Types of Weight Loss Surgery: Roux-en-Y Gastric Bypass Surgery

Friday, October 23, 2009 by Terri Hohlt
This operation is the most common and successful malabsorptive surgery. First, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the amount of calories and nutrients the body absorbs. It is the primary surgery performed by The Clarian Bariatric Center.

This operation can be performed either by a traditional open surgery or laparoscopically, a relatively new technology using a small video camera and a few customized instruments to perform surgery with minimal tissue damage. The Roux-en-Y technique is generally more effective in reversing health problems associated with severe obesity. Patients who have malabsorptive operations generally lose two-thirds of their excess weight within two years.

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Did you know?

Wednesday, September 30, 2009 by Andy Pollen
Bariatric surgery is recognized as the most effective and durable method for persons who are morbidly obese to lose their excess weight and keep it off for many years. It is NOT a quick fix. It is NOT taking the "easy way out."

The benefits of bariatric surgery are numerous:

Longer Life – Studies show that gastric bypass surgery can improve your life expectancy by as much as 89%.

Reduced Health Problems – Severe obesity is associated with at least 50 diseases, including diabetes, high blood pressure, congestive heart failure, fatty liver, high cholesterol, sleep apnea, gout and various skeletal and joint problems. Bariatric surgery has been proven extremely successful in eliminating or dramatically reducing most of these health problems. For example, 80% of non-insulin dependent diabetics are cured as a result of gastric bypass. Sleep apnea patients enjoy uninterrupted sleep within a year of surgery, and half of the patients with high blood pressure come of their medications within a few months of surgery.

Psychological Benefits – Bariatric surgery can also help reduce the stress and anxiety associated with obesity. With a new self-image, issues like depression and fear of social situations can be overcome. A new desire and ability to interact with family and friends is also a common benefit following bariatric treatment.

Want to learn more about how Indiana weight loss surgery can help you? Then join us at a FREE informational seminar where Indianapolis bariatric surgeons and staff will discuss treatment options. Learn more by clicking here.


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Exercise Boosts Mood After Bariatric Surgery

Monday, August 31, 2009 by Erin Light
Below is text from a recent article I found on the American Diabetes Association Web site that I thought was interesting. Now there is scientific proof that exercise can make you happier!

People who engage in moderate physical activity in the months after bariatric surgery report fewer mental health issues than those who exercise less, according to research reported at the Annual Scientific Meeting of NAASO, The Obesity Society, held October 20–24 in Boston.

Kathryn E. Henderson, PhD, and colleagues at the Rudd Center for Food Policy and Obesity at Yale University in New Haven, Conn., conducted a study of 134 patients who underwent gastric bypass surgery. The patients—140 females and 14 males—were extremely obese, with an average body mass index (BMI) of 51.7.

The participants completed a battery of self-reported measures before surgery, and at 6 and 12 months after surgery. The evaluations sought detailed information about physical activity, depression, self-image, and a range of mental and physical health issues.

Responses were divided into three groups: No exercise, physical activity one to three times per week, and physical activity four or more times per week.

In general, patients with lower BMI tended to exercise more. While exercise levels rose overall postoperatively, <50% of participants reported moderate physical activity at 6 and 12 months.

According to the researchers, the most physically active group of patients reported the lowest psychosocial stress. Those who engaged in moderate physical activity at least four times per week reported superior physical and mental health, had fewer depressive symptoms, and reported higher self-esteem than nonexercisers.

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Kidney Stones and Gastric Bypass Surgery

Saturday, August 29, 2009 by Jack Ditslear
Benefits of weight loss surgery are lower blood pressure, remission of diabetes, decreased risk of heart disease, lower blood cholesterol level, etc. as we all know, every benefit has a potential risk. A recent article in the Journal of Urology looked at the risk of kidney stones and gastric bypass surgery.

4,639 patients who underwent bypass surgery and 4,369 obese patients in a control group who didn’t have bariatric surgery were followed for four years. Of those, 4.6 percent of the control group developed kidney stones versus 7.7 percent of the bypass surgery group developed stones. This is a slight increase risk of developing kidney stones after bariatric weight loss surgery.

