Benefits of Surgical Weight Loss
After bariatric surgery, the amount of weight loss will depend on a variety of factors — your weight before surgery, your willingness and ability to follow the nutritional programs postoperatively and the activity level you maintain. Continuing exercise is a major factor in your postoperative plan. The medical literature reports that the average weight loss can be 35% to 75% of excess body weight. Each procedure is unique in assisting patients with weight loss and improving associated health issues (co-morbidities).
Immediately following gastric bypass surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. Most patients will find it difficult to lose significant weight after 24 months. A few patients may then start to regain some of their lost weight. Strict adherence to your surgeon’s instructions after surgery will help you maintain your weight loss. Using an adjustable gastric band device (Realize, Lap-Band) may result in slower and less overall weight loss but may provide some patients with life-long hunger control and less weight regain. The weight loss derived from a sleeve gastrectomy procedure is felt to be greater than banding but less than bypass procedures. The long term weight loss with the sleeve is unknown.
Weight reduction surgery has been reported to improve many of the co-morbid conditions produced or aggravated by obesity, such as type II diabetes mellitus. Blood sugar levels of most obese patients with diabetes returns to normal, or near normal levels in the majority of gastric bypass patients. Recent literature also supports that the use of adjustable bands and sleeve gastrectomies have shown improved blood sugar levels. Improved peripheral insulin resistance and pancreatic preservation is felt to be the mechanism by which this works.
Metabolic syndrome is the leading health problem today. Over 65% of all primary care visits are related to this health issue. Metabolic syndrome exists when obesity (central) combines with altered blood sugar tolerance, elevated blood lipid levels, and high blood pressure. Patients diagnosed with metabolic syndrome are 5 times more likely to die from cardiac related disease before age 50 and generally have a 10 year average reduced lifespan. Preliminary data show heart function improved by the sustained weight loss, with decreased ventricular wall thickness and decreased chamber size. The single best therapy for metabolic syndrome is weight loss.
Improvement is seen in sleep apnea and obesity associated hypoventilation.
The majority of Gastro-esophageal Reflux Disease (GERD) patients see immediate relief with gastric bypass or adjustable gastric banding. Patients who experience heartburn symptoms after these procedures usually have a band which is too tight or may have developed a gastric bypass pouch ulceration. The sleeve gastrectomy does not appear to alleviate reflux symptoms and may actually worsen this disease and is not recommended for patients with significant reflux complaints.
Other issues that have been seen to change after weight loss surgery include: increased fertility (younger females who may have been having difficulty with becoming pregnant), decrease cancer incidence, improvement of urinary stress incontinence symptoms, decreased arthritic symptoms (degenerative arthritis), decreased back pain, and decreased lower extremity discomfort (chronic pain, venous stasis disease and restless leg syndrome).
Other benefits seen in some patients after obesity surgery include improved mobility and stamina. Many patients find themselves in a better mood, with increased self-esteem, improved interpersonal relationships, and a much improved quality of life. They are less self-conscious. They are able to improve social activities, find employment and participate in activities formerly inaccessible to them. Contemptuous body image perception decreases. Marital satisfaction increases, but usually only if a measure of satisfaction existed before surgery. If marital problems existed before the surgery, the improved self-image may lead to a higher divorce rate after the surgery and the weight loss it brings.
More long term follow up data will prove what magnitude of weight loss is necessary to achieve the greatest benefit in terms of longevity. Procedures that result in faster weight loss will most likely result in quicker resolution or improvement of health issues. Data from medical weight reduction studies suggest that a small weight loss will favorably affect most obesity related conditions. Studies have shown even patients over 55 years old at the time of surgery, followed for six or more years after gastric bypass, reflect significant sustained improvement in health and longevity.
YOU will play the major role in your eventual weight loss. You will need to make adjustments in your present lifestyle, but the pride and feeling of accomplishment as you lose weight will be yours.