Weight loss is a common goal for many people. The physical, mental and social benefits are all major factors, and if you feel like you would benefit from weight loss, you’re not alone. According to the National Institutes of Health, as many as 75% of Americans are either overweight or obese.
Although it’s normal for our body weight to fluctuate based on many social and environmental factors, research has also shown clear links between long periods of being overweight and serious health concerns.
Benefits of weight loss surgery
High blood pressure, heart disease, poor sleep or sleep apnea, Type 2 diabetes, cancer and other health problems are made worse by excess weight. The good news is losing weight can help reduce the risk of developing these conditions, reduce their severity or eliminate them altogether.
While diet and exercise are important foundations for a healthy weight, some individuals need additional support losing weight or achieving a healthy body weight. That additional support can include medical or surgical weight loss options.
Michelle Bauche, a registered dietitian and program coordinator of MU Health Care’s Weight Management and Metabolic Center, helps people find answers to their questions, including whether weight loss surgery is a way forward.
“A strength of our program is that we can personalize care for each patient,” Bauche said. “We have a wealth of expertise
Deciding if weight loss surgery is right for you
Weight loss surgery isn’t the only choice available and isn’t the best one for some people. If you’re interested in losing weight, here are four questions you should ask yourself before moving forward.
1. Do I meet general criteria for weight loss surgery?
Weight loss surgeries are a commitment and have wide-reaching impacts on a person’s life. Candidates are usually people who have a body mass index (BMI) of 40 or greater, or a BMI of 35 or greater with associated health risks such as sleep apnea, high blood pressure or diabetes.
“Our patients want to lose weight, not only to be healthier, but because they want to take fewer medications, live more active lifestyles and live without the health issues that can come with excess weight, and our job is to partner with them on those goals,” Bauche said. “We ask patients to start making lifestyle changes before surgery so they know it’s something they can achieve and maintain after surgery, and we work with them on strategies to do so.”
If you don’t meet the general criteria for surgery, or if your insurance plan won’t cover it, you still have options, including medical weight loss programs that use FDA-approved medications to either curb appetites or create a sensation of feeling full with less food.
2. What surgery options should I consider?
There are three main options for weight loss surgery available for people who have not already had weight loss surgery: Vertical sleeve gastrectomy, Roux-en-Y gastric bypass and Duodenal switch. Your doctor will discuss your options with you and help you understand the benefits and risks of each procedure.
For example, gastric bypass may be more effective for people with metabolic syndrome, while sleeve gastrectomy is more easily performed in people with high-risk medical conditions but may cause or worsen acid reflux and gastroesophageal reflux disease (GERD). The Duodenal switch can be the best option for people with Type 2 diabetes because it bypasses most of the small intestine, but patients must take more nutrition supplements to meet their daily nutritional needs.
“It starts with the patient and provider talking through each procedure so that the patient understands each one and how they differ,” Bauche said. “Then we review their unique health condition to have that discussion with the patient. In many cases, the final decision is up to the patient.”
3. Have I considered all of the mental aspects of weight loss?
Significant weight loss has many physical aspects to it. But it also has as many, if not more, mental aspects. How will your own self-image and body image be affected? How will other people in your life react to your changing body, and your changing body image?
“Some people see an improvement in their self-esteem, but others have a hard time seeing and accepting themselves in a smaller body,” Bauche said. “We try to help patients focus on non-scale victories, like bending to tie their shoelaces or going from sitting to standing without assistance. And we offer behavioral health support groups to offer specific strategies to address and overcome the mental hurdles.”
Social situations where food is the center like holidays, potlucks and other group events can be challenging too. And giving up specific comfort foods and drinks is another area where mental preparation can help with physical success.
At MU Health Care, all surgical weight loss programs provide counseling before and after to help patients make and keep healthy lifestyle changes. Our support services, including support groups, last for as long as each patient needs them.
“Our whole team works together with each patient to address nutrition, exercise and behavior modification both before and after surgery,” Bauche said. “Surgery changes the way that we think about food and how we eat. It is a lifestyle change, which is not just about eating less, so we do everything we can to help set our patients up for long-term success.”
4. What will my life be like after surgery?
Most patients will lose 20-30 pounds in the first month and weight loss continues until each patient reaches a weight they maintain with diet and exercise. For most people, this weight loss includes benefits like less joint pain, reduced blood pressure and increased sensitivity to insulin, which can help resolve Type 2 diabetes.
“Because of the metabolic changes, many people see these conditions improve fairly quickly,” Bauche said. “Paying close attention to hydration and protein intake are especially important in those first few months, and about a month after surgery, a lot of patients find they have a lot more energy and can be more active in ways they weren't able to be before.”
Immediately following surgery your food intake will be very strict, beginning with a liquid diet for at least one week, followed by pureed consistency foods for another couple of weeks. As your body heals, restrictions will relax: This process is different for some people, but you can return to eating a wide variety of foods after three or four months. Our experienced dietitians will help you plan out bariatric-friendly meals and guide you through adjusting family favorites to fit your needs. Your team will also recommend bariatric-specific vitamins and supplements including calcium and vitamin D.
Eating smaller portions more slowly is generally good advice after surgery. Certain foods will still be restricted, particularly sugar, carbonated beverages and alcohol.
“Sugary foods and drinks are usually calorie-dense but don’t make you feel full,” Bauche said. “High-protein, high-fiber foods will meet your dietary needs and help you feel full for longer.”