, the more accountable you will be.
  5. Be prepared to distract yourself or to avoid circumstances in which you are will be tempted to smoke. 
  6. Try smoking cessation medications, but consult with a physician first to find out which one is best for you. 
  7. Understand that tobacco addiction is challenging to overcome, and most people will relapse. However, relapsing is not an excuse to quit. Learn from your mistakes and start again. 

If you are committed to losing weight to live a healthier life, we urge you to commit to quitting smoking after bariatric surgery to reap all the benefits that come with breaking this bad habit. 

Why You Must Quit Smoking Before Bariatric Surgery

If you are considering have weight loss surgery and are currently a smoker, you will have to quit before beginning your journey. Not only does smoking lead to serious health concerns, but tobacco use before and after weight loss surgery can increase your overall surgical risk and healing process.  

We all know that smoking is a bad habit and can contribute to many medical problems, including coronary artery disease, blood clots, chronic obstructive pulmonary disease (COPD), and increased cancer risk. Tobacco use is the leading cause of preventable death in American adults, followed by obesity. 

According to the CDC, around 16 million people are living with a disease caused by smoking. And for every person who dies from smoking, 30 more are seriously affected by a smoking-related illness. 

However, aside from the health risks that regular tobacco use carries, there is a severe risk of surgical complications if you smoke before or after weight loss surgery. Studies have shown that the risk of serious surgical complications doubles for smokers compared to nonsmokers. Also, individuals who regularly use tobacco products are 1.5 times more likely to experience less serious surgical complications as well. 

Risk of Smoking before Bariatric Surgery

1. Pulmonary Complications

After any surgery, you may experience breathing issues, and a compromised immune system as your body heals the surgical wounds. If you are a smoker, you likely already have damaged lungs, making it difficult to get enough oxygen needed for healing. This can decrease your lung’s ability to fight off infection, leaving you vulnerable to develop pneumonia or other pulmonary complications.

2. Marginal Ulcers

Ulcers are already common in smoking adults, but after bariatric surgery, the risk of developing an ulcer significantly increases. In a healthy adult, ulcers are healed by themselves by pumping blood to the stomach. After the surgery, however, the stomach is smaller, limiting blood flow to the stomach, thus impacting the ability of ulcers to heal.

3. Blood Clots

Blood clots are a risk for any individual after bariatric surgery due to poor blood circulation and decreased physical activity. In less than 1% of patients, blood clotting in the legs can break off and go to the lungs or heart, causing a pulmonary embolism. Smokers have a decreased ability to pump blood through the body, significantly increasing your risk of blood clots after bariatric surgery compared to nonsmokers.

4. Wound Healing and Infections

Surgical wound infections or difficulty healing the wounds is a serious concern for patients who smoke before bariatric surgery. In general, smokers have a decreased blood flow rate to tissue due to vascular occlusion (blockage of veins). Since bariatric surgery involves cutting and stapling the intestines, if there is not enough oxygenated blood pumped to the surgical wound, the healing process can be significantly impacted. This can result in infections as oxygen is the primary source of wound healing.

Other Reasons to Quit Smoking before Bariatric Surgery

In general, smokers after bariatric surgery have a 30% increased risk of complications. Similarly, long-term smoking can decrease your ability to lose weight and increase the risk of future complications such as anastomotic ulcers.

If you have smoked within four weeks before your bariatric procedure, you may risk having your surgery postponed or canceled. Some surgeons will not risk surgical complications and the difficult healing process you may experience due to smoking before weight loss surgery.

Weight loss surgery is known to increase your overall life expectancy by about 10 to 15 years, while smokers, on average, die ten years earlier than nonsmokers. Therefore, we encourage all of our bariatric patients to stop smoking as they make this commitment to leading a healthier life. 

Options to Pay for Weight Surgery Without Bariatric Insurance Coverage

If your insurance does not pay for weight loss surgery, the costs can become worrisome for you and your family. Medical bills are the third largest cause of debt in the United States, aside from divorce lawyer fees and job loss. 

With weight loss surgery being an elective procedure, it is easy to decide not to have the surgery if you do not have bariatric coverage on your insurance plan. Unlike being diagnosed with cancer or having a heart attack, your weight is not going to kill you…yet

Many overweight and obese individuals fail to recognize the danger of living with obesity and its impact on their overall health and quality of life. Similarly, over time, carrying around excess weight will lead to health complications that must be treated, ultimately forcing you to rack up those medical bills. 