Prevention of kidney stones requires staying hydrated by drinking at least 64 ounces of fluid each day. This will prevent concentrating your urine which will decrease risk of kidney stones. If possible learn what type of kidney stones that you may be at risk of developing –calcium based kidney stone may require you to watch your intake of dairy products or if it is oxalate based may require you to limit your intake of dark green vegetables (spinach, kale,) and herbal teas. Consult with your primary care doctor if you suspect you are at risk of kidney stones.
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News article: Bariatric surgery challenges the perception of Type 2 diabetes as a chronic condition

Sunday, June 21, 2009 by Andy Pollen
This article from Endocrine Today, highlights one of the ongoing discussions about how bariatric surgery has been proven to cure Type 2 diabetes. We've discussed this topic on the blog before and I would encourage anyone with the disease to talk with your physician about how weight loss surgery may help your condition. The first few paragraphs are below and full text can be found here.

A surgeon argued today that the criteria for bariatric surgery should be changed, allowing more overweight people to undergo the procedure.

Even though there is a 92% reduction in diabetes-specific mortality risk after gastric bypass, only a small percentage of patients who could benefit are eligible to undergo the procedure, Francesco A. Rubino, MD, said. Those with a BMI greater than 40 are eligible for the procedure; those with a BMI greater than 35 are eligible only if comorbidities are present. “These criteria should change,” he said.

Rubino, chief of gastrointestinal metabolic surgery at Weill Cornell Medical College and head of the Diabetes Surgery Center at New York Presbyterian/Weill Cornell Medical College, also argued that the success of gastric bypass surgery “challenges the idea that diabetes is chronic and irreversible.”

The outcomes of the surgical procedure suggest an intestinal contribution to diabetes pathophysiology. Diabetes may be a “dysfunction of the bowel,” he said.

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Did you know?

Friday, June 12, 2009 by Terri Hohlt
Bariatric surgery is now accepted as the best and most effective treatment for morbid obesity. About 65 percent of all bariatric surgery patients are able to lose their excess weight and keep it off for more than five years.

When you consider that only approximately two percent of nonsurgical treatment patients are able to lose and keep off their weight for more than a year, you can appreciate these surgical results.

Health problems resolved or improved after surgery:
  •     86 percent diabetes
  •     70 percent high cholesterol
  •     78 percent high blood pressure
  •     84 percent sleep apnea

Expected weight loss (weight loss occurs for 18-24 months after surgery — mostly in first year):
  •     Lap-band surgery — 40-48 percent excess weight loss (national avg. = 47 percent)
  •     Gastric bypass surgery — 65-80 percent excess weight loss (national avg. = 62 percent)
  •     Duodenal switch — excess weight loss (national avg. = 70 percent)
Learn more about how weight loss surgery can change your life, by attending a FREE Indianapolis surgical weight loss seminar. Dates and times can be found by clicking on the image at the right of this page.
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Benefits of Weight Loss Surgery, Part II

Friday, June 5, 2009 by Andy Pollen
Following up on a post from Wednesday, below are the benefits of weight loss surgery discussed by Dr. Gonzalez in a recent news article in a medical journal.

Cardiovascular Benefits
Compared to patients undergoing conventional dietary regimens, patients undergoing bariatric surgery have lower incidence rates of high blood pressure, coronary artery disease, and high blood triglyceride and cholesterol levels.

Type 2 Diabetes
The first reports that weight loss through bariatric surgery improves type 2 diabetes were published in 1982. Improvement occurs in over 80 percent of patients, depending on the type of bariatric operation performed. An interesting phenomenon was described following gastric bypass surgery: diabetes disappears even before substantial weight loss is achieved. This triggered investigations regarding hormonal changes occurring following the intestinal disconnection, one of the most promising fields in the search for the cure of diabetes even in non-obese people.  

Obstructive Sleep Apnea
Obesity is the single most important factor for developing obstructive sleep apnea, a disease characterized by limited oxygen supply and diminished pulmonary ventilation resulting in pulmonary hypertension and respiratory insufficiency. Bariatric surgery reduces the incidence of sleep apnea to less than one third before surgery.

