 |
  |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
|
Some Documents on this site require Adobe Reader. You may download this free of charge from Adobe  |
|
Some Documents on this site require Windows Media Player. You may download this free of charge from Microsoft  |
|
Some Documents on this site require the Flash player plugin. You may download this free of charge from Macromedia  |
 |
 |
 |
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Introduction to Weight Loss Surgery
Obesity surgery is the most effective weight loss treatment available to people suffering from morbid obesity. Recently surgery for morbid obesity has received widespread acceptance because of very effective and long term weight loss and resolution of co morbidities. Choosing weight loss surgery to control your overweight is a major decision. For success, both your mental and physical effort will be needed. Talk with your family, your doctor, and other people who have had the surgery. If possible, attend a weight loss surgery support group meeting. Please click on the SUPPORT GROUP link for more information. You will have a chance to ask questions and obtain direct answers from our Bariatric surgery center staff and will be able to talk to others who have had weight loss surgery. Think carefully about your hospitalization, recovery, and chances for a successful outcome. Obesity surgery is indicated for well informed, motivated individuals suffering from morbid obesity who have failed non surgical treatment for weight loss. Information on this page is meant to help you make your decision. It gives you tips for your preoperative (before surgery) and postoperative (after surgery) care, your recovery at home, and changing your eating habits to lose weight after surgery.
If you have already been registered with EMMI Solutions through Hamot Bariatric Surgery Center, you can click on the above link to complete your preoperative education. You will need an access code from our office to visit this website. Please call Lori at 814-877-6619 for your access code.
People with BMI higher than 40 are considered Morbidly Obese or Clinically Severely Obese. Morbid obesity is a chronic, life threatening, progressive, genetic and multi factorial disease of excess fat storage. It is progressive because it does not go away and in the absence of an effective treatment, it only gets worse. It is life threatening because of the several co-morbidities caused by morbid obesity. Finally it is now considered a disease. It is not something trivial. It is not a matter of mind over matter but something lot more complex. It is not a matter of the obese person's fault and it is not a character defect. Recent research has shown a central role of genetics in the causation of morbid obesity and it is hoped that with increasing understanding of this complex disease, public and medical community will stop stigmatizing morbidly obese individuals and treat morbid obesity like any other disease. Research has shown that non surgical means of weight loss (dieting, exercise, behavior modification and medications) are ineffective in causing significant amounts of weight loss in 98% of morbidly obese individuals. Average weight loss with such modalities is 10-15% over a period of 1 to 2 years. Unfortunately all of that weight comes back in majority of patients in 5 years plus more. Weight loss surgery is the only effective treatment available for morbid obesity at this time. You and your doctor need to decide if gastric surgery is likely to help you. In most cases, you must meet the points listed below:
The most commonly performed operation for morbid obesity in USA is called Gastric Bypass. Other names for this procedure include Roux-N-Y gastric bypass or Roux-N-Y Gastrojejunal bypass. This is one of the two operations approved by National Institute of Health (NIH) consensus conference in 1991 for the treatment of morbid obesity. The stomach is divided into a small upper part and a large lower part. The small upper part of the stomach now acts as new stomach. This part of the stomach is also called stomach pouch or gastric pouch. Usual size of the gastric pouch is one to two ounces after surgery. The size of an average stomach is equal to the size of a person's head or 6 cups and the size of the stomach pouch after gastric bypass is equal to the size of a person's thumb. About one third of the small intestine is bypassed and a two-and-one-half foot length of intestine is connected from the small stomach pouch to the rest of the intestines. The lower part of the stomach and its intestine will no longer be used. Roughly two thirds of the small intestine is still used for digestion and absorption of food after food passes from the small stomach pouch into the small intestine.
Since the stomach holds less food, person feels full after a very small meal. The connection between the gastric pouch and the small intestine is very small, and food tends to stay in the gastric pouch for a long duration, giving the person a feeling of fullness for several hours. Since a part of the small intestine is bypassed, all of the calories in the food are not absorbed. This method helps weight loss but still requires a change in life style. This is one of the operations performed for weight loss at Hamot Medical Center. Gastric bypass surgery has been performed for weight loss since 1960s. The procedure was initially performed using an open incision. In early 1990s, a laparoscopic technique to perform this operation was developed. During laparoscopic surgery, six tiny incisions are made to perform the operation. Surgeons insert long instruments through these tiny holes to perform the procedure. A camera is attached to one of these instruments. The camera shows a video image of the operation on a television monitor. Laparoscopic approach offers the advantages of smaller incisions, less pain, and earlier recovery. There is also a lower incidence of ventral hernias (abdominal hernias) after laparoscopic gastric bypass compared with open gastric bypass. Since the exact same operation is performed during open and laparoscopic surgeries, other outcomes including weight loss are similar with both approaches. Both open and laparoscopic gastric bypass surgeries are performed at Hamot Medical Center. Laparoscopic gastric bypass can not be performed in every patient. During your consultation, you will be able to find out if you qualify for a laparoscopic gastric bypass surgery.