Would you rather pay a larger lump sum now to treat your obesity or continue to pay medical bills over the years to treat your health complications?  

We recognize that finding ways to pay for weight loss surgery can be difficult, and not everyone will have the same options. But before you settle with the choice to continue living with obesity, take a deeper look into your payment options. 

1. Take out a personal loan

Look into taking out a personal loan from the bank. Although you will have to pay interest on this loan, the total interest paid may be insignificant in relation to the amount you would have had to pay in late payment penalty fees. 

2. Use a personal line of credit

A personal line of credit will allow you to make withdrawals up to a certain amount. The benefit of a personal line of credit compared to a personal loan is you only pay interest on the amount that you withdraw instead of the entire lump sum.

3. Borrow against your home equity

If you have around 15 to 30% equity in your home, you may be able to take out a loan while securing your property as collateral. The downside to this option, though, is that if you can not afford the loan payments, you risk losing your home. 

4. Partner with a healthcare financing company

Apply for a healthcare credit card, such as CareCredit, to help you pay for your medical expenses. This option, if you qualify, is an excellent choice because most healthcare financing companies offer shorter financing options with little-to-no interest payments. However, make sure that your provider accepts CareCredit or other healthcare financing services before applying.

5. Withdraw funds from your retirement plan

If you have a 401K with your employer, you may be able to withdraw funds from this retirement savings. It is important to note, though, that the IRS will limit how much you can take out to either $10,000 or 50% of the vested amount. Similarly, you may be faced with a large tax bill at the end of the year due to the early withdrawal from your 401K.

6. Ask your family or friends to be lenders

Although there may be a lot of shame surrounding this option, it never hurts to ask for help. Explain to your family and friends the importance of bariatric surgery for your health and your quality of life. Even if they can’t afford to pay for it all, some help is better than no help. 

7. Tap into your savings

If you have the financial means, we always recommend this option to pay for weight loss surgery. By using your savings, you won’t have to pay interest, risk losing your assets, or be penalized due to an early withdrawal.

We encourage you to think about just how much your life is worth before you settle with continuing to live with the extra weight. Not only is your weight likely inhibiting your ability to enjoy life, but over time, it could lead to serious health complications, or worse, death.

The Risks Associated with Having Bariatric Surgery in Mexico

Over the last several years, a growing trend has been medical tourism, with many patients seeking bariatric surgery in Mexico. Yet, aside from the appropriate aftercare that we discussed in last week’s blog, traveling internationally for weight loss surgery carries a considerable risk for your health and your wallet. 

All surgeries carry a risk, and even the most well-trained and skilled surgeons have complications. Therefore, it is imperative that the patient has a relationship with their operating surgeon and that this surgeon is readily available to manage any of their complications.  Within our practice, we have cared for numerous patients who have had to come to the emergency room due to post-surgical complications within days of returning home.

Risk of Having Bariatric Surgery in Mexico

1. Insurance Coverage for Complications

Many patients do not realize that when they return home after having weight loss surgery in another country, their insurance will not cover these complications. In most cases, the patient is left with thousands of dollars in out-of-pocket expenses. The thought of saving some money by having weight loss surgery in Mexico soon evaporates as they are faced with a mountain of bills. 

Furthermore, you may be unable to file a medical malpractice lawsuit in another country, being it’s complicated. The medical malpractice laws in Mexico are significantly different than in the United States, and you may not be able to sue for malpractice.

2. Lack of Post-Surgical Care for Complications

Complications, if they happen, usually do not occur until the patient has returned home. I have personally cared for individuals who have gone straight from the airport to the emergency room with devastating post-surgical complications. It is not surprising that the surgeon at your local emergency room would not be enthusiastic about taking care of the complications created by another colleague, especially when the surgery was performed in another country. 

Furthermore, this leaves the patient in a very awkward position, not knowing who to call or what to do. I have taken care of patients communicating with the program in Mexico for several days, being told that everything would be okay only to end up in the emergency room days later. If the patient were to know who to call locally, they could have been physically examined when the problem arose, potentially saving them a trip to the ER. 