Risk of Developing Cancer
Obesity is responsible for at least 20 percent of cancer-related deaths in women and 14 percent in men, which represents over 90,000 people every year. A recently published study showed that patients undergoing weight loss surgery reduce the risk for developing cancer in up to 80 percent of the times. The benefits were greatest in breast cancer (85 percent) and colon cancer (75 percent). Others significantly reduced were pancreas, skin, uterus, and non-hodgkin lymphoma.

Overall Mortality and Quality of Life
Obesity is second only to smoking as the most common preventable cause of death. It is estimated that life expectancy in obese patients is shortened between 10 and 20 years. Quality of life is also significantly affected. Resolution of obesity-associated diseases following bariatric surgery not only improves the quality of life, but also lengthens patients’ survival.

Join the staff at Clarian Bariatrics at a FREE informational seminar and find out how weight loss surgery can help improve your life. Visit our Web site to view upcoming dates. We look forward to meeting you! 

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Comfort Food, Part I

Thursday, June 4, 2009 by Traci Baker
I remember the days when no matter what mood I was in, food was my friend just waiting to wrap its arms around me like a big fluffy blanket and snuggle.  I am 19 months post-op from having gastric bypass surgery and still think about comfort foods! These past few weeks I’ve been on a very emotional roller coaster ride and many of us know that it can become a slippery slope if we aren’t careful. 

I’m currently taking a few college courses and spending any spare time I have studying, doing homework and taking tests, which involve late nights along with lack of sleep.  I gave up my five month old puppy for adoption, which is very heart wrenching to me because I have always been a dog lover.  I cried many times with a close friend who lost two people in her life within four days of each other.  I cried again with another friend as she was going through some personal struggles, and I’m working on helping my son deal with teasing and bullying due to his weight. 

I look back and think what has been so traumatic in my life to make me constantly think about food and needing the feeling of comfort?  I think I’ve answered that question!
Being addicted to food can truly be a struggle physically, emotionally and spiritually.   I can’t tell you how many times I thought to myself, go find something to eat you will feel better and the pain will go away. 

I can’t count how many times I got up and went into the kitchen searching my cabinets for some comfort. I wanted to eat because I was exhausted from lack of sleep and worry.  I felt like a failure as an owner when I gave up my puppy while my heart ached for my friends who were going through so much pain.  As a mother who has a child being bullied and teased I just wanted to eat and make it all go away. 

I longed for some snuggle time with my old friend and wanted to forget about life even if it was just for a moment.  Every time I passed the McDonalds, Wendy’s or Burger King I thought how wonderful would it be to drive through and pick up my favorite super sized meal!  How I wished for that comfort. 
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Did you know?

Tuesday, May 19, 2009 by Terri Hohlt
Clarian Bariatrics is composed of staff and surgeons who specialize in the advanced surgical treatment of clinically severe obesity, a condition recognized by medical authorities as a major health problem in the United States today. In fact, obesity is the second leading cause of preventable death in the United States, surpassed only by cigarette smoking.

The surgeons of Clarian Bariatrics are highly skilled, experienced professionals backed by the vast network of Clarian specialists, affording you the latest in proven medical techniques. These include laparoscopic gastric bypass surgery, resulting in shorter hospital stays; advanced pain management techniques; and long-term support and follow-up. Patients can and do achieve major weight loss, a healthful and vigorous body and long-term weight control.

Want to learn more? Then join us at an upcoming FREE informational seminar. Click here to learn about upcoming seminar dates.

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Did you know?

Friday, May 8, 2009 by Andy Pollen
Weight-loss surgery falls into two basic categories: restrictive surgery and malabsorptive surgery.

Operations that reduce the stomach size are known as restrictive surgery because they restrict the amount of food the stomach can hold. An example of this type of procedure is the adjustable banding.

Some operations combine stomach restriction with a partial bypass of the small intestine. These procedures create a direct connection from the stomach to the lower segment of the small intestine, literally bypassing portions of the digestive tract that absorb calories and nutrients. These are known as malabsorptive surgery.

