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FAQs on Laparoscopic Procedures

Dr. Arif Ahmad is very cognizant of the questions asked by many patients. Some of them include the following:

1.What is obesity?

Obesity is a health condition that leads to accumulation of fat on the body and has adverse effects on the patient’s health. To determine whether a person is obese or not, then he or she should have their body mass index (BMI) checked. If it exceeds 30, he or she is obese.

2.Are there any risks entangled with weight loss surgery?

Well, different laparoscopic surgeries pose some risk to a patient’s health. However, the licensed laparoscopic surgeon is trained to mitigate any emerging issues.

3.How long are patients’ out of work after laparoscopic surgery?

Obesity is a health condition that leads to accumulation of fat on the body and has adverse effects on the patient’s health. To determine whether a person is obese or not, then he or she should have their body mass index (BMI) checked. If it exceeds 30, he or she is obese.

4.Can a patient exercise after surgery?

Yes, it is recommended that patients’ exercise to prevent a hernia. It also aids in weight loss. However, it is advisable that for the patient to consult with a weight loss surgeon.

5.What are the nutrient requirements for weight loss surgery?

After the surgery, the patient should eat food rich in minerals and vitamins such as iron, vitamin D, and vitamin B12.

6.Will a newborn baby be healthy after the weight loss surgery?

Yes, the weight loss surgeon guarantee a fruitful procedure and good health to the baby at birth.

7.Do pregnant patients’ benefit from the surgery?

Sure, there are numerous benefits accrued from weight loss surgery especially during pregnancy. One of them is that it lowers complications rate while giving birth.

8.Do insurance companies provide insurance coverage for weight loss surgery?

Yes, they do. There comprehensive insurance plans for patients in case of any damage during weight loss surgery.

9.How does one calculate his or her body mass index (BMI)?

Well, he or she should use a body mass index calculator to find out the BMI.

After looking at the frequently asked questions, the next step is to learn more about weight loss surgery.

Risks Involved

Laparoscopic surgery, as weight loss surgery, does not fall short of risks. It is on this premise that the weight loss surgeons find it prudent to elaborate on the risks.

  • Malnutrition – This occurs when a patient’s body is deprived of key nutrients and minerals. These include vitamin B12, iron, vitamin D, and calcium.
  • May lead to dumping syndrome which results to diarrhea, nausea, abdominal cramps and diarrhea
  • Weight regain especially if not accompanied by exercises and a healthy diet
  • Dilation of the esophagus
  • Risk of infections
  • Acid reflux
  • Complication risk during or after the weight loss surgery.
  • Obstruction of the stomach

Engaging in Exercises

Exercise is not solely meant for people wishing to fit into body tight garments. That said people who are obese but dedicated to losing weight should take up exercises. Before getting into the exercises, patients should ensure that they have gone for a medical examination. This is paramount especially if one is on medication or suffers from chronic diseases. Exercises also help the weight loss surgeons to develop a workout plan for the patient. Some of the fitness exercises include:

Walking

This is the simplest and most effective exercise to help with weight loss. Obese patients are only required to take regular walks, preferably in the morning and evenings.

Viable Walking Program

  • In the first five minutes of the walk, one should ensure that the pace is slow.
  • Gradually increase the pace to constant and agile movement for five minutes
  • One should end by slowing down the pace to help relax the muscles

The weight loss surgeons recommend that patients add 2 minutes, for walking, in the subsequent two weeks. This should continue for the next six weeks. As they get into week seven, they should ensure that they walk briskly for 18 minutes. Additionally, patients should continue adding the minutes for the next 4 weeks. In total, obese patients should at least set aside 150 minutes for walking per week.

Tips and Precaution

While going for the walks, it is important to ensure that the arms swing naturally and maintain a good body posture. Furthermore, they should make sure that they wear shoes with great arch support to prevent blisters. This also helps in cushioning the feet from shock.

Health Benefits

For years, walking has been advocated for especially when it comes to burning calories. For example, a 155 lb patient can burn up to 268 calories in one hour. Amazing, right? The best part of walking is that it is less strenuous compared to other weight loss procedures.

Walking also helps to strengthen the bones and muscles. Finally, it is useful in preventing and containing health problems such as hypertension, type 2 diabetes, and cardiovascular diseases.

