HCA Midwest Health - December 18, 2017

Embarking on a new weight loss journey can sometimes feel like an overwhelming, uphill battle. And for many, it’s a hurdle that they’ve faced for most of their life. Weight loss is complicated, but you’re not alone. The U.S. Centers for Disease Control says that more than one-third of the people in the United States are at least 20 percent over the ideal weight for their height. But let’s dig a little deeper because this statistic doesn't tell the whole story about obesity and the factors that influence obesity – some controllable, some not – like:

  • Genetics: Studies show some people are more likely to gain weight than others based on a genetic predisposition to it.
  • Hormonal Disorders: Disorders like hypothyroidism and polycystic ovarian syndrome cause hormone imbalances in the body that make it easier to gain weight and more difficult to lose it.
  • Psychological Factors: How your family treated food growing up has a large impact on your eating habits. Studies show that children in families who don't eat together at the table are more likely to be obese. Parents who restrict access to food, control their kids' intake and use food as a reward can also play a role in childhood obesity and into adulthood.
  • Societal and Economic Factors: It's easier than ever to drive through a fast food restaurant – and that food is sometimes cheaper than other options, making it more appealing even if it's not the best choice for health.
  • Technology: As a whole, people are more sedentary now. While technological advances like computers, remote controls, food delivery services and even cars, make our lives more efficient and convenient, they also allow us the ability to not get up and move as much.

No matter the cause, obesity can affect your quality of life and increases your risk for other life-threatening diseases like heart disease, stroke, hypertension (high blood pressure), sleep apnea and Type 2 diabetes.

However, losing at least five to 10 percent of your weight – as little as 10 pounds if you weigh 200 pounds, for example – can decrease your chances of developing these diseases, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Weight loss may also improve your cholesterol levels, blood flow and blood pressure.

First, Talk to Your Doctor

There's no shortage of information out there about weight loss, and the right combination of tools and lifestyle changes are essential to a successful obesity treatment plan. But it can be difficult to find the right options for you. That's why it's best to get your primary care doctor involved – he or she can give you recommendations based on your medical history.

If appropriate, your doctor may also recommend bariatric surgery as an option for weight loss, in addition to a supervised weight loss program. A 2011 study published in The New England Journal of Medicine found that 40 percent of obese patients who participated in a weight loss program lost five percent of their body weight.

So, What is Bariatric Surgery?

Bariatric surgery – also called weight loss surgery – surgically reduces the amount of food your stomach can hold at a time. By cutting down on the amount of food you’re able to consume, you’ll also reduce the number of calories you take in. The most common options include:

  • Gastric bypass surgery: Also known as Roux-en-Y, gastric bypass involves two parts. First, the surgeon reduces the stomach to a small pouch with staples. Next, the surgeon cuts the small intestine and attaches it directly to the stomach pouch. This severely limits the amount of food the stomach can hold and reduces the number of calories the body can absorb.
  • Gastric (vertical) sleeve surgery: With this procedure, the surgeon removes most of the stomach, leaving it the size of a banana. The gastric sleeve procedure can also affect hormones in addition to limiting the amount of food the stomach can hold.
  • Gastric band surgery: The stomach is not surgically removed with the gastric band. Instead, the surgeon places an adjustable band around the top of the stomach to create a small pouch. The band also contains a balloon filled with salt solution. This limits the amount of food the patient can eat, but the size can be adjusted by adding or removing solution through a port placed under the skin.
  • Intra-gastric balloons: For this non-surgical procedure, the physician inserts a deflated balloon into the stomach through the esophagus and then fills it with a saline solution until it's about the size of a grapefruit. It's only designed to stay in the body for six months to a year, making it the most temporary of the bariatric options.

Many of the bariatric surgical options also use minimally invasive laparoscopic techniques, meaning that surgeons only need to make small incisions in your body. This increases safety for you – and decreases healing time.