A combination of restrictive and malabsorptive procedures tend to produce more weight loss than either procedure does on its own. An example of a combination is called Roux-en-Y Gastric Bypass Surgery. Today, this procedure is considered the "Gold Standard" for bariatric surgery.

Want to learn more? Then click here!

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Trigger Foods

Thursday, March 26, 2009 by Traci Baker
Do you ever feel like you struggle with food?  I’m 15 months post-op from gastric bypass surgery and I know I still struggle with food.  Do you ever say one bite one hurt?  Does that one bite turn into two, three or four throughout the day? 

Do you find yourself constantly thinking about when you will get to have the next bite of that certain food? Think about it for a minute.  Does anything come to mind?  If there is a food that you have these feelings about it’s probably a “trigger” food for you.  These foods can become detrimental to those of us who had weight loss surgery. If we aren’t careful this can lead to binge eating and bad old habits.

A trigger food can cause us to over indulge and become sick. Learning to identify and avoid your trigger foods. Try journaling about your food intake and see if there is a trigger food in your diet.  Do some positive self talk!  Remind yourself what originally contributed to our obesity problem and then say I have a choice today.  I will not suffer and go back to the old way of eating. 

Have you been to a Clarian Bariatrics support group lately? If not, we would love to see you!

Also, please know that you can contact me confidentially by e-mail at bariatric@clarian.org or you can call me at 317-275-7010 and leave a message on my confidential voicemail.  Please visit our Web site for locations and times on our support groups! 
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My Re-birth...It Isn't Always Easy

Wednesday, February 25, 2009 by Traci Baker
My re-birth date is October 18, 2007.  This was the day I had been fighting for the past two years.  That date marks the start of my journey when I had a RNY gastric bypass surgery.  Four days after my re-birth date on October 22, 2007 I was readmitted to the hospital for revision surgery.

The following weeks consisted of some mild dehydration, lack of energy and the consumption of protein drink after protein drink.  November 12, 2007 I again visited the hospital only to discover I had an abscess!  Again, tests, Bariatric Surgery Costs, Causes of Obesity, Indianapolis Bariatric Surgery, Indiana Hospitals, Bariatric Weight Loss, Weight Loss Surgeryblood, and the insertion of a drainage tube this time.  My next trip was December 11, 2007 which was minor and was only a marginal ulcer.

What I learned throughout this experience was that nothing worth doing is ever easy, and weight loss surgery is no exception.

The next few months were basically uneventful compared to the previous three months.  I finally switched jobs and came to work for Clarian Bariatrics in April 2008.  Working in the medical field with bariatric patients has been a passion of mine for quite some time.  This was a very exciting time for me.  I was at my six month mark from surgery and had lost 100 pounds. I NEVER thought that was possible in such a short period of time.

Although I had two more hospitalizations last year, I have no regrets about my decision to undergo bariatric weight loss surgery. In a later post I will discuss the "priceless" aspects of this procedure, and trust me, they far outweigh any possible hesitations I may have had...even in light of the hospitalizations after the initial procedure.

On July 19, 2008, my husband and I renewed our vows for our 10-year wedding anniversary.  Not only were we celebrating the last ten years of our lives with our son, we were also celebrating each other.  I can honestly say that I would NOT have made it these past months without the love and support of my husband. 

You never know how truly blessed your relationship is until you have major life altering events happen like we did this past year.  Vince did more for me than I ever imagined I would need.  Words can not express my deepest appreciation for him and depth that our love has grown over this journey. 
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Did you know?

Tuesday, February 17, 2009 by Lorie Blythe
After weight loss surgery you lose weight even in your feet.  Yep, that's right, your shoe size might get smaller.  As you continue to lose weight from your bariatric weight loss surgery, you might to ask your sweetie for a new pair of shoes instead of forbidden items like chocolate and other sweets.