Patients can expect to lose 40-75% of their excess weight over a period of 18 months after gastric bypass surgery. Over a five year period, patients tend to regain 10-20 lbs. However most people are able to lose significant amount of weight and keep it off long term. Many factors influence weight loss after gastric bypass surgery. Younger patients, men, and patients who are committed to making permanent life style changes, usually lose more weight. Individual weight loss results vary. 10-15% of patients lose less than 50% of their excess weight.
Risks of Gastric Bypass Surgery Listed below are problems you need to think about before choosing gastric bypass surgery. The percent is the risk to you, based on how often each one has happened to other people having this surgery.
Modifications of Gastric Bypass: Over the years, surgeons have tried to improve the results of gastric bypass procedure even more by making a few changes in the procedure. Most of these changes are minor. In the beginning, the stomach was stapled and not divided. Later studies showed better results when the stomach was stapled and divided. Therefore that has become the most common technique over the last 10-15 years. Some surgeons place a ring around the gastric pouch to prevent the outlet of the pouch from getting larger with time. Some studies have shown better long term weight loss results with this technique. However the ring can also cause complications in a very small number of patients. Some surgeons place a marker on the big stomach that can help find the position of the big stomach during CT scanning and facilitate future evaluation in the rare situation when it may be needed. The placement of such a ring does not affect the amount of weight loss.
Laparoscopic Adjustable Gastric Banding or Lap-band is the second most commonly performed operation for weight loss in USA. This operation has been popular in Europe, Australia and many Latin American countries for more than a decade. In many European countries, it is the most common weight loss operation. It was approved in USA by FDA in June of 2001. This operation also creates a small stomach pouch in the upper part of the stomach. However no staplers are used to staple or cut the stomach. In stead a silicon band is placed around the upper part of the stomach, creating a small upper gastric pouch. The size of the stomach pouch is similar to the size of the pouch after gastric bypass surgery. The band has a balloon on the inner surface which is connected to a reservoir through tubing. The band is placed around the stomach in an empty state. The patient returns to the office a few weeks after surgery. At that point the surgeon starts gradually filling the band with saline solution. Small amount of saline is added to the band reservoir every few weeks. The ‘filling procedure’ is usually performed on bedside in the office. In a small number of patients, the reservoir can not be felt through the skin and filling may need to be performed in the x-ray department. The procedure takes 10-15 minutes and involves very little pain. Each filling narrows the opening of the stomach pouch. This helps the patient feel full with smaller amount of food. Most patients reach an adequate filling volume by the end of the year and do not need any more fillings.
There are several reasons for the recent popularity of Lap-band procedure.
Complications of Lap-Band Lap-band is not free of complications. The risk of complications is low and they are different from the complications of gastric bypass. Here is a list of lap-band complications.
It is also important to understand that weight loss after lap-band is slower than gastric bypass. Patients usually lose 1-3 lbs per week. The rate of weight loss is roughly half the rate of gastric bypass. However a slower weight loss is not necessarily bad. Some studies have also shown that weight loss after lap-band continues up to 5 years as opposed to 18 months after gastric bypass. On the average patients can expect to lose 30-60% of excess weight over a period of 5 years after lap-band. Individual results vary. For more information about lap-band, please visit www.lap-band.com. Gastric Bypass and Lap-Band are the two procedures performed at Hamot Medical Center for weight loss. Dr. Amjad Ali and Dr. Rodolfo Arreola both perform laparoscopic and Open Roux-N-Y gastric bypass procedures. In addition Dr Amjad Ali also performs lapband procedures. We try to individualize the surgical treatment of morbid obesity based on patient's medical background, food and exercise habits and expectations of weight loss.
To learn more about this procedure, visit the website of the American Society for Metabolic and Bariatric Surgery (ASMBS) and review the ASMBS Position Statement on Sleever Gastrectomy As a Bariatric Procedure.