A quick internet search will reveal many news videos and stories of patients who underwent surgery in Mexico to save money, only to end up with severe complications resulting in lifelong health problems and significant debt, or even worse – death.

Other options that will allow you to have bariatric surgery without traveling internationally:

With the cost of bariatric surgery being around $20,000, it’s no wonder that many Americans are finding other options to be able to afford weight loss surgery. Unfortunately, though, when it comes to healthcare, cheaper is not always better since many patients do not realize the potential hidden cost beyond saving money. We recognize that surgery in the United States is more expensive than in Mexico; however, when you consider the additional costs of long-term care, the cost savings are soon lost, especially if the individual were to have a complication.

If your insurance does not cover weight loss surgery, we encourage you to consider other options before traveling to Mexico for bariatric surgery. Weight loss surgery is an investment in your health and something that should be taken seriously. 

We know that many patients do not have the financial resources to make this investment right before surgery, so many medical financing companies will provide short-term secured loans. In most cases, the cost is no more than a car payment. Additionally, most retirement plans will allow for a penalty-free withdrawal to pay for medical care. Other options include home equity loans that would provide the individual with a much lower financing rate.

At Live Healthy MD, our surgeons are happy to discuss all of these options with you. We encourage you to make an appointment to sit down and discuss the possibility of seeking surgical care outside of your local community. We want to make sure that you make a well-informed decision before committing to surgery performed by someone outside your local community.  

Why You Should NOT Have Bariatric Surgery in Mexico

At a cost of $15,000 to $20,000 for bariatric surgery, it’s no wonder that many Americans whose insurance does not cover weight loss surgery are seeking other options. Over the last several years, a growing trend has been medical tourism, with many patients seeking bariatric surgery in Mexico. The chance to save $10,000 or more is very tempting to consider, especially when somebody is desperate to lose weight and realizes that their best, and often only, option is weight loss surgery.  Unfortunately, though, when it comes to healthcare, cheaper is not always better since many patients do not realize the potential hidden cost beyond saving money.

Indeed, there are skilled surgeons and exemplary medical care in other countries; however, one needs to consider other factors apart from the cost to ensure that the patient has a good outcome. Here are some of the top reasons why we believe an individual should avoid traveling overseas for weight loss surgery.

Reasons to NOT Travel Overseas for Weight Loss Surgery

1. No Consistent Standard of Care

For better or worse, the medical industry in the United States is highly regulated, meaning there are federal and state standards to how hospitals, clinics, and physicians can practice. Unfortunately, in many other countries, the standards are lacking or significantly different from what we are used to in the United States. 

For instance, many surgeons in Mexico can perform advanced procedures, such as weight loss surgery, in a clinical environment that lacks a hospital’s standard capabilities. Additionally, the medical training and the level of quality and skill of the physicians may be difficult to ascertain. 

In the United States, most weight loss surgical procedures are performed in a hospital setting designated for their quality outcomes based on the American Society of Metabolic and Bariatric Surgery Center of Excellence (ASMBS COE)standards. Surgeons performing weight loss surgery procedures within a Center of Excellence must adhere to certain standards and quality measures tracked regularly.  

International facilities have the capability of becoming designated a Center of Excellence; however, many of the facilities advertising for “cheap” bariatric surgery in Mexico do not follow these protocols. We have seen that some physicians claim to be certified in a specialty field (such as bariatric surgery) despite having insufficient training.

The United States has very stringent licensing and accreditation guidelines. When a physician advertises that they are board-certified, you can rest assured that their skills and experience have been verified by the American Board of Medical Specialties, as well as state and local licensing boards. Confirming that your surgeon is board-certified by the American Board of Surgery is an absolute must.  

In Mexico, The Mexican Council for the Surgery of Obesity and Metabolic Diseases is the official organization to certify a surgeon in bariatrics. If your surgeon is not certified by this organization, they may be performing surgery outside of their scope of practice.

2. No Strict Guidelines on Bariatric Qualifications 

Within the United States, there are excepted standards on who should and should not have weight loss surgery. This is based on the National Institute of Health‘s published guidelines. However, when traveling overseas for weight loss surgery, healthcare facilities do not follow the same criteria and are not very strict. 

Often, patients might have weight loss surgery even if they do not need it or do not qualify for it by traditional American standards. Many international surgeons are more than willing to take a patient’s money, knowing that they will be back in the United States if and when a complication were to happen after surgery. 