Weightlifting

According to the weight loss surgeons, patients can also lose pounds by lifting weights. However, this weight loss procedure should be done systematically. Before going through the nitty gritty, it must be acknowledged that weightlifting is better when under the guide of a personal trainer.

Steps

Patients should use weights that they can comfortably lift. Weightlifting encompasses maintaining an upright body posture. Here, they should make sure that the breathing is controlled for good air circulation.

Precaution

Always consult a weight loss surgeon before starting to lift weights.

Other fitness procedures include jogging, mental exercise, and group-class exercises.

How to Balance the Nutritional Needs

Apart from undergoing a weight loss surgery, it is paramount for patients to eat nutritious food. Luckily, there is a comprehensive guide to help with this. According to Dr.Arif Ahmad, patients should consume lean protein. This entails fish chicken and pork. By consuming such foods, they also get to boost their satiety.

Furthermore, a patient should ensure that he or she incorporates multivitamins in his or her daily routine. So why is emphasis made on multivitamins? Well, weight loss surgery such as Lap Band may minimize the intake of the nutrients. For this reason, patients are encouraged to supplement vitamin D and B12 with multivitamins.

As patients diligently embark on the new diet, there are some foods to avoid. These include whole milk, spicy foods, sugary foodstuffs, and high-calorie meals.

Weight Loss Surgery and Pregnancy

Patients should not be misguided by the myth that weight loss surgery will hamper pregnancy. The weight loss surgeons reaffirm that patients can get pregnant after laparoscopic surgery. However, there are some aspects to observe.

  • One has to wait for at least two years before they can get pregnant
  • Weight loss surgery may interfere with the use of birth control methods
  • Malabsorptive components put the patient and baby at risk of malnutrition

Moreover, there are some pros of weight loss surgery to pregnancy. They include:

  • Resolves infertility
  • Reduces the chances of the baby being obese
  • Improves neonatal care
  • Lowers the risk of cardiovascular-related ailments to the baby
  • Minimizes maternal complication rates
  • Reduces the risk of high blood pressure

Calculating the Body Mass Index (BMI)

At the beginning of this article, it was mentioned that a patient is diagnosed as obese when he or she has a BMI of over 30. So will a patient know his or her body mass index? Well, it simple. He or she should use the BMI calculator and input the measurements. Here the weight and height are inserted, metric or standard measure, and the BMI will be calculated.

Patients should note that this calculator can be used by both sexes.

Get an Insurance Cover

Given the risk highlighted by the weight loss surgeons, it is important for patients to get an insurance cover. Here, they are expected to scrutinize the insurance plan for each weight loss surgery covered. This encompasses cover for gastric bypass, gastric balloon among others. Additionally, you can extend the cover to include your family.

To learn this and many more, you can contact Dr. Arif Ahmad and book an appointment.

Is Bariatric Surgery Right For Me?

Questions to Consider

  • Are you more than 100 lbs over your ideal body weight OR 80 lbs over your ideal body weight and have health problems such as type II diabetes, hypertension or sleep apnea?
  • Are you unable to achieve a healthy body weight for a sustained period of time by diet or exercise alone?
  • Does your weight cause physical problems that interfere with family or work-related activities?
  • Are you willing to take the first step to proactively make a lifestyle change in order to improve your health and quality of life?
  • Are you well informed about the available surgical procedures and the effects of these treatments?
  • What is the track record of your surgeon and their program?
  • Does the bariatric surgery program provide the needed support and aftercare to enhance your success?
  • Does the bariatric program provide the personal attention that you need and deserve?

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Bariatric Surgery Misconceptions

Misconception: Surgery is a ‘cop-out’. To lose and maintain weight, individuals affected by severe obesity just need to go on a diet and exercise program.

Individuals affected by severe obesity are resistant to long-term weight-loss by diet and exercise. The National Institutes of Health Experts Panel recognize that ‘long-term’ weight-loss, or in other words, the ability to ‘maintain’ weight-loss, is nearly impossible for those affected by severe obesity by any means other than metabolic and bariatric surgery.

Bariatric surgeries are effective in maintaining long-term weight-loss, in part, because these procedures offset certain conditions caused by dieting that are responsible for rapid and efficient weight regain following dieting.

