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NEW LEASE on life

BARIATRIC SURGERY OPTIONS, WHAT TO EXPECT, AND ARE YOU A GOOD CANDIDATE

BY MIMI GREENWOOD KNIGHT

The first thing to understand about bariatric or weight-loss surgery is that it’s only part of a lifetime weight-management plan. But for many, it’s an absolute game changer after years of trying — and failing — to permanently lose weight. There are several wonderful options available, and perhaps one that fits you, your health, and your lifestyle. A consultation with an experienced bariatric surgeon can be the first step in a new life for you and those you love.


Bariatric surgery has been around since the 1960s, and over the past six decades, it has become safer, less invasive, and more available. In fact, in 2022, an estimated 243,254 bariatric surgeries were performed in North America. The goal of any weight-loss surgery is to change the shape and function of your digestive system to aid in weight loss and management of medical conditions such as diabetes and obstructive sleep apnea and to decrease risk factors for heart disease and stroke — to make you a healthier you.


WHAT ARE MY OPTIONS?


According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), U.S. surgeons most often perform three types of weight-loss surgery.


  • Gastric sleeve, during which a surgeon removes most of your stomach, leaving only a banana-shaped section that’s closed with staples.

  • Gastric bypass, during which a surgeon staples your stomach, creating a small pouch in the upper section.

  • Adjustable gastric band, during which a surgeon places a ring around the top of your stomach to create a small pouch.

Each option works by allowing you to feel full after eating less food. But because you’ll be eating less, you’ll need to ensure that what you do eat is nutritious. Food choices are as important as portion sizes.


AM I A GOOD CANDIDATE?


One of the first things your bariatric surgeon will do is calculate your body mass index (BMI). American College of Surgeons (ACS) guidelines recommend bariatric surgery for:


  • Individuals with a BMI greater than35 kg/m2, regardless of presence, absence, or severity of co-morbidities.

  • Patients with T2D and a BMI greater than 30 kg/m2.

  • Individuals with a BMI of 30– 34.9 kg/m2 who haven’t achieved substantial or durable weight loss or co-morbidity improvement using nonsurgical methods.


Your doctor will also spend time talking with you to ensure you understand the commitment you’re undertaking and are devoted to changing long-standing habits and educating yourself about nutritional eating. And if you smoke, you’ll be asked to quit.


MORE THAN JUST SURGERY


As mentioned, weight-loss surgery is only one part of an overall treatment plan. Successful, long-term treatment includes adherence to nutrition guidelines, exercise, and mental healthcare to help you establish new, healthy lifestyle patterns. You may also need to take supplemental vitamins and minerals for the rest of your life to ensure you’re getting enough nutrition. But for many, bariatric surgery is the jumpstart they need to lose excess weight, and once they realize how much better their life is without those extra pounds, following the rest of the protocol is easy.


Changes You Might Not Expect


If you’ve been dreaming of losing weight, be prepared for all the ways life can change after you do. To begin with, you’ll need to confront the reason you ate poorly in the first place. Were you self-medicating with food or stress eating? If so, you’ll still need to manage that stress and anxiety. You also may struggle with people treating you differently.


Because you may no longer feel hungry or thirsty, be intentional about staying hydrated and nourished. You may miss the social aspects of eating and drinking with others.


Additionally, some bariatric patients experience “hair shedding” for months after surgery, while others have adverse reactions to sugar and/or alcohol for the rest of their lives.


Of course, these negative changes are more than offset by positive ones, such as being able to forego medications, fewer aches and pains, more energy and flexibility, a resurgence of your libido, and elevated self-esteem.


Some helpful post-surgery strategies are:


  • Tracking your food intake

  • Involving loved ones

  • Seeing a therapist

  • Joining a support group


In the end, bariatric surgery is one powerful tool in your tool chest to help you live a healthy life for the rest of your life.

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