Is Bariatric Surgery Right For You?

Do you struggle with your weight? You are not alone. Over 40% of American adults are obese and 1 in 20 are morbidly obese. Though obesity is common, it can cause serious related conditions, such as heart disease, stroke, type 2 diabetes and certain types of cancer.

Unfortunately, losing weight is much more difficult than gaining it. Many people spend years trying to manage their weight with diet and exercise but don’t achieve the results needed to fix the health complications that coincide with morbid obesity. If you have exhausted your options for losing weight naturally, it may be time to talk to your doctor about bariatric surgery.

Bariatric surgery doesn’t just treat obesity, it treats all of the comorbid conditions related to excess weight. Studies show that bariatric surgery may reduce a patient’s risk of premature death by 30-50%. It lowers the risk of death related to many diseases including heart disease (40% lower), diabetes (92% lower) and cancer (60% lower).

There are several types of bariatric surgery to choose from and your doctor will help you decide which procedure is right for you. The end goal of all bariatric surgical procedures is to help the patient achieve a healthy weight in order to improve overall health and establish a path to maintain a healthy weight for life.

Benefits:

After bariatric surgery, it is possible to lose 70% or more of excess weight. Your success will also depend on the type of surgery and your dedication to change in lifestyle habits like eating a healthy diet and exercising.

Weight loss surgery can also improve weight related comorbidities, including:

  • heart disease
  • high blood pressure
  • type 2 diabetes
  • high cholesterol
  • certain cancers
  • stroke
  • sleep apnea
  • infertility

One of the greatest benefits to weight loss surgery is that it can open up the opportunities to things that obesity can limit. You will feel more energetic and more comfortable to enjoy physical activities, even something as simple as playing with your kids or doing chores.

Many patients report feeling like food doesn’t rule their life anymore. Hunger decreases and patients feel satiated. Weight loss surgery not only creates changes in your digestive system, but also in your brain.

As medical conditions like blood pressure and diabetes tend to decrease or resolve, many patients are able to significantly decrease the number of medications they take on a daily basis.

Why choose UPMC Washington for weight loss surgery:

When you choose Bariatrics at UPMC Washington, you get the best of both worlds including a highly experienced surgeon while also enjoying the convenience of staying close to home. The doctors and staff at UPMC Washington want to see their patients live the happy, healthy and active lives they deserve. We can offer bariatric surgery options that will set you up for weight loss success.

Bariatrics at UPMC Washington offers an individualized multidisciplinary approach to weight loss. We work closely with dieticians, psychologists, exercise physiologists and insurance specialists to create a personalized plan for our patients.

You will receive guidance and support every step of the way, from helping navigate the insurance approval process to post-surgical dietary guidelines that will help you maintain your weight loss for life.

Am I a candidate for bariatric surgery?

To be considered for bariatric surgery, you must meet the following guidelines:

  • At least 18 years of age
  • Morbidly obese with a BMI of 40 or above
  • BMI of 35-40 with comorbidities, which include type 2 diabetes, hypertension, heart disease, sleep apnea and other respiratory diseases, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities and gastrointestinal disorders.
  • Have tried to lose weight in the past through diet and exercise
  • In good mental health and able to manage the psychological aspects of weight loss surgery
  • Not drug or alcohol dependent

Surgery Options

UPMC Washington offers several surgery options. Your surgeon will further explain the procedures and help choose the best one for you.

  • Gastric Sleeve Surgery
    During gastric sleeve surgery, the surgeon removes a large portion of the stomach and reshapes the remaining portion into a sleeve shape. This restricts the amount of food that the stomach can hold, which helps you feel less hungry and also eat less at a time.
  • Gastric Bypass (Roux-en-Y)
    Gastric bypass surgery is a procedure that closes off a large section of the stomach, creating a small pouch. The pouch is then directly connected to the small intestine, bypassing a large part of the stomach and the first section of the intestinal tract. The pouch acts as a new stomach, with a much smaller capacity that makes you feel full longer. This procedure also changes the digestive process, so it is considered both restrictive and absorptive.

The Process:

Step 1: Consultation

Your family doctor can refer you to our practice but you can also schedule on your own without a referral. Your physician at UPMC Washington Bariatrics will review your medical history and discuss the available options for bariatric surgery. The physician will help create a plan for insurance approval which will include obtaining clearances to ensure you are healthy enough for a safe surgery. Your physician will meet with you regularly throughout the process.

You will meet with a dietician to create a plan for nutrition to meet pre-surgical insurance requirements and to learn how to manage proper nutrition after surgery.

Step 2: Clearances

Your insurance provider may require clearances from medical specialists if you have any other medical conditions. This may include bloodwork and medical testing to ensure you are physically healthy enough for surgery.

Insurance plans also require psychiatric evaluation prior to surgery. This process ensures that patients are mentally prepared for surgery and the necessary long-term changes in behavior. Bariatric surgery is a serious procedure and it is important to evaluate the patient’s motivation for surgery and their post-surgical expectations. The patient can also expect to discuss any beliefs about food from growing up (like always cleaning your plate) and emotional issues that may have led to their weight gain. Many people are resistant to this process but mental health is just as important as physical health when considering surgery.

Step 3: Insurance Approval

Your insurance provider will require all of the medical clearances, testing and bloodwork as discussed above. Patients should be prepared to commit to 3 to 6 months of monitored and documented diet and weight loss efforts. Your physician will submit all of the documentation and clearances to your insurance provider.

Your insurance provider may take 2-6 weeks to review and approve your case. Around 75% of cases are approved. If your insurance company denies your case, your physician will help you with the process of appeal.

Step 4: Pre-op Education and Instructions

You will meet with your surgeon to discuss all pre-op testing results. You may be required to follow a specific diet in the weeks leading up to your surgery. You doctor will review your current medications and you may be required to make adjustments to reduce the risk of complications from surgery.

Step 5: Surgery Prep

Prior to surgery you will be required to undergo a physical exam, medical history and some tests including upper endoscopy, blood tests, and EKG.

Step 6: Post-operative Care

In the early stages after your surgery, it is very important to adhere to your provided dietary plan as your stomach heals. Your stomach will be substantially smaller and will hold only small amounts of food. You will be on a liquid diet for some time and gradually move to purees and then soft food. It is important to take small bites and chew thoroughly as you adjust to the changes in your digestive system. There may be certain foods that you can no longer tolerate, like foods high in fat and sugar.

Your doctor will closely monitor your post-operative health to ensure the best possible health and weight loss. You can expect to meet with your surgeon about a week post-op and then several times within the next year.

Step 7: Life after Bariatric Surgery

Bariatric surgery will result in substantial weight loss. But in order to maintain weight loss for life, patients need to learn how to optimize their health by adopting healthy nutrition and exercise habits. Through counseling with our registered dieticians, you will learn about the early stages of post-op eating as well as create a long-term plan for healthy eating.

Because gastric bypass changes absorption, you may be required to take vitamin and protein supplements to avoid nutrition deficiencies.

Step 8: Exercise

Staying active will help you maintain your weight loss, become stronger and improve other aspects of your health. A UPMC Washington exercise physiologist will help you create an exercise plan that is effective and realistic. Prior to surgery you can begin walking for exercise. As you lose weight you will find that exercise becomes easier and enjoyable as you become stronger and improve your stamina.

Risks

Bariatric surgery, as with all surgical procedures, naturally carries some risks. Your surgeon will discuss these risks and complications with you prior to surgery. Most complications are rare and carry less risk than the long-term dangers of remaining obese.

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