Category: Blog Posts

There is a lot of misinformation surrounding bariatric surgery, and it’s likely that some of what you’ve heard is mere hearsay. But if you’re ready to pursue bariatric surgery to change your life for the better, what you really want to understand is whether or not bariatric surgery is safe.

Surgery requirements

It’s important to understand that bariatric surgery isn’t offered as the first weight-loss option for people. It is often only turned to when individuals are unable to lose weight despite repeated diet and exercise regimens. Many people choose bariatric procedures to improve their health because they are at an elevated risk of life-threatening diseases like heart disease, certain cancers, and Type 2 diabetes. They may already have some health problems related to weight, such as high blood pressure. Regardless, patients are unable to undergo bariatric surgery unless they meet certain guidelines.

Surgery risks

There is always a risk when you undergo surgery under anesthesia, whether it’s for a broken bone or bariatric surgery. Risks of surgery include: excess bleeding, infection of surgery site, blood clots, and reactions to anesthesia. While death is extremely rare, it is important to note that there is risk of death with even the simplest surgeries. With bariatric surgery, you may also experience leaks in the gastrointestinal system. Before undergoing bariatric surgery, your surgery team will conduct thorough tests to ensure you are healthy enough for surgery. You may have to change your habits before surgery, such as eliminating smoking and drinking.

Risks depending on type of bariatric procedure

There are several different types of bariatric surgery—among the most common being gastric bypass, sleeve gastrectomy, and gastric banding (the Lap-Band® Procedure). The risk of complications goes up depending on how complicated the surgery you choose is. For instance, during gastric bypass surgery, a small stomach pouch is cut and part of the small intestine is cut and sewn directly into the pouch. During a sleeve gastrectomy, a majority of the stomach is removed. The Lap-Band Procedure, however, does not require any cutting or rerouting of the intestines or stomach, making it a safer, simpler procedure with fewer complications and lower mortality rates. A band is laparoscopically placed at the top of the stomach, creating a smaller stomach pouch. It also does not take as long to perform as other bariatric procedures. The procedure is typically performed in less than an hour, and you can usually return home the same day. It boasts the shortest recovery time of all the bariatric procedures. If for any reason your Lap-Band needs to be removed, it is easily reversible, unlike other bariatric procedures.

Safety conclusion

Despite some risks, bariatric surgery is still considered one of the safest surgeries patients can undergo, especially when you consider the technological advancements made in recent years and the improved aftercare programs. It is also important to note that taking on surgery risks may mitigate the consequences of morbid obesity, such as diabetes, heart disease, and other weight-related health conditions.

There are a few questions you must ask yourself before you pursue bariatric surgery, such as, How will my life change? Am I ready to make a lifetime commitment to a healthier lifestyle? Which bariatric procedure is the right choice for me? Along with those questions will come more specific sets of questions, especially related to food. Many people wonder if they’ll still be able to consume the foods they love and if they’ll still be able to meet their nutrition requirements when consuming less food. Read on to learn whether or not you’ll need to take supplements after bariatric surgery to meet your nutrition requirements.

Limited food capacity

It is difficult to obtain the amount of nutrients we need each day, and that’s without having a restrictive or malabsorptive bariatric procedure completed. This is why many individuals (who haven’t had bariatric surgery) opt to take a basic multivitamin. However, after bariatric surgeries that restrict the amount of food consumed, it is incredibly difficult to consume enough nutrients in the day because patients simply do not have the capacity for the nutrient-dense food they need. 

Malabsorption

While it is true that each bariatric surgery option you pursue results in the inability to eat as much food as you once could, not all procedures are linked to malabsorption. Malabsorption is when your digestive tract is unable to properly absorb nutrients from food. This typically happens because the digestive tract is cut and rerouted, bypassing some of the small intestine. When the small intestine is bypassed, food touches less of the absorptive surface and the nutrients cannot be extracted and absorbed by the body. Additionally, the food does not mix with bile and enzymes as much, which is a necessary part of nutrient absorption. As a result, individuals may find themselves low in B vitamins, iron, calcium, folate, vitamin A, vitamin D, vitamin E, and vitamin K.

