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What age do I have to be to have weight loss Surgery?
Both procedures are generally indicated for people who are between the ages of 18 and 55, though we have had patients at this practice who are in their late 60s.
How long will I be in hospital?
Following gastric banding surgery, we generally keep you in overnight. Following a gastrograffin swallow (to check the band position) in the morning, you are free to go home.
After a sleeve gastrectomy, we like to keep you in for 3-4 nights to monitor you closely for any complications.
In that both surgeries are laparoscopic, you can generally return to work after one week on light duties, and resume driving and normal activities at this time also.
How much weight will I lose?
The success of weight loss surgery is dependent on the individual. Those patients who continue to eat a healthy, balanced diet and incorporate exercise into their lifestyle, will lose more weight that those who eat high calorie foods, particularly liquids, and do very little physical activity.
Ideally, we would expect you to lose between 2-4kg a month for the first 12-18 months, or lose 50% of your excess weight. In our practice we have had several patients that have reached their goal weight within this time period.
Studies show that weight loss surgery (as compared to other options) offers the best results for sustained long-term weight loss in patients who have failed with other treatments*.
There is an abundance of long-term data available, confirming that gastric banding is an effective weight loss tool not only in the first year following surgery, but in the long term. Combined international data show that weight loss after gastric banding surgery is characterized by steady progressive weight loss over a 2- to 3-year period followed by continued, steady weight maintenance. The average excess weight loss (%EWL) at 2 years is between 52% and 65%**
The sleeve gastrectomy has perhaps a greater %EWL initially. Research > 4 years old is now becoming available and showing that average %EWL after one year is 60% increasing to 62% at 3 years and 48.5% at > 4 years***
Can I eat normal food?
In the 4 weeks following surgery, your diet will graduate from liquids that you can suck through a straw such as Optifast, juice and clear soup, to thicker foods such as yoghurt and cream soups, to mushy foods such as mashed potato and fish.
After this time you can eat almost anything that you want. The beauty of this surgery is that you can continue to eat the same meals as your family, but a smaller portion size. Hopefully you won't mind this because you will be losing weight every week!
The biggest change will be in the size of your meals and the new eating behaviors you will have to adopt. It will still be up to you to make healthy food choices. Solid foods are ideal as they stay in the stomach pouch longer, so you should feel full after eating only a small meal. In order for your body to remain healthy and function properly, it will be important to choose foods are high in protein and nutritional content.
What about adjustments?
Gastric banding is an adjustable procedure, whereas sleeve gastrectomy is not.
The Band is tightened by accessing the port with a needle. This is most commonly done in our office. Sometimes we use x-ray guidance, but this is generally not necessary. You must never attempt to adjust your own band. The first adjustment of the band will occur four weeks later with up to 5-6 adjustments in the first year.
I have heard that weight loss surgery causes vomiting; is this true?
Vomiting following restrictive surgical procedures is not normal. Generally speaking, the patients the we see who are vomiting, are doing so because of the following reasons:
- Your portion size is too large: It takes the brain a while to register that you are full. If you continue eating and eating, then it may be too late before you realise you are full and have overfilled your new small stomach.
- Chew chew chew: If you do not chew your food well then it becomes much harder to digest.
- You're eating too fast: You're much more likely to vomit your food if you eat too quickly and thus overfill the pouch, or do not chew well because you're in a rush.
- Your food choices are poor: Eating foods that have the potential to become stuck can also cause vomiting.
So what foods should I avoid?
We recommend that patients stay away from foods like steak, since red meat is more difficult for the body to digest. Bread and rice can also be difficult to digest, so these two foods are often avoided. Sugary, high-calorie foods can interfere with weight loss, so these foods should be eaten sparingly. Patients often have to wait a couple of months before consuming carbonated soft drinks as they can cause bloating and gas.
Is follow-up really important?
Follow up is essential for gastric band patients. Regular follow-up visits with the staff and surgeons at NQOSC must be maintained to examine weight loss progress and adjust the band as necessary. Recent research has shown that patients who attend follow-up regularly, particularly in the first year, lose more weight than those who do not.
This is not the case with the sleeve gastrectomy, where follow-up is 3-6 monthly in the first year, making it more ideal for patients who live in rural and remote areas.
Do I have to take vitamins?
Technically there is no need for you to take vitamins if you are eating a healthy diet. If you have reduced your caloric intake significantly then you may become deficient in some vitamins and minerals and in this case may benefit from a multivitamin.
I have heard recently that weight loss surgery can cure my diabetes. Is this true?
There has been quite a bit of media coverage regarding this topic in the last year. Most of it stems from a recent study, where patients with type II diabetes were randomized to have either bariatric surgery or participate in a conventional weight loss program. After 2 years, 73% of the surgical group compared to 13% of the conventional-therapy group had complete remission of type II diabetes. Although this was the first study of its kind, it presents strong evidence to support the early consideration of surgically induced loss of weight in the treatment of obese patients with type 2 diabetes#.
Can I become pregnant after weight loss surgery?
The good news is that in addition to improving your overall health, bariatric surgery can have a positive effect on fertility. For this reason, we recommend you take precautions in the immediate postoperative phase. You can safely conceive six months after the procedure, but might not have lost enough weight yet to avoid pregnancy related health conditions. If you fall pregnant then we would recommend that you see a dietitian regularly to ensure that your nutritional needs are fulfilled.