Vertical Banded Gastroplasty This operation is also called stomach stapling or gastric stapling. The other names include gastroplasty (reshaping of the stomach). This is the second operation approved by NIH conference in 1991 for the treatment of morbid obesity. In this operation, the stomach is almost closed with staples. A small opening is left for food to pass through from the upper to lower part of the stomach. This is a simple and safe method, causing no change in normal digestion and absorption of food. However, this method may not result in enough weight loss and may eventually cause heartburn and cause some food to back up into the throat. Average weight loss with this operation is 30-40% of excess weight or 75 lbs after one year. This operation has become less popular in the last 10-15 years.
This operation is the more modern version of Jejuno Ileal Bypass. It was popularized by Dr Scopinaro at University of Genoa in Italy. This is the only operation that leaves a relatively large size stomach behind (7 to 12 ounces). The operation depends on malabsorption for weight loss. Because of its malabsorptive nature, the operation causes severe malabsorption of fats and proteins. Although it enables the patient to eat a larger meal, compared to gastric bypass patients, it has other serious problems including socially embarrassing flatulence and offensive body odor ( a result of severe fat malabsorption. About 7 to 10 percent of patients also suffer serious protein malnutrition requiring nutrition through the veins (total parenteral nutrition). This operation is not very popular in USA. The operation is shown in a schematic diagram borrowed courtesy of American Society of Bariatric Surgery.
Duodenal Switch procedure is a modification of Biliopancreatic Diversion. The operation preserves the valve at the lower end of the stomach and the lesser curvature of the stomach and is supposed to reduce the incidence of some of the complications associated with biliopancreatic diversion. However both biliopancreatic diversion and doudenal switch operations are not very popular in USA because of higher incidence of complications and other side effects.
In summary gastric bypass is the most common operation for morbidly obese people in USA because of the low risk of complications and excellent weight loss. Lap-Band is the newer and less invasive procedure which also offers the advantage of being reversible. It is the second most common weight loss operation in USA. Both of these procedures are performed at Hamot Medical Center.
Other tests may be done for:
Tell your doctor if you have trouble with any of these now. All patients must also undergo:
Your surgeon may also want you to be seen by the following specialists:
If you decide to go for surgical treatment of morbid obesity, an appointment will be made for you at the time of your visit to see other specialists if indicated. You will also be given written information about weight loss surgery. Please read that information thoroughly and write down all your questions and bring those questions up at the time of your future visits. If you are interested in gastric bypass surgery or if you are not sure about the type of weight loss surgery, you should have, we recommend our patients read Barbara Thompson's book... "Weight Loss Surgery: Finding The Thin Person Hiding Inside You" If you are interested in lap-Band we recommend our patients read Jessie H. Ahroni's book It is also mandatory to attend at least one surgical support group meeting before making an appointment with Dr Arreola or Dr Ali and attend at least 3 support group meetings before proceeding with surgery. Please click on the Support Group Link for more details about this issue.
Major weight loss will result in big changes in your life, often causing emotional and social stress. Even good changes are stressful. The psychologist will be able to help you cope with such stress. Another reason to see the psychologist is to make sure your hopes and expectations match with the possibilities and limitations of this surgery. For example, it is unrealistic to expect that weight loss will turn you into a totally new person. However, it is realistic to expect better health and to be able to do new activities.
