Taking A Quick Look at Gastric Bypass Surgery

By Dr. Nilesh Pate., M.D., F.A.C.S. – January 2, 2013

Obesity is a rising concern in the United States.  Predictions for 2030 have 45 percent of Americans with a body mass index (BMI) of greater than 30, which is a clinical definition of “obese.”  More people are turning to surgical options to help deal with obesity, and AFM asked Dr. Nilesh Patel, M.D., F.A.C.S., with Texas Bariatric Specialists, to give some basic information about surgical weight loss options.  Dr. Patel emphasized that surgery is “a tool, not a cure” and that “exercise is a must.”  He also stressed the importance of choosing a surgeon and hospital carefully, sticking to the “rules” after a procedure, and attending support groups in order to find lasting surgical success.

Who is a Candidate?

  • BMI > 40 or BMI between 35-40 with comorbidity 
  • (presence of other diseases)
  • Has failed medically supervised weight loss programs
  • No endocrine/metabolic cause of obesity
  • Is free of psychological impairment
  • Committed to implementing follow-up regimen

What to Do to Prepare for Surgery

  • Quit smoking
  • Increase amount of exercise
  • Drink more water
  • Eliminate empty caloric drinks 

 Four Options for Weight Loss

1) Medically supervised weight loss program
  • No surgery required
 2) Lap Band 
  • Purely restrictive procedure
  • Primarily behavioral with variable results
  • Reversible and adjustable
  • Requires close follow-up
  • Works well for BMI<40 and those with inflammatory bowel disease
 3) Sleeve Gastrectomy
  • 60-80% of the stomach is removed
  • Intermediate results
  • Almost totally reduces gherlin 
  • (appetite hormone)
  • Less invasive than Bypass
  • No foreign body, as in Lap Band
 4) Laparoscopic Roux en Y Gastric Bypass
  • 30cc pouch created
  • Malabsorption results
  • Reduces need for various medications 
  • (diabetes, blood pressure, cholesterol)
  • Before weight loss 
  • Appetite loss, due to lack of gherlin 
  • (appetite hormone)

 To calculate your BMI, go to bmicalculatorusa.com


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