3. No Appropriate Bariatric Aftercare

Successful weight loss surgery requires ongoing care. In our practice, we take a considerable amount of time preoperatively to adequately educate the patient of the risks and benefits of weight loss surgery. In Mexico, patients show up a few days before their procedure, undergo basic education, and briefly meet the surgical team. There is hardly any time to develop a relationship with the team and process the importance of making this life-changing decision. 

Additionally, every program has specific protocols for eating after weight loss surgery. A registered dietitian should be on staff to help guide your recovery. Patients desperate to have weight loss surgery are only thinking about the moment of getting the procedure done. Most individuals do not think about aftercare. 

Even if the surgery goes well, having an ongoing relationship with your surgeon and their team is critical to long-term success. For most patients to do well long-term in maintaining their weight loss, they need to have ongoing counseling and guidance from an expert weight loss team that incorporates the Center of Excellence standards within their program.

At Live Healthy MD, we believe that every patient deserves excellent aftercare, so we will never turn away a patient who needs our help; however, before considering surgery in Mexico, we strongly encourage you to seek a bariatric surgeon’s advice in your local area

If you are considering bariatric surgery in Mexico, look out for this:

If it sounds too good to be true, it probably is. Many websites are simply advertising tools for surgeons south of the border, claiming surgeries performed in the thousands with virtually no complications.

Before you decide to have your bariatric surgery at one of these facilities, verify the following: 

  1. Make sure the facility is a hospital and not an outpatient clinic. 
  2. Ensure that the facility is Jcaho certified.
  3. Verify that the surgeon is trained in bariatric surgery and board-certified by the American Board of Surgeons or did their training in the United States.  
  4. Make sure the center is certified as an International Bariatric Center of Excellence by ASMBSQIP program. 
  5. Ensure the program has a multi-disciplinary team of nutritionists and psychologists that you will have access to on an ongoing basis. 
  6. Finally, do not believe the claim that the surgeon is affiliated with programs in the United States unless you speak with that U.S.-based surgeon yourself. 

Bariatric Liquid Diet Before Weight Loss Surgery

Before weight loss surgery, all patients must adhere to a two-week liquid diet no matter the type of bariatric procedure being performed. The thought of drinking only liquids for two weeks sounds horrible and quite intimidating. But in this blog, we hope to educate you on the purpose of the liquid diet, the dangers of not adhering to the diet, and how to follow the diet. So grab your drink and take a seat; let’s dive in! 

As a bariatric dietitian, I understand how difficult it can be to even think about giving up solid foods in preparation for weight loss surgery. I have seen many patients struggle during these two weeks, and I do feel for them. However, despite what you may think, this is not to torture you! In fact, we require patients to only consume liquids before surgery to limit the procedure’s risk. 

Purpose of the Bariatric Pre-Op Liquid Diet

Prior to surgery, many patients will have excess fat sitting around and/or in their liver. In order to effectively reach the stomach to perform the bariatric procedure, the surgeon has to move the liver. And the larger the liver is, combined with the fat in and around it, the harder it is for the surgeon to safely and effectively maneuver around it. 

This can result in more time that the patient will be under anesthesia, significantly increasing their risk of complications, not to mention their medical bills. 

On the two-week liquid diet, patients lose enough weight to shrink the liver and limit the amount of time the surgeon will have to spend moving around the liver. 

The Pre-Op Liquid Diet Meal Plan

The pre-op liquid diet will consist of approved protein shakes, sugar-free beverages, sugar-free gelatin, sugar-free popsicles, and broth.We always recommend that our patients consume five protein shakes a day and consume at least 64 ounces of sugar-free liquids. Patients cannot consume carbonated beverages such as sodas, sparkling waters, milk or alcohol, etc., and all drinks should contain no more than 10 calories per serving. We also recommend that patients limit their caffeine consumption to two 8-ounce servings a day—all you coffee lovers can still enjoy your cup of joe (with sugar-free sweetener, not sugar).

*This plan does not need to be followed precisely. You can adjust the times based on your own schedule. 

*This plan is based on the liquid diet our practice requires patients to do and is a case-by-case diet plan. Therefore we recommend you talk with your surgeon about what you should be consuming leading up to surgery.

