For many people with clinically severe obesity, surgery is the only option which can provide significant weight loss and long term weight maintenance.
Procedures for weight loss are either restrictive and /or malabsorptive: they limit the intake of food and/or cause some of the food to be poorly digested and absorbed. Gastric banding and sleeve gastrectomy are "restrictive" surgeries, whereas gastric bypass, banded gastric bypass and duodenal switch are "combination" type procedures resulting in both a restrictive and a malabsorptive effect.
We strongly believe that obesity surgeons should be skilled in more than one surgical approach as the specific procedure needs to be carefully matched to the individual patient.
Because surgery requires significant lifestyle changes, the Adult Weight Loss program at the Center for Metabolic and Weight Loss Surgery includes an in-depth orientation and a rigorous follow-up schedule. "We devote significant resources to pre-operative education and long-term follow-up," Dr. Bessler says. "The payoff is that our patients have fewer post-surgery complications, compared with the national average. It also helps ensure that our patients will have a good transition to their new life."
The point of entry to the program is an introductory seminar to make sure participants understand the diet requirements and lifestyle changes required by each type of surgery. The seminar, which is now available online or in person, is managed by our nurse practitioner to educate patients about weight loss surgery, the process, and outcomes.
The next step is a one-on-one meeting with our nurse practitioner, followed by a series of medical evaluations. Once patients have been cleared for surgery, they will see either Dr. Bessler or Dr. Kirkhely.
The average patient in our program loses 50-70% of their excess weight, depending on their choice of surgery and commitment to the lifestyle changes necessary for success.
The amount of weight patients lose after surgery varies widely depending on many factors such as the patient’s age, starting weight, ability to exercise, and the type of operation used. One very important determinant of a patient’s success is his or her adherence to postoperative dietary and behavioral changes. On average, patients lose one half to two thirds of their initial excess weight at the end of one year. Initially heavier patients tend to lose more actual pounds, but lighter patient are more likely to come close to their ideal weight.
The degree of improvement of complications related to obesity is also dependent on many factors. In general, about half of our surgeries result in an improvement in high blood pressure and high cholesterol. Almost 80% of non insulin dependent diabetes is controlled without medication following the surgery. Respiratory complications, including sleep apnea and shortness of breath, typically show much improvement following the surgery. Other conditions associated with obesity such as joint and back pain, urinary incontinence, venous insufficiency in the legs, acid reflux, menstrual irregularity, and certain kinds of headaches may also improve following weight loss surgery.