Bariatric Surgery 101 by Christina Twyman, M.D.

Obesity plagues America and in particular the African American community.  The Office of Minority Health reports that 4 out of 5 African American women are overweight or obese.  Obesity is not only associated with one’s self image and mental health, but also physical health as it is associated with higher rates of high blood pressure, high cholesterol, and diabetes.

With so many people afflicted with obesity it comes as no surprise that diet and weight management is a very lucrative business. Many people are unsuccessful despite their efforts. It is no fault of their own as weight loss is very difficult to achieve and maintain.

Bariatric surgery is an option for some people. There are currently 4 different types of bariatric surgeries, including gastric bypass (one of the most common) and the lapband, both offered in the United States.  You and your surgeon determine which is best.  The National Institutes of Health has strict guidelines for who qualifies for the surgery.  The person must have a Body Mass Index (BMI) greater than 40 or have a BMI greater than 35 along with another disease which is due to the individual being overweight such as high blood pressure or diabetes.  The person must also be an adequate candidate for the surgery.

PREPARING FOR BARIATRIC SURGERY

Preparing for bariatric surgery is not an easy task.  The most reputable surgeons are affiliated with weight loss centers comprised of doctors, nurses, psychologists and dieticians.  They will work to help you identify why you are obese and lifestyle changes that can be made both before and after surgery.  They will also follow you after the surgery to monitor your progress and continue to give you support.  The best centers, in my opinion, will address your physical and mental needs and not just focus on the surgery.

RECOVERING FROM BARIATRIC SURGERY

Recovering from the surgery is also very demanding.  Most surgeries are now done laparoscopically, thus a smaller incision in your abdomen. However, you are at risk for many post-operative complications including infection and blood clots.  You will also be in the hospital for several days and not able to eat for the first few days.  Once you start eating, you may have increased diarrhea and other gastrointestinal side effects. You will also most likely require lifelong vitamins supplementation in the form of both pills and injections.

After spending all of this time meeting with those in the bariatric center prior to the surgery then healing from the surgery, you hope that the procedure is a success.  However, up to 10% of patients are unable to maintain their weight loss.

If you are interested in bariatric surgery, I suggest you start by talking with your primary care provider. Your provider will be able to recommend reputable surgeons in your area who take your insurance.  Be careful about reading the Internet as websites may not come from reputable sources. When you meet with the surgeon, ask if there is support from nurses and dieticians both before and after the surgery.  Ask the surgeon how many procedures they have done, their rate of post-operative complications, and the success rate of their patients.  Don’t get excited if they show you one before and after picture; anyone can lose weight short term, you want to know who kept it off.  And finally, ask if the surgeon will help you navigate applying for insurance. The procedure cost $20,000 and you want to make sure it is covered.

Bariatric surgery has lead to many people losing weight and improving their health.  However, it is not an easy or cheap method of weight loss. You must be committed to maintaining a healthy lifestyle after the procedure for it to be success.

Christina Twyman, M.D. is a senior resident at the Johns Hopkins Osler Internal Medicine Residency Program. She will specialize in Gastroenterology starting July 2010.

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12 Comments

  1. Erica on May 3, 2011 at 3:40 pm

    If I”m gonna lose my weight I”m gonna do for me and me only…. my b/friend always tells me he love me just the way I am and every inch of me…. yes I would love to lose weight for 2 reasons #1 cause of me and #2 health….

  2. [email protected] on May 3, 2011 at 3:41 pm

    I need to lose weight. I’ve been working on it, but not as earnestly as I could. But I’m getting there, slowly but surely. I used to let it get me down, but then I realized that I’m still the same person. I’ve been much happier as a result and I’ve lost some weight. I make sure keep myself up and keep it moving! I no longer allow my weight to get the best of me anymore.

  3. [email protected] on May 3, 2011 at 3:42 pm

    I sometimes joke about getting weight loss surgery, but I don’t think I ever will—LOL! I know a woman who got the gastric bypass surgery and she looks great. She’s kept the weight off after all of these years, but she can’t absorb enough nutrition from the foods she eats. She has to get shots. I guess it’s a trade off…

  4. Nicole on May 3, 2011 at 3:42 pm

    I have often thought about getting the surgery and then I realized I was just being lazy so now I have made a lifestyle change for myself. Now I would be lying if I didn’t think that weight loss won’t effect my social life. I see myself be…

  5. Felicia on May 3, 2011 at 3:43 pm

    I just came home from walmart with my new “George forman Grill”!! I feel better when I am looking good!! Trying to get 20lbs before trip to myrtle beach in july!! My health has is important since my mother had type 2 diabetes!! I want to be around for a long time!! Plus this size 8 has me attracting much younger guys!! Toot toot!! 🙂

  6. Lungile on May 3, 2011 at 3:43 pm

    i’m an african woman,im trying to loose.But i’m only doing it for my health’s sake not for a man.I’ve joined the gym & i feel like its the bestest choice i’ve eva made in ages.

  7. Gene on May 3, 2011 at 3:44 pm

    I can’t lie! I do have a weight standard BUT I believe that there is some one for every body! So to the fellas that like thick & beautiful I tip my hat to u!

  8. Jasamine on May 3, 2011 at 3:44 pm

    I personally would never have surgery, I believe men have a standard about weight and lie and say they don’t care but look at that man’s second or third wife and most times she is thin she’s the trophy…

  9. Perry on May 3, 2011 at 3:45 pm

    beauty comes n all shapes nd sizes…. one size fits all is not n my view what its all about….. now if its for health reasons i understand… but i can dig variety! what evr size: IT LOOKS GOOD ON YOU!

  10. Liara on May 3, 2011 at 3:46 pm

    for me it plays a big role in my life when it comes to how i feel about myself, which i work on everyday by doing little more for myself each an everyday

  11. Dianne on May 3, 2011 at 3:49 pm

    Hot green tea packs, with honey, not sugar, burns belly and waist fat, kills cancerous cells, and kills the H.I.V virus when its 1st contrated, health survey! The 1s that we see jogging at the age of 50, in shape, been known the secret. Dri…

  12. Terrance on May 3, 2011 at 3:51 pm

    i dont have standards on wieght the size doesnt make the person there heart does but i do think we need to put emphasis on how to eat healthy and stay awy from things that can cause cancer or heart disease.

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