What to Expect with the Pre-Op Liquid Diet

When you restrict the total calories and carbohydrates you consume in a day to an extremely low amount, some patients may experience symptoms.

Some of the symptoms you can expect to experience include:

  • Extreme Hunger Pains
  • Fatigue
  • Headaches
  • Nausea, Constipation, Diarrhea
  • Mood Swings

The symptoms listed above are completely normal, and they should subside within 3 to 4 days, once your body gets used to consuming so few calories and carbohydrates. Drinking 64 oz of sugar-free beverages and broth can help with the severity of these symptoms.

Success Tips for the Pre-Op Liquid Diet

The pre-operative liquid diet is hard—there is no doubt about it! Therefore, we highly recommend that our patients mentally and physically prepare themselves for the challenge ahead.

1. Plan ahead for success.

Leading up to the days you will be participating in the liquid diet, we recommend that you go to the grocery store to stock up on all the items you will need throughout the two weeks. Waiting to buy the protein shakes, gelatin, and broths until the last minute can lead to failure in adhering to the plan. You want to make sure you set yourself up for success from day one.

2. Find a support and accountability system.

We recommend that bariatric patients find a support system; it can be friends, family, or a group of current/past patients at your bariatric clinic. By enlisting support, you are not only holding yourself accountable, but others are holding you accountable. We have seen it first hand; patients who decide to do it all on their own (pre and post-op meal plans) are not as successful with their weight loss as those are who find support. 

3. Remember, it’s temporary.

The two-week liquid diet can be daunting. It is critical that you mentally prepare yourself for the challenge. Tell yourself, this is temporary, and it is a part of a bigger plan! 

4. Ignore the numbers on the scale.

Although the liquid diet is in place to lose weight rapidly before surgery, don’t get caught up on the number on the scale. If you see that you aren’t losing weight like you want to, you may be more inclined to start cheating because “what difference does it make anyway?” 

We know that the pre-op liquid diet can be intimidating, especially if you have never been on a highly restrictive diet plan before. However, you want to be sure that you are fully committed to the pre-op liquid diet, or else your surgeon may have to cancel or reschedule your surgery. The pre-op liquid diet is a critical step leading up to the weight loss surgery, and all patients have to participate in it—so you are not alone! 

Requirements for Weight Loss Surgery

Contrary to popular belief, having weight loss surgery IS NOT the easy way out. If you talk to any successful bariatric surgery patient, they will tell you about the amount of determination AND effort it took to have a better quality of life and healthier lifestyle.

Continue reading “Requirements for Weight Loss Surgery”

5 Reason to Have Weight Loss Surgery This Year

Weight loss surgery seems like a potentially radical or even a scary option for losing weight. However, when you take a closer look at the risks and benefits of bariatric surgery, most experts and patients usually conclude that the reward is much greater than the risks when the procedure is performed by an expert bariatric surgeon.

Continue reading “5 Reason to Have Weight Loss Surgery This Year”

Video Blog: How to Start Your Weight Loss Journey

Weight loss surgery is becoming a popular choice for many overweight and obese individuals. Within our own practice, we have seen a growth of over 30% in surgery volume when comparing 2019 to 2020. Continue reading “Video Blog: How to Start Your Weight Loss Journey”

How to Decide What Bariatric Procedure to Get

What weight loss procedure should I get? This is one of the most common questions I hear in my office when meeting new patients. It may sound simple but after hearing about the advantages of each operation from multiple sources (the bariatric surgeon, internet, television, friends and family, etc.), this decision can seem overwhelming.

Continue reading “How to Decide What Bariatric Procedure to Get”

Is Weight Loss Surgery Right For Me?

Weight loss surgery is becoming a popular choice for many overweight and obese individuals. With the rising number of bariatric cases performed each year, weight loss surgery may seem like a good option for you. However, there are several important qualifications that you need to consider if you are looking into having bariatric surgery. In this blog, we will review what they are.

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Deciding to Have Weight Loss Surgery

If you are thinking about having weight loss surgery, I first want to say “congratulations”.  The decision to have weight loss surgery is not an easy decision and must not be taken lightly. With that being said, it is a wonderful way to transform your health, and your life when everything else has failed.