Download a list of prior authorization requirements here Many insurance companies demand a proof that non surgical methods of weight loss have failed in your case before approving your request for weight loss surgery. Studies have shown that 98% of morbidly obese people are unable to lose significant amount of weight and keep it off through non surgical means. On the average morbidly obese people lose 10-15% of their weight over a period of 1 to 2 years through non surgical means and over 5 years all of that weight comes back plus a bonus. Most of the morbidly obese patients have tried very hard to lose weight before considering weight loss surgery but insurance companies still want documentation of your weight loss attempts. Therefore, try to collect as much documentation as possible before submitting a request to your insurance company. If your primary doctor understands the need for weight loss surgery in your case, request a letter from the primary doctor to be sent to your insurance company. If your insurance company refuses to pay for your surgery in spite of all your efforts, you can get in touch with a team of lawyers at Obesity law and advocacy center at http://www.obesitylaw.com/. They have helped several morbidly obese patients with their claims. The firm is headed by Mr. Walter Lindstrom Jr. who himself had gastric bypass surgery and has become a very enthusiastic advocate of this operation. Their telephone no. is (619) 656-5251. At Hamot Bariatric Surgery Center, patients are seen by Dr Amjad Ali or Dr Arreola for a determination of the need for weight loss surgery. Our office tries to keep track of the pre-authorization requirements of the most common insurance plans we deal with. After the patient has undergone necessary preoperative tests and met the preauthorization requirements of his/her insurance carrier, a letter is sent to the insurance carrier along with the required documentation. We encourage you to find out from your insurance carrier if weight loss surgery is covered under your plan; enquire about the preauthorization requirements mandated by your insurance carrier (as they keep changing frequently) and start collecting documentation even before making an appointment at our office. Now most insurance plans require a proof of six months weight loss attempts under the supervision of a physician before preauthorizing weight loss surgery. If you see a primary care physician, discuss your weight at every visit with your doctor and request the doctor to document that in your chart. This will expedite preauthorization of your request for weight loss surgery. Our office has also developed a template that can be used for such documentation. You can pick a copy of that template from our office and give it to your primary care physicians office to use it for documentation of your weight loss discussions and attempts in your chart. You may also download a copy of this template, print it, and take it to your primary care physicians office during your next appointment. Diet (Pre-Op) Documentation Sheet You should request your primary care physician to send a letter to our office recommending you for weight loss surgery. You could also write a letter explaining why you want weight loss surgery. You should send these letters along with other documentation of weight loss attempts to our office. All enquiries about pre-authorization are handled by Jeffrey Hart in our office. His email address is jeffrey.hart@hamot.org. Finally, if your insurance company will still not pay for your surgery, and you have made up your mind to go ahead with weight loss surgery, your only option may be to pay out of pocket. Although many patients are choosing this option and most of them have been happy with their choice. This is a risky alternative. Because pre-operative estimates of cost of surgery can be offset if patient suffers a complication. Therefore it should be the last resort. Our office will be able to help you with estimates of the cost of surgery if you plan to pay out of pocket. Carecredit.com is an organization that provides no interest loans for 3, 6, 9, 12 and 18 months and low interest rate loans for 24-60 months to patients who are interested in treatment not covered by their health insurance. Please visit their website for more information. If your insurance will not cover it and you cannot afford to pay for it, please do not begin the surgery tests and interviews. They would be a waste of your time and there is a waiting list of other patients.
By eating only at mealtime and only until you feel full and combining it with 30 minutes of exercise, you will be able to lose significant amount of weight. However, it will be up to you to choose the best and most healthy foods for successful weight loss. Be sure you are willing to change your eating habits. If not, you will be wasting your time and money by having weight loss surgery. You will be most successful if you also make changes in your work, your exercise, and your use of leisure time. In the beginning most people feel full with a small amount of food and they do not feel like eating more than three meals a day. However it is important to stick to 3 meals a day forever after surgery and avoid unhealthy snacks. You can compromise weight loss by drinking fluids with a lot of calories or eating frequent snacks. You should drink plenty of fluids after surgery. Fluids should be mostly water or diet flavored liquids like Diet Snapple and Crystallite. Avoid carbonated beverages for a few months to prevent the distension of new gastric pouch with gas. Most patients should drink at least 64 ounces or 2 liters of fluids a day. You will be on liquid diet for first two to three weeks after weight loss surgery. During that period, your diet should be high in proteins. Try to take about 60 to 70 grams of proteins daily. By taking adequate amounts of proteins, you prevent the breakdown of your muscles and your body is forced to breakdown fat in stead of muscle to cause weight loss. You can use a protein powder or a protein shake to supplement your protein intake early on. Be careful and choose a protein supplement with the lowest fat content. Many patients use Designer protein powder for protein supplementation for first 3 to 6 months. Your diet will be advanced to puree and then semisolid food gradually over next few weeks. Be sure to chew your food very well and avoid liquids for half an hour before and half an hour after meals when you start taking solid food. Liquids fill up your small gastric pouch with fluid and you end up eating less solid food. However liquids do not stay in the pouch long enough and you will feel hungry sooner if you had liquids with your meals because liquids will wash the solid food out of your stomach. Ultimately you should set a goal of a balanced diet, with 60 to 70 grams of proteins, 100 grams of carbohydrates and 30 grams of fats daily. Try to keep the carbohydrate content of your diet low. Although your gastric bypass can be reversed, it would mean serious surgery again. If you have your stomach returned to normal size, you will most likely gain back any or most of the lost weight. For these two reasons, think of gastric bypass surgery as being forever.
