Living with Bariatric Surgery: Managing your mind and your weight

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not getting enough vitamins and minerals from your diet – you'll probably need to take supplements for the rest of your life after surgery This diet must only be used for the 10 days prior to surgery. It is not a diet to lose weight and must not be used at any other time.

Be cautious with drugs with a narrow therapeutic index. These will require close monitoring and titration especially following gastric bypass. When possible, monitor serum concentrations and the effects of these drugs e.g. anticoagulants, anticonvulsants, lithium, digoxin. Sweating, dizziness, or fainting after eating or drinking – this may be from post-prandial reactive hypoglycaemia especially if provoked by high-glycaemic index foods or drinks. The symptoms may include flushing, weakness and loss of consciousness and can be severe, and may impair driving, and have implications for the DVLA. Specialist referral to an endocrinologist is recommended for confirmation of the diagnosis, which can be complex as symptoms may overlap with dumping syndrome, and a dietetic referral in the interim can be helpful if there is likely to be a long wait. If you qualify for bariatric surgery, your health care team gives you instructions on how to prepare for your specific type of surgery. You may need to have lab tests and exams before surgery. You may have limits on eating and drinking and which medicines you can take. You may be required to start a physical activity program and to stop any tobacco use. Adjustable gastric banding (lap band): Gastric banding involves the placement of a permanent silicone band around the stomach. The band reduces the size of the stomach without cutting away any portion of it. This procedure is usually performed laparoscopically. A small port is placed directly underneath the skin so the band can be adjusted.

Bariatric Seminar

Small studies suggest that the bioavailability of antidepressants may be reduced after gastric bypass, particularly in the first six months after surgery. Serum concentrations of SSRIs returned to baseline in 50% of cases after 12 months in one small study, suggesting adaptation to effects may occur over time.

The message from the media and medical science is that they are likely to get cancer or diabetes unless they lose weight and the surrounding world regards their obesity as self-inflicted. Some have children and are afraid to die and leave them alone.”Continued surveillance of blood pressure is needed after surgery because of the high risk of recurrence over time. Life expectancy in patients with obesity has also been studied in the context of BMI “trajectories.” A study using data from the U.S. Health and Retirement Study, which included adults aged 51 to 77 years, defined 6 categories of BMI trajectories. These included normal weight downward, normal weight upward, overweight stable, overweight obesity, class I obese upward, and class II/III obese upward. Confirming a finding seen in prior studies, individuals in the overweight stable group had the highest survival rate, while individuals in the class II/III upward trajectory had the lowest survival rate. This finding persisted after controlling for socioeconomic factors and multiple chronic illness states. Using an attributable risk analysis, the authors found that about 7.2% of deaths after age 51 were due to obese upward trajectories [10]. VSG may also reduce the production of intestinal hormones that influence hunger and metabolism. One of these hormones is called GLP1. This hormone can reduce hunger signals and better regulate blood glucose (sugar) levels. Diarrhoea, or abdominal pain after eating or drinking. This may indicate dumping syndrome which is caused by the release of gut hormones and the rapid entry of water into the gut. It is classified as early or late dumping. Early dumping is most common type (40% after RYGB and SG), late dumping is experienced by around 25% of patients ( Bettini et al). Early symptoms are predominantly vasomotor (palpitation, flushing, faintness) and gastrointestinal (abdominal pain, diarrhoea, bloating and nausea) and occur within 15 min after meal. Late symptoms (tremor, perspiration, aggression, fatigue, weakness, confusion, hunger and syncope) occur in 1–3 hr after eating when the blood sugar drops to lower level. These patients should be referred to a bariatric dietitian.

Today, most types of bariatric surgery are performed laparoscopically. A laparoscope is a small, tube-shaped instrument with a camera attached. The laparoscope is inserted through small cuts in the belly. The tiny camera on the tip of the laparoscope allows the surgeon to see and operate inside the abdomen without making the traditional large cuts. Laparoscopic surgery can make recovery faster and shorter, but it's not the best option for everyone. The bypass routes food through only about 10 feet of the small intestine, instead of the usual 25. This means there is less time and distance for the body to absorb fat and calories. She notes that this was down to the development of chronic stomach and intestine problems, and one woman became so ill that she had to endure another operation because of problems with her scar tissue after the gastric bypass procedure. Sleeve gastrectomy. With sleeve gastrectomy, about 80% of the stomach is removed, leaving a long, tube-like pouch. This smaller stomach can't hold as much food. It also produces less of the appetite-regulating hormone ghrelin, which may lessen the desire to eat. psychosocial distress, such as low self-esteem, teasing and bullying (see also NICE's guideline on managing overweight and obesity in children and young people)Be careful to avoid stigmatising language or blaming the patient for weight regain. Some weight regain is expected due to powerful biological drivers even with good adherence to dietary advice. You’ll likely need to follow this puréed food diet for a few weeks until the doctor clears you to begin incorporating more solid foods into your diet. At this point, you can introduce some new soft foods into your diet, including: In some patients (particularly those with autoimmune thyroiditis), thyroxine dose requirements may increase. Increase your protein intake: to make sure your body is still getting the recommended amount of protein each day According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the most common types of bariatric surgery include:

Longer term risks and complications of weight-loss surgery vary depending on the type of surgery. They can include: Surgery usually takes several hours. After surgery, you awaken in a recovery room, where medical staff watches you for any complications. Depending on your procedure, you may need to stay a few days in the hospital. Types of bariatric surgery Follow a specific diet for several months: Your insurance company may require you to undergo a medically monitored diet for 3 to 6 months before your surgery. More long-term risks are associated with the changes made to your stomach. According to the Endocrine Society, these may include: You will need to take vitamin/ mineral supplements for the rest of your life. What you are required to take will depend on the surgery you have. The dietitian will discuss with you after your surgery.

Results

But it's a major operation and in most cases should only be considered after trying to lose weight through a healthy diet and exercise. NHS weight loss surgery Gastric bypass and other weight-loss surgeries don't always work as well as you might have hoped. If a weight-loss procedure doesn't work well or stops working, you may not lose weight and you may develop serious health problems.