Some procedures, like biliopancreatic diversions and the biliopancreatic diversion with duodenal switch are categorized as malabsorptive procedures because that is primarily how patients lose weight: through malabsorption.

Why is Lap-Band different?

The answer to the question of whether or not you’ll require daily supplements is dependent upon the bariatric procedure you proceed with. The Lap-Band® Program is different than other bariatric procedures because there is no cutting or partial “amputation” of the stomach or intestines. This means that patients are not at risk of malabsorption. Lap-Band is categorized as a limited-capacity procedure because it limits the amount of food patients can consume, so nutrient deficiencies may result. However, they can be resolved by taking a daily multivitamin. Other expensive supplements, such as the ones recommended after gastric bypass and the sleeve gastrectomy, are typically not needed after the Lap-Band Procedure.

To see a comparison of the Lap-Band Procedure and other bariatric procedures, visit https://www.www.lapband.com/why-its-different/.

Each year on March 4, we recognize World Obesity Day. Recognized internationally, the day is designed to raise awareness about the obesity epidemic and provide individuals with obesity helpful information and resources. There is an unfair bias toward individuals with obesity and the false assumption that obesity is caused by factors entirely in our control, such as laziness and overeating. There are countless factors that play a role in the disease of obesity—many of which are not in our control.

Genetics

Genetics play a role in obesity. For example, if an individual’s parents both have obesity, the child is more likely to also struggle with obesity. The way fat is distributed and your metabolism are affected by genetics. We also learn eating and exercise habits from our families, meaning that individuals may be more likely to pick up unhealthy habits if they’re surrounded by them growing up.

Lack of accessibility

The lack of accessibility to resources can play a role in obesity in more ways than one. This includes environmental, social, and economic factors. Some people do not have access to a safe environment that allows them the space to exercise. There may not be an accessible fitness center in town and there may not be sidewalks or bike trails. Other individuals do not have access to healthy foods, whether that is because they cannot afford healthy foods or because there is a lack of resources nearby. Many people do not have access to affordable health care to help them treat their obesity either. These same individuals may also not know how to cook healthy foods or have the resources to learn. This lack of resources is an unfortunate reality that many organizations, like the World Obesity Organization, are aiming to fix.

Illnesses and medications

There is a whole list of illnesses and medications that can cause people to gain weight and struggle to lose it. Steroids and antidepressants, which are commonly prescribed, are linked to weight gain. Similarly, certain illnesses make exercising difficult, if not nearly impossible.

Lifestyle choices

 Making unhealthy food choices—such as eating a diet high in fat and sugar—or overeating can lead to weight gain. A sedentary lifestyle is also linked to weight gain. However, it is important to remember that this is not the only factor that contributes to obesity.

There are other factors that can make it more difficult for individuals to maintain a healthy weight, such as stress, poor sleep habits, and yo-yo dieting. To access weight-loss resources, visit our blog.

Obesity has an impact on the quality of life, but it can also make you more at risk for life-threatening diseases like cancer, diabetes, and heart disease. February is National American Heart Month. It’s a good idea to review the link between obesity and heart disease, review your heart health, and make any necessary changes.

High blood pressure

Obesity is associated with a rise in blood pressure. That’s because individuals with obesity need more blood to supply the body with oxygen and nutrients. This requires more pressure. High blood pressure, or hypertension can increase your likelihood of having a heart attack. It may also lead to an enlarged left ventricle and increase your risk of heart failure.

High cholesterol

Not only does obesity make you more likely to have high levels of bad cholesterol—including triglycerides and low-density lipoprotein (LDL cholesterol)—it may also lower your levels of good cholesterol. High-density lipoprotein (or HDL cholesterol) is important. It actively works to reduce your levels of bad cholesterol and lower your risk of heart disease.

Type-2 diabetes

Individuals with obesity are more likely to develop type 2 diabetes, which is the impaired ability to tolerate glucose. In turn, type 2 diabetes is associated with an increased risk for developing heart disease. In fact, it’s reported that individuals with type 2 diabetes are “two to four times more likely to develop heart failure than someone without diabetes.”  You can learn more about diabetes and heart disease in our blog here.

