Higher self-esteem, medication discontinuation, and improved relationships—these are just some of the life-changing benefits of undergoing weight loss surgery.
Also called bariatric surgeries, these operations help you lose weight if you have morbid obesity, characterized by a body mass index (BMI) of more than 40 or over 35 with an accompanying medical condition like high cholesterol, hypertension, or type 2 diabetes. They may be the best option if other weight reduction methods have failed, and if obesity poses a greater health risk than undergoing a procedure.
“Obesity is a chronic disease like high blood pressure and high cholesterol. It’s not a patient’s failing; sometimes you cannot control the weight. You need support to change your habits, and surgery gives you a lot of that,” says Dr. Jessica Gonzalez Hernandez, a bariatric surgeon and medical director of Bon Secours St. Francis’ Comprehensive Weight Loss Clinic.
Even with the prevalence of GLP-1 medications, bariatric surgeries are “still the standard of care for obesity,” she adds. “GLP-1s help you lose weight. But when you are 100, 150, 200 pounds overweight, they are not the best solution.”
The most common surgeries are the gastric sleeve and gastric bypass. During a non-reversible gastric sleeve procedure, surgeons remove 80 to 90 percent of the stomach. This naturally reduces the amount of food you can consume in one sitting and makes you feel fuller faster. It also reduces the hunger hormones that are normally produced in your stomach.
During the restrictive and reversible gastric bypass surgery, surgeons make a small pouch in the stomach and connect it directly to the small intestine, rerouting your consumed food. “That means food goes through a portion of your intestine without being able to be absorbed. So, you won’t absorb the same number of calories you were absorbing before,” Gonzalez Hernandez says.
To decide which procedure is right for you, she and her team review your medical history and conduct necessary tests, such as an upper GI
study or EGD. It will determine if you have esophageal reflux, a condition that gastric sleeve surgery can worsen.
Surgery preparations include meeting with a nutritionist to learn healthy eating habits and getting a psychological evaluation to ensure “you are committed to surgery and there’s nothing else that would affect your success,” Gonzalez Hernandez says, adding that you’ll eat a high-protein, low-carb and low-fat diet for two weeks pre-procedure.
This will help shrink the liver, giving surgeons a better view of the stomach, and “will make the surgery faster, which hopefully will result in less pain and a faster recovery,” she says.
Each surgery—done robotically—comes with an overnight hospital stay, and fewer hunger cues make dehydration and constipation the most common post-surgery complications.
“I usually tell patients to take two weeks off work because for the first two weeks you’re on a liquid diet only, so nothing will disrupt your staple lines,” Gonzalez Hernandez says. “Think of it as the time to plan what your new life is going to be like, what your nutrition is going to be like, if you want to incorporate a new exercise routine.”
That’s because these surgeries are not quick fixes. “It is a tool we give you. The only way it will serve you well is if you combine it with healthy eating habits and physical activity. You can have the surgery, but if you don’t make changes, you’ll regain the weight you lost initially,” Gonzalez Hernandez says.
To see if bariatric surgery is the right option for you, visit Bon Secours St. Francis Weight Management.
