What is Gastric Bypass Surgery?
What is Gastric Bypass Surgery?
Gastric bypass surgery is simply another procedure used to fight morbid obesity (individuals with BMI’s over 40.) Gastric bypass basically redesigns your stomach to make it smaller. Surgeons alter your stomach to create a small upper pouch which will then be about the size of a golf ball or walnut; your new pouch will be designed to hold about 1 ounce of food! Since your stomach will be much smaller, you will need less food to feel full and you will also absorb fewer calories. The next step of the operation will be to alter your small intestine. Your surgeon will redesign your small intestine so it connects to the small pouch (stomach.) Food items consumed after surgery will now bypass the traditional digestive tract and will flow from the pouch to your small intestine. Thus, your body will absorb less calories and weight loss should occur.
Gastric bypass procedures. Doctors have created numerous ways to reconnect the small intestine which has spawned different types of gastric bypass procedures such as the gastric bypass roux en-Y (proximal) and gastric bypass roux en-Y (distal.) Basically, the small intestine is rearranged into a “Y” shape arrangement. Surgery is performed under general anesthesia and usually takes about one to four hours to complete.
What are the risks associated with gastric bypass? Physicians perform this procedure on patients who have trouble losing weight through diet, exercise, and behavior modification programs. There are several diseases linked to obesity such as diabetes, cancer, high blood pressure, sleep apnea, and cardiovascular issues just to name a few. Therefore, doctors may suggest weight loss surgery to help obese individuals achieve better health. However, as with any major surgery, there are risks involved such as blood loss, blood clots, infection, heart attack, stroke, or sudden breathing problems.
What to expect. Patients who have gastric bypass surgery can expect to stay in the hospital for 3 to 5 days. The individual will have a catheter inserted through his/her nose into the stomach for approximately two days. This will help drain fluids from the abdomen. The patient will not be able to eat for the first three days and after that he or she will only be allowed liquids and pureed food items. The patient will need to wear special stockings on his or her legs to help prevent blood clots (the doctors will also prescribe medicine to fight blood clots.) Finally, your physician will determine when you can go home. This is usually when the patient is observed to be able to eat liquid or soft food without throwing up, and when he or she can move without significant pain.
The gastric bypass diet. Once you’ve had gastric bypass surgery, your diet will never be the same. Since your stomach will be reduced to the size of a walnut, what you eat and how much you eat will change. Your doctor will likely advise that you meet with a registered dietitian who can help design meal plans for you. The type of food you eat, the quantity, and texture will be important considerations. Why? After surgery, you will need to allow the staple line in your stomach to heal; attention should be focused to avoid stretching the newly created pouch by the food you consume. Also, you will need to get familiar with eating smaller amounts of food that can be digested safely and without causing side effects and other complications.
What is Laparoscopic Adjustable Gastric Surgery?
Laparoscopic gastric surgery is simply another form of weight loss surgery for obese individuals. Weight loss surgery is often recommended for individuals who have BMI’s between 35 and 40; or for men and women who have BMI’s between 30 and 35 but also posses medical diseases associated with obesity. Before any weight loss surgery is considered, the patient will undergo an extensive medical evaluation including a psychiatric screening. The weight loss is achieved by managing the patient’s stomach with an implanted device such as a gastric band.
The laparoscopic gastric band operation (commonly referred to as lap band,) works basically by curbing the amount of food that an individual can eat at one time. Relative to other weight loss surgeries, lap band operations are less invasive and result in a shorter hospital stays. Patients also recover faster, have smaller scars, and experience less pain. This is because other weight loss surgeries remove or staple part of the stomach and also re-route the patient’s intestine.
During Lap Band Surgery, a surgeon makes a small 1/2 inch incision near the belly button. With the aid of a small laparoscopic camera, the doctor makes a small circular tunnel behind the stomach and inserts an adjustable silicone band (made of biocompatible material) around the top portion of the stomach to create a petite egg sized pouch (which will hold 1/2 cup of food vs. 6 cups for a regular stomach.) After the surgery, the newly formed pouch will fill with food quicker while the band slows the passage of food to the lower part of the stomach. This process enables the patient’s brain to receive messages that he or she is full. This new sensation helps lap band patients feel full quicker, feel hungry less often, and ultimately lose weight over time. Moreover, smaller meals are consumed and the patient can’t over-eat without feeling some discomfort.
What does adjustable band mean? Your doctor can adjust (or fill) the lap band. Lap bands can be increased or decreased to manage the flow of food between the pouch and lower stomach. -Too loose and the patient’s hunger may not be controlled. -Too tight and the patient will not be able to pass food through his or her digestive system. Also, as the patient loses weight, the band needs adjustment to ensure effectiveness and comfort. Gastric bands are adjusted by injecting a saline solution into an access port created by the surgeon that lies just under the skin. The band can hold between 4 – 12 cc of saline and when it’s filled, it places pressure around the stomach. This of course enables your doctor to manage the size of the passage between the pouch and the lower stomach. Typically, during the first four weeks after surgery the lap band will be empty. The patient may not discern any difference in how much he or she can eat (unless he or she doesn’t chew carefully or eats too quickly.) At last, the restricted sensation and difference in how much an individual can eat will come gradually over time as his or her physician fills the band (about every 4 weeks or until the patient reaches the point of appropriate restriction.)