How to Qualify For Weight Loss Surgery

Not everyone is a good candidate for bariatric surgery. In general, people who have a body mass index (BMI) of 40 or more are good candidates. People with a BMI of 30 or more may also be candidates for surgery or a non-surgical procedure (depending on their BMI and obesity related health concerns). Your bariatric doctor will walk you through your options including what surgeries, procedures and technologies are FDA approved for you.

Take the Weight Loss Quiz

If you meet the initial qualifications, your doctor will also evaluate a variety of other factors to determine if you're ready for the surgery. These factors include:

  • Previous weight loss and nutrition efforts: You must show that you've made attempts to lose weight through non-surgical options before you can qualify for surgery.
  • Mental health: Certain mental health conditions (like binge eating disorder, depression and anxiety) can make it difficult to follow through with a healthy lifestyle post-surgery. These conditions won't immediately disqualify you from surgery, but you may have to go through additional treatment or therapy before surgery.
  • Other health conditions: Some health problems – like blood clots, liver disease and heart conditions – can make bariatric surgery unsafe.
  • Motivation: You must show a willingness to live a healthy lifestyle post-surgery and keep up with your nutrition plan.
  • Age: The very young and old are at an increased risk for complications. Though there isn't a minimum age, surgery is not recommended for children under 18.

How Much Weight Can I Lose?

The amount of weight you can lose depends on your size before surgery, the procedure and your efforts. One study showed that more than 90 percent of people are successful in losing about 50 percent of their excess weight. Another study that followed patients for three years post-surgery found that people who had gastric bypass lost 90 pounds on average, while those who had gastric band lost about 45 pounds.

Most people do regain some weight over time, though maintaining a healthy lifestyle can limit how much is regained.

The Risks of Bariatric Surgery

All surgeries carry a potential for complications and bariatric surgeries are no exception. Risks include:

  • Blood clots
  • Infection
  • Stomach perforation
  • Breathing problems
  • Gallstones
  • Hernias
  • Death; the American Society for Metabolic and Bariatric Surgery reports the chance of dying from the operation to be exceptionally low; the risk of death within the 30 days following bariatric surgery averages 0.13 percent.

You can also experience complications in the long term, including:

  • Bowel obstructions
  • Dumping syndrome – this is when foods move from the stomach to the small intestine too quickly. Can cause nausea, vomiting and diarrhea.
  • Malnutrition because of hormonal changes that prevent proper absorption of essential nutrients and vitamins.

How to Get Started on Your Weight Loss Surgery Journey

Finding the right team for your surgery is vital for its success. Luckily, you have world-class options available right in your backyard at HCA Midwest Health hospitals, Menorah Medical Center, Centerpoint Medical Center and Lee’s Summit Medical Center. The proof is in the reputation: Menorah Medical Center is accredited by the American College of Surgeons as a Comprehensive Bariatric Surgery Program and Center of Excellence.

You'll work with a multi-disciplinary team from day one when you decide to explore bariatric surgery at one of our Kansas City hospitals. The team includes board-certified surgeons, a registered dietitian, physical therapists, occupational therapists, exercise physiologists, a medical weight loss physician and a bariatric coordinator who are there to listen to you, discuss your expectations, needs and goals for weight loss and then make the decision on the best options for you based on your body and medical history.

All treatment plans also include additional services designed to help long-term success, including nutritional counseling, peer support groups, meal planning with our registered dietitian and personalized exercise plans developed by our exercise physiologist.

Ready to start? The first step is to check to see if you qualify for bariatric surgery. Then, sign up for an online seminar to learn more about your options and if it's truly the right choice for you right now. You can also get in touch with a bariatric coordinator to get your questions answered.

Centerpoint Medical Center

Online Seminar

Bariatric Coordinator – (816) 698-8030

Menorah Medical Center

Online Seminar

Bariatric Coordinator – (913) 498-7367

Lee’s Summit Medical Center

Get Started

(816) 282-5991

No matter where you are in your weight loss journey, we’re here to support you, find out more.