- Our Practice
- Facts and Solutions
- Obesity Surgery
- Contact Us
Please ask any questions either through our website here or by calling 1300 WEIGH LESS or (07) 47252833.
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#.
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.
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.
Following laparoscopic gastric banding surgery, we generally keep you in overnight. Following a gastrograffin swallow (to check the band position) in the morning, you may be discharged and free to go home.
After a laparoscopic sleeve gastrectomy, we like to keep you in for approximately three nights to monitor you closely.
Both laparoscopic procedures generally allow patients to return to work after one week. We prefer light duties to ensure any incisions heal with minimal scarring. You may resume driving and normal activities when you feel well enough to do so. Usually it is within a few days.
The endoscopic procedure, gastric balloon is usually a day surgery procedure and you should be able to return to normal work and activities in a day or two depending on how comfortable you feel with the gastric ballon.
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 two and five kilograms each 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 and indeed sooner.
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 two to three year period followed by continued, steady weight maintenance. The average excess weight loss (%EWL) at two years is between 52% and 65%**
The laparoscopic sleeve gastrectomy has perhaps a greater %EWL initially. Research is now becoming available showing that average %EWL after one year is 60%, increasing to 62% at 3 years and 48.5% at greater than 4 years***.
It is essential that for all surgical weight loss procedures that follow-up appointments be attended. To assist you we offer SKYPE for our out-of-town patients.
In the four 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. Benefits of weight loss surgery is that you can continue to eat the same meals as your family however they will be a smaller portion size. Hopefully you won't mind this because you will be losing weight.
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.
Dining out has been a challenge for some of our patients so we have introduced a business card sized Doctors' Certification Notice which you can show to waitstaff. The card may assist you in being permitted to order from children's and entree menu's as your main meal order.
Gastric band and gastric balloon procedures are adjustable procedures. At follow-up appointments we will asses correct placement and discuss any adjustments with you.
The gastric band is tightened by accessing the port with a needle. This is most commonly done in our procedure rooms at NQOSC. 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.
Vomiting following restrictive surgical procedures is not normal. Generally speaking, the patients who experience vomiting, are doing so because of one or more of the following reasons:
If you experience vomiting and the above does not apply, contact our rooms as soon as practicable for further advice.
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.
Follow up is essential for all patients. Regular follow-up visits with the staff and surgeons at NQOSC must be maintained to examine weight loss progress and adjust the balloon or band as necessary. Follow-up is equally important for sleeve gastrectomy patients as incidental, distracted and boredom eating can impede your weight loss progress.
Evidence shows that patients who attend follow-up appointments regularly either face to face or via SKYPE, particularly in the first year, lose more weight than those who do not.
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.
*SAGES/ASBS Guidelines for Laparoscopic and Conventional Surgical Treatment of Morbid Obesity
American Society for Bariatric Surgery. http://asbs.org/html/guidelines.html
**O'Brien, P.E & Dixon, J.B 2002
‘Weight loss and early and late complications-the international experience'
The American Journal of Surgery 184: 42S-45S
***Gagner, M et al. 2009
‘The second international consensus summit for sleeve gastrectomy, March 19-21, 2009'
Surgery for Obesity and Related Diseases. 5, 4: 476-485
#Dixon, J.B et al 2008
‘Adjustable gastric banding and convention therapy for type 2 diabetes'
The Journal of the American Medical Association: 299, 3: 316-322