When a person loses weight, energy expenditure (the amount of calories the body burns) is reduced. With diet, energy expenditure at rest and with activity is reduced to a greater extent than can be explained by changes in body size or composition (amount of lean and fat tissue). At the same time, appetite regulation is altered following a diet increasing hunger and the desire to eat. Therefore, there are significant biological differences between someone who has lost weight by diet and someone of the same size and body composition to that of an individual who has never lost weight.

For example, the body of the individual who reduces their weight from 200 to 170 pounds burns fewer calories than the body of someone weighing 170 pounds and has never been on a diet. This means that, in order to maintain weight-loss, the person who has been on a diet will have to eat fewer calories than someone who naturally weighs the same.

In contrast to diet, weight-loss following bariatric surgery does not reduce energy expenditure or the amount of calories the body burns to levels greater than predicted by changes in body weight and composition. In fact, some studies even find that certain operations even may increase energy expenditure. In addition, some bariatric procedures, unlike diet, also causes biological changes that help reduce energy intake (food, beverage). A decrease in energy intake with surgery results, in part, from anatomical changes to the stomach or gut that restrict food intake or cause malabsorption of nutrients. In addition, bariatric surgery increases the production of certain gut hormones that interact with the brain to reduce hunger, decrease appetite, and enhance satiety (feelings of fullness). In these ways, bariatric and metabolic surgery, unlike dieting, produces long-term weight-loss.

Misconception: ‘Most people who have metabolic and bariatric surgery regain their weight.’

Longitudinal studies find that most bariatric surgery patients maintain successful weight-loss long-term. ‘Successful’ weight-loss is arbitrarily defined as weight-loss equal to or greater than 50 percent of excess body weight.

Often, successful results are determined by the patient, by their perceived improvement in quality of life. In such cases, the total retained weight-loss may be more, or less, than this arbitrary definition. Such massive and sustained weight reduction with surgery is in sharp contrast to the experience most patients have previously had with non-surgical therapies.

Misconception: ‘The chance of dying from metabolic and bariatric surgery is more than the chance of dying from obesity.’

As your body size increases, longevity decreases. Individuals with severe obesity have a number of life-threatening conditions that greatly increase their risk of dying, such as type 2 diabetes, hypertension and more.

Data involving nearly 60,000 bariatric patients from ASMBS Bariatric Centers of Excellence database show that the risk of death within the 30 days following bariatric surgery averages 0.13 percent, or approximately one out of 1,000 patients. This rate is considerably less than most other operations, including gallbladder and hip replacement surgery. Therefore, in spite of the poor health status of bariatric patients prior to surgery, the chance of dying from the operation is exceptionally low.

Large studies find that the risk of death from any cause is considerably less for bariatric patients throughout time than for individuals affected by severe obesity who have never had the surgery. In fact, the data show up to an 89 percent reduction in mortality, as well as highly significant decreases in mortality rates due to specific diseases. Cancer mortality, for instance, is reduced by 60 percent for bariatric patients. Death in association with diabetes is reduced by more than 90 percent and that from heart disease by more than 50 percent. Also, there are numerous studies that have found improvement or resolution of life-threatening obesity-related diseases following bariatric surgery. The benefits of bariatric surgery, with regard to mortality, far outweigh the risks.

It is important to note that as with any serious surgical operation, the decision to have bariatric surgery should be discussed with your surgeon, family members and loved ones.

Misconception: ‘Many bariatric patients become alcoholics after their surgery.’

Actually, only a small percentage of bariatric patients claim to have problems with alcohol after surgery. Most (but not all) who abuse alcohol after surgery had problems with alcohol abuse at some period of time prior to surgery. Alcohol sensitivity, (particularly if alcohol is consumed during the rapid weight-loss period), is increased after bariatric surgery so that the effects of alcohol are felt with fewer drinks than before surgery.

Studies also find with certain bariatric procedures (such as the gastric bypass or sleeve gastrectomy) that drinking an alcoholic beverage increases blood alcohol to levels that are considerably higher than before surgery or in comparison to the alcohol levels of individuals who have not had a bariatric procedure. For all of these reasons, bariatric patients are advised to take certain precautions regarding alcohol:

  • avoid alcoholic beverages during the rapid weight-loss period
  • be aware that even small amounts of alcohol can cause intoxication
  • avoid driving or operating heavy equipment after drinking any alcohol
  • seek help if drinking becomes a problem

If you feel the consumption of alcohol may be an issue for you after surgery, please contact your primary care physician or bariatric surgeon and discuss this further. They will be able to help you identify resources available to address any alcohol-related issues.

