Bariatric Surgery

BARIATRIC SURGERY CAN BE EXTREMELY HELPFUL AS A LAST RESORT

Bariatric surgery is generally only available for severely obese individuals who have not succeeded in controlling their weight using diet and exercise. Almost all of our patients at Penn have tried traditional diet programs and lost significant amounts of weight, but they aren’t able to keep the weight off. For them, being overweight is more than carrying extra pounds. It can mean significant psychological and medical issues; such as depression, heart disease, diabetes, severe sleep apnea, a great deal of physical pain, and a shorter life.

For these individuals, bariatric surgery is a tool that by itself isn’t going to solve their problems. However, by following the post-operative recommendations, which include eating a diet high in protein and low in carbohydrates, with five or six small meals throughout the day, and with exercise, bariatric surgery can help patients to lose significant amounts of weight and to keep it off over the long-term. This means both a longer life and a higher quality of life.

 

GUIDELINES FOR BARIATRIC SURGERY

Per the recommendations of the American Society for Metabolic and Bariatric Surgery, patients are eligible for bariatric surgery if they have a BMI of 35 along with co-morbidities such as high blood pressure or diabetes, or if their BMI is 40 or more even without co-morbidities. However, more and more surgeons are allowing individuals with lower BMIs to get the surgery.

 

BARIATRIC SURGERY ISN’T ALWAYS A SUCCESS

Although it is not widely talked about, bariatric surgery failure rates are higher than you would think. A recent study published in JAMA Surgery (2012) showed that nearly 20% of Roux-en-y gastric bypass patients failed to lose at least 50% of their excess BMI by both the 1- and 2-year follow-ups. The person who doesn’t follow the lifestyle recommendations and instead drinks milkshakes all day long is going to regain the weight. It’s a misconception that “I’ll get the surgery and not have to do anything.”

There’s also a 0.5% risk of death either during the surgery or within 30 days of the surgery. Many people don’t realize that this is a serious surgery that involves a massive change to their lifestyle.

 

WHAT WORKS FOR WEIGHT CONTROL ISN’T EASY OR SEXY

Our recommendations for a healthy lifestyle haven’t changed much in 50 years: have three balanced meals a day; eat a range of low- calorie foods while limiting high-fat and high-sugar foods; and enjoy your food without making it your primary means of enjoyment. In other words: moderation. This is not a sexy answer, and it’s not an easy answer. But it really is the best answer we have right now.

 

DON’T BLAME YOUR PATIENT

We know that a huge amount of stigma is associated with being overweight. This comes not only from the public, but also from health care providers. Your patient doesn’t want to be overweight. Being judgmental only makes them feel guilty, depressed. Not to mention it will make them less likely to want to come back and may lead to binging. Instead, recognize that in the current environment, it’s truly challenging to maintain a healthy body weight.

 

Continued….

CHANGE NEEDS TO COME BOTH THROUGH EDUCATION AND AT THE POLICY LEVEL

In this country, making the choice to eat healthy is very hard, given that high-calorie, highly processed food is available everywhere all the time. This can be addressed at the policy level, for example by changing the food that’s available in schools or taxing soft drinks.

But education is also tremendously important. I have clients who come in thinking that drinking a typical soft drink is like drinking water. They’ve never been taught that there are often as many as 140 calories in just one 12-ounce can. They also need to know that eating a small orange may involve something in the range of 45 calories, versus eating a candy bar, which could easily be 250 calories. Choosing an orange over a candy bar doesn’t make a difference in weight for one day, but we quickly develop habits, and 20 years of eating a candy bar instead of an orange makes an enormous difference.

Search Articles

Latest Articles

Wisdom from Mitzi Perdue, Daughter of the Sheraton Founder

Wisdom from Mitzi Perdue, Daughter of the Sheraton FounderAbout The Episode In this episode of the Think Millions Podcast, we delve into the extraordinary life of Mitzi Perdue, who has been surrounded by greatness her entire life. As the daughter of Sheraton Hotels...

read more

Subscribe to Updates

About Author

Mitzi Perdue is the widow of the poultry magnate, Frank Perdue.  She’s the author of How To Make Your Family Business Last and 52 Tips to Combat Human Trafficking.  Contact her at www.MitziPerdue.com

All Articles

A Diabetes Management, Current Therapies

A Diabetes Management, Current Therapies

A Diabetes Management, Current Therapies The Bionic Pancreas Offers New Hope For type 1 Diabetes There’s good news for those with type 1 diabetes.  The FDA has just approved a device (Medtronic MiniMed 670G) that automates keeping their blood sugar at healthy levels. ...

read more
Transgender Medicine

Transgender Medicine

Transgender MedicineYou Are Likely to Have Transgender Patients All health care providers are going to have a transgender person as a patient at some point. Statistically, roughly one person in 200 has a gender identity that differs from the sex they were assigned at...

read more
Candida Treatment for Simple and Recurrent Cases

Candida Treatment for Simple and Recurrent Cases

Candida Treatment for Simple and Recurrent CasesA Large Number of Women Will Experience a Candida Infection in their Lives In the United States, 75% of women will have a vulvovaginal Candida infection during their lifetimes. In any one year, this means 13 million...

read more
Help For Sexual Dysfunction

Help For Sexual Dysfunction

Help For Sexual DysfunctionSexual Dysfunction is Common Forty-four percent of women have a sexual complaint. 32% experiencing a lack of desire, 27% not experiencing orgasm, and 21% having pain during sex. Although 44% have a sexual complaint, not all of these women...

read more
Cognitive Problems: Often They’re Treatable

Cognitive Problems: Often They’re Treatable

Cognitive Problems: Often They’re Treatable Dementia and Specifically Alzheimer's Disease Dementia are for More Common Than Statistics Indicate The statistic that 5.5 million people in the United States have Alzheimer’s disease dementia is an underestimate. My...

read more
Breast Cancer: Don’t Over diagnose, Do Improve Lifestyle

Breast Cancer: Don’t Over diagnose, Do Improve Lifestyle

Breast Cancer: Don't Over diagnose, Do Improve LifestyleAvoid Overdiagnosis When you screen a healthy population for breast cancer, you’re going to get over-diagnosis. This has become particularly evident. As screening practices switched from film-based mammography to...

read more