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The Importance of Support for Weight Loss Success

I can not stress enough just how important it is to find support after having weight loss surgery. Many studies have proven that physical and emotional support will ultimately help patients become more successful in the long run. Support can come in all forms but regardless of the type or the degree of involvement you would like your “mentor” to have, it is just important that you find encouragement to meet your goals.

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Video Blog: Deciding in Weight Loss Surgery is For You

The Talking it Up Show with Arlean Edwards is a local production that interviews keynote speakers within the CSRA. I, Dr. Jacome, was invited to join Arlean on set in a series of videos where I talk about what it takes to live healthy. This is the fourth video we are sharing from this series. You can find the first three videos on Calories, Dieting, and Family Dynamics on our blog. Be sure to stay tuned to see what other exciting topics I cover in the coming months! Continue reading “Video Blog: Deciding in Weight Loss Surgery is For You”

The Period Before Weight Loss Surgery

The decision to use surgery as a treatment for the disease of obesity is one that takes a considerable amount of thought. Most patients will spend the better part of a year researching their options for treatment. At Live Healthy MD, we take this decision seriously and encourage our patients to get the most information as possible. In the past couple of blogs I have written, we have explored the process of considering weight loss surgery. Today I want to talk more about the actual process leading up to surgery.

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Paying for Weight Loss Surgery: Insurance Coverage and Costs

One of the most daunting factors when considering bariatric surgery can be how you are going to afford it. I frequently see patients who desperately need and want weight loss surgery, however they do not have the funds to pay for it. With the average cost of surgery in the thousands of dollars, it is not surprising that some patients won’t even come in for an initial consultation because they either don’t have money to pay cash for the surgery or their insurance does not cover the procedure.

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The Pre-Op Liquid Diet: All You Need to Know

We all love food. Anyone who claims they don’t is lying. It can be difficult to even think about giving up all those delicious meals and treats you enjoy when preparing for weight loss surgery. In this blog post, we will discuss exactly what you need to do to prepare your diet for weight loss surgery, both physically and mentally. So let’s dig in!

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How Safe is Weight Loss Surgery?

One of the biggest myths surrounding weight loss surgery has to do with the safety of these procedures. I can’t begin to tell you the number of patients who say, ”I thought these operations were risky” or “I have too many medical problems for that to be safe”.  They are not completely wrong—this is surgery and surgery does have its risks. However, what most patients find surprising is that all of the modern weight loss procedures performed today are as safe, if not more safe, than most commonly performed procedures. Similarly, in most cases, the risk of this disease (a.k.a obesity) is GREATER than the risk of surgery.

Continue reading “How Safe is Weight Loss Surgery?”

Preparing Your Diet For Weight Loss Surgery

The decision to have weight loss surgery should not be taken lightly. We encourage patients to research different procedures, speak to their surgeon, and speak to others who have already had surgery. We want our patients to fully understand the process and have realistic expectations for both their weight loss and the changes they must make to be successful long term. Having weight loss surgery is not an easy solution, but with proper education and support we know that patients can change their lives and health forever. In fact, we get to witness success stories every day!

Continue reading “Preparing Your Diet For Weight Loss Surgery”

Choosing The Right Surgery For You

In previous blogs I’ve talk about the duodenal switch, the gastric bypass, and the gastric sleeve. Today I want to summarize these different operations and talk about what I tell my patients when they come to see us about weight loss surgery.

First off, let’s talk about the gastric sleeve. This operation we started to do in the field of weight loss surgery around 10 years ago and it has gained a lot of popularity over the last several years. In our practice it probably accounts for about 40 to 50% of the procedures that we do. This procedure is a relatively simple technical operation, where we remove about 80 to 90% of the stomach volume leaving the stomach as a small narrow tube.

In effect, what we have done is reduce is the volume of the stomach so a patient eats significantly less. But we also believe that hormones are in play that reduce hunger—so the patient feels much less hunger than they previously did before. As a result of these two effects, reduced volume of food in an early sense of satiety, along with decreased hunger, patients tend to have fairly significant weight loss. I tend to tell my patients that they will lose about 10 to 20% less weight loss than they typically will with the gastric bypass.

Moving on to the gastric bypass, this really has been the mainstay procedure that we have done in the field of weight loss surgery for many, many decades—going back to the 1980s. This probably is the operation that we have the greatest experience with, knowing about it short and long-term weight loss effects.