Before Surgery, liquid diet for 24 hours the day before surgery and from midnight before your surgery to after surgery: An IV will give you liquid. You may also need bowel prep to clean your bowels and our staff will let you know if you need it. First or second day after surgery: Bariatric clear liquids (sugar free jello, dilute juice, broth), ice chips and water in 30 cc medicine cups. Second or third day after surgery: Bariatric full liquids (skim milk, low fat yogurt, low fat pudding, low fat cottage cheese, other foods and liquids that do not need chewing) Take it slowly. You do not have to eat all you are given. Remember, your new stomach is only one to two tablespoons big. The opening into the intestine is only the size of a dime. At first, about ¼ cup of food or less is the most your stomach can hold at one time. Such liquid food will not stretch your small stomach and will pass through the small opening easily without blocking it. You may find that you need to spread your food or fluids out over the hour when you get to three or four ounces in an hour. Avoid liquids will a lot of simple sugars, and carbonation. In stead drink water, or flavored diet non carbonated liquids e.g. diet Snapple, crystallite, propel etc. Begin taking daily vitamins. We recommend Optisource multivitamin one tablet 4 times a day. Optisource will also provide you extra iron, calcium and B12. If you do not like their taste, you may take two chewable multivitamin with iron, or one prenatal vitamin a day is fine. Begin taking a calcium supplement, such as three to five Tums per day or other pills to equal 1,000 milligrams of calcium. Download recipe ideas for extra protein here Patients stay on full liquid diet for 2 weeks after gastric bypass and 3 weeks after lap-band. It is very important to drink at least 2 liters (64 ounces) of liquids per day and supplement your diet with a protein powder or protein shake at this time. Your goal is 60 to 70 grams of proteins per day. In the beginning, it is very difficult to achieve this goal and 30-40 grams of proteins per day are an acceptable goal for the first few weeks. Do not take a protein supplement with a lot of fat calories. You can take Designer protein powder mixed in 8 oz of water or skim milk two to three times a day. Some patients like to drink Boost High Protein at this stage. If you choose Boost High protein, you should dilute it with skim milk in a 1:1 ratio. As a rule, any liquid that has more than 20 grams of sugar per serving should be diluted to avoid dumping syndrome symptoms after gastric bypass surgery. Dumping symptoms are not seen in patients after lap-band surgery. Another option is to drink Low Carb Carnation Instant Breakfast. Keep in mind that Boost High Protein and Low Carb Carnation Instant Breakfast are high in calories compared to Designer protein shakes. When you eat solid food, it is very important to chew your food very well. Place your knife and fork on the table after every bite and concentrate on chewing. Do not watch TV and do not talk to anyone during eating for the first few weeks because you could inadvertently swallow a bite without chewing and if that happens, it will cause a lot of discomfort and pain. Stop eating immediately when you feel full. Most patients suffer from a change in their taste after surgery. Many foods that tasted good before surgery, do not taste good any more and vice versa. It is partly related to the breakdown of fats (ketoacids) and their release into the breath. Mouth washes or low sugar mints are very helpful. About 15 to 20% of patients suffer from nausea and retching in first few weeks after gastric bypass surgery. It is most noticeable between 4th and 12th week after surgery. Nausea is usually more common and more severe after gastric bypass surgery than lap-band. When you feel nauseous, or have dry heaves, go back to the previous stage of food. If you are on semisolid food stage, go to puree food. If you are at puree food, go to liquids for 24 to 48 hours. Also try hot or cold liquids. If these measures don’t help, call your doctor, you may need a medication for nausea or may even need admission in the hospital to give you intravenous fluids. It is very common to be able to eat a certain food one day and not be able to eat the same food some other day. This stage can be very annoying but it shall pass too. Even though nausea is less common after lap-band, it is extremely important to avoid severe nausea, retching and dry heaving for first 3 weeks after lap-band to minimize the possibility of band slippage. We usually advise patients to take scheduled nausea medication for the first 3 weeks and avoid all kind of solid food during that period. You will receive more detailed information from our dietitian. Please follow those instructions closely.
Do:
Do not:
Return to the Bariatric Center to have your weight and general health checked:
When To Call Our Office?
