Tag: Pre 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.

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. 

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. 

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.  

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. 

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.

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