The gastric bypass involves creating a small pouch out of the stomach and rerouting the small intestine up to that pouch. Effectively what we’ve done with this operation is bypass the main part of the stomach to divert food away from the duodenum, which is the first part of the small intestine. Therefore, the digestive process begins further downstream; probably somewhere in the 20 to 30% range. So effectively what we’ve done is shorten the small intestine by about 20 to 30% and also made the stomach smaller so that when we eat we have a much earlier sense of satiety.

I tell my patients that the weight loss effects probably have more to do with some of the hormonal effects that we believe are occurring. Certainly patients eat significantly less as a result of the operation but by bypassing the first part of the duodenum, we believe that we are altering hormones that regulate our metabolism. Thereby, resulting in significant weight loss. Typically I would expect most of our patients lose somewhere in the 60 to 80% excess weight loss range with this operation.

The duodenal switch is an operation less commonly performed and in our practice probably about 10% of patients receive this operation. The easiest way to look at this procedure is to think of a sleeve gastrectomy along with the gastric bypass. We do the sleeve, like was previously described in earlier blogs that I’ve written about, and we also bypass the duodenum like we do with the gastric bypass.

But instead of bypassing somewhere in the neighborhood of 20 to 30% of the small intestine, we’re bypassing an excess of 70 to 80% of the small intestine.  So the duodenal switch not only has all of the benefits of the sleeve gastrectomy and the gastric bypass, but there is also significant malabsorption.

And although one might think that this would be a good thing, it certainly does have some side effects. Nutritional deficiencies are much more likely to occur after the duodenal switch and there are fairly significant changes in the bowel pattern.

So what you might be asking yourself is why would we do this procedure. Well typically I would look to this operation as a potential choice for our patients who are in the heavier weight range.

So to summarize, when I see a patient for the first time and we’re talking about the various different procedures and what might be more or less effective for them, I tend to look at two things; number one what are the medical problems the patient is suffering from and also what range weight are they starting at. So to generalize, if a patient is in the lower weight range and does not have significant ongoing medical co-morbidities, like diabetes and hypertension, I tend to lean more to the sleeve gastrectomy.

For patients more in, what I would consider the middle-weight range, maybe somewhere with a body mass index in the mid-to-upper 40s and lower 50s range, or particularly with patients who suffer from diabetes where they may be taking multiple injectable type medications, I would lean more to the gastric bypass.

And then for our patients who are in the heavier weight range, and I would consider those people to be in the body mass index range of 55 and particularly above 60, I tend to direct direct those individuals to the duodenal switch. And the reason being is that for our heavier patients, although they will have significant weight loss with the sleeve and the gastric bypass, they may not achieve the degree of weight loss that we would like to see—whereby they would reduce their body mass index to a more medically acceptable range (typically under a body mass index of 40). But it is just not statistically likely that those patients in the upper body weight ranges with body mass indices above 60 are probably going to achieve that degree of weight loss with a gastric bypass or a sleeve. Now, it’s not to say that doesn’t happen, and it certainly does occur quite frequently, but just as a statistical matter a fair number of people will not achieve that degree of weight loss. Thereby in my practice I start to look toward a duodenal switch for these individuals.

Certainly there is a lot more to know about these operations. When a patient comes to see us in our practice and they go through the initial consultation and education process, we get into much greater detail about all of the procedures. We encourage any individual that is suffering from weight-related medical problems to at least seek some treatment. This doesn’t necessarily have to involve surgery, but certainly should be directed towards an aggressive medical weight loss program. And if it’s felt that a surgical approach is an option for that patient, seeing a competent bariatric surgeon who is at a center of excellence designated facility would be something that that you should certainly get more information about. Therefore you can learn what your treatment options are for this serious medical problem—the disease of obesity.

Well I thank you for listening and if you’d like more information you can check out our other blogs or come to our weight loss seminars. We have both surgical and nonsurgical weight loss seminars directed towards treating this disease.

Weight Loss Surgery Misconceptions

As a weight loss surgeon, one of the many questions I get from patients about weight loss surgery is “Do I have too many medical problems for surgery?”  The answer is  NO! Weight loss surgery is meant for patients with multiple, and in most cases severe, medical problems.  Most, if not all, problems that we have as humans can be linked to excess weight.  The most common problem we deal with is diabetes and weight loss surgery is usually a CURE for this chronic disease.

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