If you are very overweight, you have more to lose and probably will lose more. On the average, patients lose 65% of their excess weight in 12-18 months after gastric bypass surgery and 55% of excess weight by 5 years after lap-band. This is an average, so some lose more and some less. If you are younger and get more exercise, you may lose more. Most patients stay 30 to 50 pounds over "ideal" weight, even after surgical weight loss. After surgery, your small stomach and its small outlet reduce hunger and the amount you can eat. It is then up to you to choose the best and most healthy foods for successful weight loss. The tips below will help you make changes in your eating habits. These changes are yours to make. Pride and feeling good about your weight loss will also be yours. Tips for Changing Your Eating after Weight Loss Surgery
When you begin to lose weight, you will have more energy than before surgery. Exercise will become more fun. Exercises, such as sit-ups, leg lifts, weight lifting and yoga help to tone muscles. They will strengthen your muscles and improve your health. However, exercises cannot prevent loose, saggy skin if you lose a lot of weight. Check with your doctor before beginning active and/or toning exercises.
Weight loss surgery sets you up for success with losing weight. However, it still will not be easy. You will need to work to make it work, but feeling healthy and successful will be well worth it.
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
linically severe obesity or 'morbid obesity' is defined as body weight 100 lbs above ideal in adults. It corresponds to a Body Mass Index or BMI or 40 Kg/ meter square. People suffering from morbid obesity are at very high risk of developing several serious medical conditions that shorten their life span.
eight loss surgery is indicated for motivated individuals who weigh 100 lbs or more above their ideal body weight or have a 
nclude but are not limited to:
Sleeve Gastrectomy or Vertical Sleeve Gastrectomy is a restrictive bariatric procedure. During this procedure , the stomach is divided to create a small sleeve shaped pouch. The stomach pouch is about the size of a banana. The small bowel is not bypassed. This procedure was initially performed as step one of a bigger procedure (Doudenal Switch procedure) in patients who were too high risk to undergo the entire procedure in one session. The patients were supposed to come back for second procedure after losing some weight. However it was noted that many patients were satisfied with weight loss after step one and did not need to proceed with the second part. This has led to development of Sleeve Gastrectomy as a stand alone bariatric procedure. Preliminary data shows that average weight loss is less than gastric bypasss surgery but slightly more than lapband procedure at 3 to 5 years after surgery. As of 2008, this procedure is not routinely covered by most health insurance providers. 
ll patients interested in weight loss surgery undergo a routine psychological evaluation. One reason for this is to check for depression or other emotional disorders. In general, obese people have no more or less emotional or mental problems than other people. However, if you have more than the normal "ups and downs," you need to get treatment before surgery. Such problems do not mean you cannot have weight loss surgery, but it may be harder for you to adjust after surgery.
here is a lot of medical data supporting the need for surgical treatment of morbid obesity. However many insurance companies and health plans still do not pay for weight loss surgery. The operation can not be performed without a pre-authorization from the insurance company or some other financial arrangement. Please check with your insurance company regarding their policy for weight loss surgery. Even though your insurance company representative may have a negative attitude towards your request for weight loss surgery reimbursement, you may be able to convince them to pay for your surgery.
ost patients lose anywhere from 40% to 75% of their excess weight after gastric bypass surgery. Most weight loss results over a period of one year. Patients usually reach their lowest weight 18 months after gastric bypass surgery. After lap-band average weight loss is 30-60% of excess weight. Weight loss is slower after lap-band but it continues up-to five years after surgery. Optimum weight loss requires life style changes and exercise after surgery. Motivated patients lose more weight because they follow dieting and exercise advice strictly. Weight loss surgery does not cure obesity. It can only help you diet successfully and stay with it, so you do lose weight. The surgery limits the amount of food you can eat at any one time, but it is not an easy way out. If you over eat your small stomach, or continue to snack frequently on high calorie snacks, you will fail to lose weight or regain after losing at first.
xercise is important to include in your daily routine for good health and weight loss. After open gastric bypass, most people can start a regular exercise schedule by six-weeks after surgery. This may take only 4 weeks after laparoscopic gastric bypass and 2 to 3 weeks after lap-band. At this time, begin active exercise slowly and increase to 30 minutes of exercise daily. Choose exercise you enjoy. Swimming, bicycling, tennis, golf, jogging, and brisk walking use the most calories. We recommend patients to use pedometers to keep track of the daily steps walked.
|
||
|
Disclaimer | Webmaster |
||