Do you have an additional question about what to expect after gastric bypass surgery or health problems with obesity? Then leave me a comment below. I'd love to hear from you.
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Keeping it hidden, Part I

Monday, February 16, 2009 by Lisa Buckalew
The reasons for bariatric surgery are personal, as I have stated in previous writings.  Some people choose to let others know of their journey while some keep it as a very private issue.  Why?  What are the thoughts behind keeping it “hidden?"  I understand the reasoning that it is very private and very personal.  It is.

The reasons I often hear, take my breath away.  It is not because our patients are extremely private people.  More often than not it is because they are ashamed.  This reason always affects me in a negative way.  Society views obese people as lazy, not having any motivation, any ambitions or having no self control.  How wrong they are, and how sad that a person cannot open up to his/her own family because of the judgment and stigma often attached to bariatric surgery.  People are not obese because they cannot push away from the table.

You would not judge a person with cancer as someone who breeds weak cells, or has no willpower to fight off that disease.  How silly does that sound in this day and age.  Obesity has many underlying factors.  Obesity is a disease.  It is not to be taken lightly.  When left untreated, kills more people than cancer, diabetes, alcoholism and high blood pressure.
 
They are often issues that exacerbate this disease and those are often sad, heartbreaking issues that are personal and private. Things you would only talk to your closest friends about. I understand that.  I got it.  The issue that you would let yourself go untreated because the neighbor down the street thinks bariatric surgery is for “weaklings" brings tears to my eyes. 

I know the stigma attached to gastric bypass surgery.  I remember the comments made and sometimes they still are. It still hurts.  The idea that just because you have fixed the body you are living in, that you now live a perfect life is wrong, deadly wrong.

Above is a picture of me prior to surgery. If you'd like to see what I look like now, then click on my name above. I'd love to hear from you, and look for part two of this post later in the week.
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Let us help you reach your goals

Wednesday, January 21, 2009 by Andy Pollen
Have you been sitting in this cold weather and eargerly anticipating the arrival of spring, or better yet, summer? Have you been daydreaming about a day at the beach? A hike with your family? A leisurely bike ride on the Monon? I know I have!

For many Americans these will remain only daydreams as they feel trapped in a body that cannot support their active imaginations. At Clarian Bariatrics we want to help you reach your goals, whatever they may be. Our skilled Indianapolis Bariatric Surgeons want to help you overcome Obesity Medical Problems and reclaim your life.

Consider joining us at a FREE information session where you can ask questions of Indianapolis Weight Loss professionals and learn more about the Lap Band, Stomach Stapling Surgery and Gastric Bypass Surgery.

We went to help you reach your goals!
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December Gastric Band Support Group Recap, Part II

Tuesday, December 23, 2008 by Alvin Furiya
Yesterday, I posted some information from our gastric bypass surgery support group from December. We had an important discussion on maladaptive eating, which should be controlled in order for weight loss surgery success. Below are a few tips to overcome one of the many causes of obesity:

Band adjustments are key for fullness but just as important is making good food choices and understanding a little hunger is okay and part of weight management. Three potential zones for fullness:

1.    Yellow Zone – Gastric band is too loose. You are hungry, both portion and total meal size are getting larger, small meals do not satisfy you, and weight loss is below expected level.
2.    Green Zone – Ideal area in which small meals are satisfying and provide fullness. Vomiting and heartburn are rare. Staying in this zone requires you to follow dietary guidelines and rules.
3.    Red Zone – Gastric band is too tight and may cause difficulty with eating, swallowing, vomiting, heartburn, and food choices are more liquid e.g. ice cream, shakes, candy, chocolate bars, rather than solid.

Key reasons that lead to maladaptive eating:
1.    Relying only on adjustments for fullness
2.    Eating too much resulting in discomfort
3.    Making inappropriate food choices or eating the wrong type of food,
4.    Improperly chewing foods resulting in choking or vomiting
5.    Want versus Need

Remember, Clarian Bariatrics will provide monthly support group for gastric bypass weight loss surgery patients on the third Wednesday of each month from 6:00 to 7:30 p.m.  Patients may bring family and/or support members to the meetings.
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December Gastric Bypass Support Group Recap, Part I

Monday, December 22, 2008 by Alvin Furiya
The Clarian Bariatrics support group meeting for gastric bypass surgery patients was held on Wednesday, December 17.  The discussion was about maladaptive eating, which is one of the long term issues that may confront patients undergoing a gastric banding procedure.