Misconception: ‘Surgery increases the risk for suicide.’

Individuals affected by severe obesity who are seeking bariatric and metabolic surgery are more likely to suffer from depression or anxiety and to have lower self-esteem and overall quality of life than someone who is normal weight.

Bariatric surgery results in highly significant improvement in psychosocial well-being for the majority of patients. However, there remain a few patients with undiagnosed preexisting psychological disorders and still others with overwhelming life stressors who commit suicide after bariatric surgery. Two large studies have found a small but significant increase in suicide occurrence following bariatric surgery. For this reason, comprehensive bariatric programs require psychological evaluations prior to surgery and many have behavioral therapists available for patient consultations after surgery.

Misconception: ‘Bariatric patients have serious health problems caused by vitamin and mineral deficiencies.’

Vitamin and mineral deficiencies are rare after the most commonly performed bariatric operation, that is sleeve gastrectomy. Bariatric operations can lead to deficiencies in vitamins and minerals by reducing nutrient intake or by causing reduced absorption from the intestine. Bariatric operations The gastric bypass my cause some protein and micronutrient deficiencies that can by and large be avoided by vitamin and mineral supplementation.

Fortunately, nutrient deficiencies following surgery can be avoided with appropriate diet and the use of dietary supplements, i.e. vitamins, minerals, and, in some cases, protein supplements. Nutrient guidelines for different types of bariatric surgery procedures have been established by the ASMBS Nutritional Experts Committee and published in the journal, Surgery for Obesity and Other Related Disorders. Before and after surgery, patients are advised of their dietary and supplement needs and followed by a nutritionist with bariatric expertise. Most bariatric programs also require patients to have their vitamins and minerals checked on a regular basis following surgery.

Nutrient deficiencies and any associated health issues are preventable with patient monitoring and patient compliance in following dietary and supplement (vitamin and mineral) recommendations. Health problems due to deficiencies usually occur in patients who do not regularly follow-up with their surgeon to establish healthy nutrient levels.

Misconception: ‘Obesity is only an addiction, similar to alcoholism or drug dependency.’

Although there is a very small percentage of individuals affected by obesity who have eating disorders, such as binge eating disorder syndrome, that may result in the intake of excess food (calories), for the vast majority of individuals affected by obesity, obesity is a complex disease caused by many factors. When treating addiction, such as alcohol and drugs, one of the first steps is abstaining from the drugs or alcohol. This approach does not work with obesity as we need to eat to live. Additionally, there may be other issues affecting an individual’s weight, such as psychological issues.

Weight gain generally occurs when there is an energy imbalance or, in other words, the amount of food (energy) consumed is greater than the number of calories burned (energy expended) by the body in the performance of biological functions, daily activities and exercise. Energy imbalance may be caused by overeating or by not getting enough physical activity and exercise. There are other conditions, however, that affect energy balance and/or fat metabolism that do not involve excessive eating or sedentary behavior including:

  • chronic sleep loss
  • consumption of foods that, independent of caloric content, cause metabolic/hormonal changes that may increase body fat (sugar, high fructose corn syrup, trans fat, processed meats and processed grains)
  • low intake of fat-fighting foods (fruits, vegetables, legumes, nuts, seeds, quality protein)
  • stress and psychological distress
  • many types of medications
  • pollutants

Obesity also ‘begets’ obesity, which is one of the reasons why the disease is considered “progressive.” Weight gain causes a number of hormonal, metabolic and molecular changes in the body that increase the risk for even greater fat accumulation and obesity. Such obesity-associated changes reduce fat utilization, increase the conversion of sugar to fat, and enhance the body’s capacity to store fat by increasing fat cells size and numbers and by reducing fat breakdown. Such defects in fat metabolism mean that more of the calories consumed are stored as fat.

To make matters worse, obesity affects certain regulators of appetite and hunger in a manner that can cause an increase in the amount of food eaten at any given meal and the desire to eat more often.

In summary, there are many causes for obesity and that the disease of obesity is far more than just an ‘addiction’ toward food. The treatment of obesity solely as an addiction may be beneficial for a very small percentage of individuals whose only underlying cause for obesity is excessive and addictive eating, but would be unlikely to benefit the multitudes, particularly those individuals affected by severe obesity.

Information collected from the American Society for Metabolic & Bariatric Surgery.