The Prevalence of Obesity in America
How is America doing in its war against obesity? Recent statistics show America is not winning any ground wars in the battle of the tummy. According to a recent report in JAMA, obesity among our adult population is still relatively high. A research study revealed that overall, 33.8% of the U.S. adult population is categorized as obese (U.S. adult men and women aged 20 years and older.) This means over a third of the American adult population has a Body Mass Index of 30 or more (32.2% among men and 35.5% among women.) What’s more distressing is if you include U.S. adults who were cataloged as overweight (BMI between 25.0 and 29.9) then, the combined prevalence of overweight and obese Americans is 68% (BMI’s > 25.0.) One can presume that only 32% of the American adult population in our country maintains a healthy weight! [1]
The good news. The research study looked at data covering 1999 – 2008, and it showed no statistical increases in the prevalence of obesity among American women and only a small increase among American men at 4.7%. This can be treated as positive news considering previous growth rates were between 7 and 8.9 percent based on data samples from 1976 – 1999. [1]
Obesity rates in our country still remain too high. Our country faces significant health challenges as obesity has been linked to various diseases such as cancer, hypertension, diabetes, stroke, and muscular skeletal trauma. According to the CDC, medical costs associated with obesity totaled approximately $147 billion in 2008. What’s more, third party vendors paid higher medical costs for obese men and women, on average $1,400 extra dollars, compared to individuals at a normal weight.
Causes of obesity. In our modern culture, there are too many villains to count. At a macro level, there are societal and economic factors. On a micro level, there genetics, poor diets, poor food choices, bad habits, over consumption of junk foods and sugar based beverages, extreme food portions, lack of physical exercise, inadequate role models and even inadequate parental leadership just to name a few.
Effects of Childhood Obesity
It is frequently calculated that one out of five kids in the United States is overweight or obese, and this figure is continuing to get bigger. This is disconcerting since overweight kids are at a higher risk of becoming overweight teens and adults, positioning them on a path of getting chronic medical conditions including coronary heart disease and diabetes later in life. They’re also far more susceptible to develop emotional issues and low self worth.
What are the health effects of childhood obesity?
The immediate health dangers can involve:
• Higher risk of glucose tolerance and insulin resistance leading to being diabetic
• Musculoskeletal and joint problems
• High Blood Pressure / Hypertension
• High cholesterol
• Higher possibility for developing cardiovascular disease
• Psychological problems such as low self esteem
Health issues if left unchecked:
• Obesity consequences will spill over into adulthood.
• Heart disease
• Cancer
• Diabetes
• Musculoskeletal and joint problems
• High Blood Pressure / Hypertension
• High cholesterol
• Psychological problems such as low self esteem and discrimination
Obesity in America
Obesity in America
Obesity is a disturbing national epidemic where nearly $1 out of every $10 dollars Americans spend on healthcare, pays for obesity related health issues. This country spends approximately $150 billion annually in obesity related health expenses. Approximately one out of three adults and one out of six children are cataloged as obese. What’s more, obesity is a leading cause of coronary heart disease, diabetes, cancer, depression, and muscular skeletal problems.
On a basic level, obesity is caused from individuals consuming more calories than their bodies can burn off. Thus, excess food calories are stored in the body as fat. There are several causes that contribute to the rise in obesity in our country; one of the more obvious core factors is the effect of societal changes over the past half century.
The American diet is killing us. Today, more people are consuming food items that were conceived around corporate board tables. -A huge percentage of our diet comes from factory made and highly processed foods which are typically cheaper and have less nutritional value relative to natural whole foods. We’re also eating several meals away from the home. Appetizing junk foods are everywhere; we’re surrounded by tasty but low quality foods. For example, after filling your car with gas you also have the option to step inside and pick up a donut, hot dog, chips, and a 52 ounce soda for around $4. “Super size that!” Did we mention that Americans are consuming larger portion sizes and more calories than ever before. We’re constantly bombarded with fast food commercials that seem to trounce the competition by offering giant food portions. Fast food meals are also typical lunch or dinner choices for busy parents . Relative to fifty years ago, families are not preparing fresh, wholesome, nutritious meals at home.
Another factor contributing to the rise in obesity is our sedentary lifestyle. In addition to the over consumption of processed, convenient, low quality foods, more Americans are spending their free time/leisure time sitting in front of the television or computer. In the workplace, more Americans are in jobs were they sit for extended hours with little physical movement. We also don’t walk much anymore. – Families drive everywhere because communities are not designed with many walking or bicycle routes. Relative to fifty years ago, our children and parents deem it too unsafe to play outside unless it’s an official team sanctioned activity. Is it just a matter of time before life imitates art and our society looks more like the one aboard the spacecraft in the Disney movie “Wall-E?”
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