A maladaptive behavior is a behavior or trait that is not adaptive — it is counterproductive to the individual. Reasons why changing eating habits is difficult:

  • Old habits are hard to break.
  • Changing lifestyle long term process and takes time.
  • No change in habits or lifestyle leads to rationalizing a behavior and returning to or continuing old habits and making poor food choices.

I will provide some tips on understanding an individuals "zone of fullness" tomorrow!
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The Bariatric Surgery Option

Thursday, December 18, 2008 by Terri Hohlt
How do you know if Indianapolis Gastric Bypass surgery is right for you?  There are many non-surgical treatments for people suffering from Obesity Related Problems and   only a physician from Indiana Bariatric Centers can properly determine the right course of action for you.

Bariatric surgery is often consider when a patient has a body mass index of 40 or more or if you have a BMI of 35 and other weight related health problems like diabetes or arthritis.  Gastric Bypass weight loss leads to lower blood pressure and other obviously beneficial outcomes.

Keep in mind that one may still be obese or overweight after Gastric Bypass Surgery as it takes several months - or years - to achieve a healthy weight depending on the individuals weight before surgery.

Because you will only be eating a few ounces of food at a time, expect some dramatic changes to your lifestyle that will contribute to a healthier you. Nutrition for patients of morbid obesity surgery will need to take vitamins and supplements and of course avoid high calorie sugary drinks.

Our Indiana bariatric doctors offer consultations and advice to those seeking help.   Attend one of our upcoming FREE informational seminars to learn more. Simply click on the image at the top right of this page. See you there!
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The Importance of Calcium, Part I

Thursday, December 18, 2008 by Andy Pollen
The following blog post was written by Jennifer Gregoline, a registered dietitian at Clarian North Medical Center, who works closely with gastric bypass weight loss patients post-operatively. Below she discusses the important role calcium plays in a patients recovery from weight loss surgery.

So often, patients come back in post-operatively for a follow-up visit and we notice when reviewing their vitamin regimen that many patients are not taking any or not taking the right amount or right kind of calcium supplement. 

There are usually several reasons for this including:  patients feel the pills are too big, too many pills to take at one time or they don’t remember to take them.  Unfortunately, none of these are good reasons to put your bones at risk. Calcium is needed before and after surgery to prevent calcium deficiency and osteoporosis. After surgery, foods rich in calcium are not enough to prevent calcium deficiencies and osteoporosis.  

When patients undergo gastric bypass surgery, the preferential sites for the absorption of calcium, the duodenum and proximal jejunum, are bypassed placing patients at increased risk for low calcium levels thus necessitating lifelong supplementation to maintain adequate serum levels.

Look for part two of this posting on Monday!
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Understanding the Insurance Process

Wednesday, December 17, 2008 by Alvin Furiya
At information sessions, one of the first questions potential patients ask is how likely it is that insurance will pay for the procedure. At Clarian Bariatrics we have a team of insurance specialists that will work directly with you - and your insurance company - to ensure that you can get the treatment you deserve.

Below is just some basic information about the insurance process that will be posted in different parts. If you have additional questions about gastric bypass surgery cost or anything else addressed on the weight loss blogs, please let me know!

Weight loss surgery can be expensive, and you will need to determine how you will pay for the surgical procedure. Most patients obtain insurance approval from their insurance carriers, and some patients choose to pay for the surgery themselves.

We suggest you pursue coverage from your insurance carrier prior to paying for surgery yourself. Insurance companies are free to establish their own criteria for approval, but many follow the surgical criteria guidelines of the National Institutes of Health and The American Society for Bariatric Surgery.

Insurance approval is often a lengthy and complicated process. The staff at the Clarian Bariatrics will assist you in obtaining insurance approval. However, they cannot act on your behalf since you are the policyholder. Therefore, you will need to work with our staff and remain active in the process.
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