Am I at risk?

Are you worried that you might be at risk for developing heart disease? A quick way to determine if you are at risk because of your weight is to check your body mass index (BMI) and waist circumference.  A BMI above 25.0 for adults is a sign that you may be overweight. A higher waist circumference is associated with more abdominal fat. If your waist circumference is above 35 as a woman or above 40 as a man, you may be at risk of developing heart disease.

If you are worried about your heart disease risk, talk to your doctor.

How often do you pay attention to food cues? Do you understand what causes you to reach for a snack or a second portion of dinner? Food cues are any kind of stimuli that trigger a food-related response and can include “viewing or smelling of food stimuli, advertisements, or any cues or situations associated with food-related memories.” For instance, this would include a fast-food commercial that plays during your favorite television show at night and encourages you to order up some French fries and a cheeseburger for delivery. Food cues, when listened to over hunger cues, can put you at risk of developing obesity.

Mindless eating

Food cues cue you to eat whether or not you are actually hungry. This encourages mindless eating behaviors. Because you aren’t hungry and you aren’t really paying attention to how much you are eating, mindless eating is associated with weight gain. If you are wondering why you can’t seem to be losing weight when you follow a healthy diet and exercise regularly, excessive snacking due to food cues may be the culprit.

Awareness — four types of food cues

Food cues present themselves in a variety of ways, and it’s important to understand how they present themselves so you can get to the heart of what triggers you to eat when you aren’t hungry. Cues may be visual, auditory, olfactory, or mental. A visual cue could be a picture of a delicious meal or a commercial for a restaurant. Auditory cues are anything you may hear related to food, whether it’s the sound of bacon frying or coffee percolating. Olfactory cues come into play when you smell food. Mental cues often have to do with your emotions. You may be cued to eat because you are stressed, bored, sad, or feeling out of control. Food cues are quite literally everywhere. You can’t watch television without seeing them and every time your coworker orders takeout, you’re cued too.

Make a list of the food cues that impact you the most. For instance, perhaps you aren’t impacted by olfactory cues, but a picture of food makes you salivate. If mental food cues affect you the most, determine which emotion triggers you the most. Do you grab a candy bar when you’re sad and stressed? Does boredom send you running to the kitchen? Understanding the emotional that cues you can help you overcome that response.

Ignore the external

It’s important to understand that food cues are predominantly external. Instead of listening to external stimuli that tells you when to eat, pay attention the internal hunger response. That may be a growling stomach, hunger pangs, or lightheadedness and tiredness associated with lack of food. Similarly, pay attention to internal cues as you eat so that you can stop eating when you are full. Your brain takes some time to process, so eat slowly.

Once you are aware of what is cueing you, take some time to think about whether or not you’re truly hungry, or if you’re just responding to an advertisement. Give it a few minutes; oftentimes, if you do not indulge your craving immediately, it will go away. Drink some water and distract yourself with another activity to take your mind off the food cue response.

For tips on mindful eating, check out our blog.

Is the scale stuck in one spot? If you can’t get that stubborn number to go down, you might be wracking your brain to figure out what you’ve been doing wrong. If you are struggling to lose weight, there may be a number of reasons.  

Excessive snacking

Do you eat several big meals per day and still snack throughout the day? You may be consuming more calories than you realize. Especially if you are snacking mindlessly, you may be taking in hundreds of calories each snacking session.

Stress

Some stress can be a good thing because it motivates you to complete tasks, but too much stress is a problem. Not only can it take a toll on your well-being, it can cause your body to hold onto fat. Stress may cause you to overeat and choose unhealthy foods. It may also cause you to lean on food as emotional support.

Slow metabolism

Our metabolisms tend to slow as we age, and it may be slower if you have a high percentage of body fat. Muscle burns calories, so if you have higher body fat content than lean muscle content, you may not be burning as many calories as you could be. If you regularly skip meals, you may also be slowing your metabolism. Eating too-few calories or skipping meals can slow your metabolism and send your body into starvation mode. Not sleeping enough can also slow your metabolism. You may also have a slow metabolism due to genetics.

Medications

There are several medications that may make it more difficult to lose weight. Such medications include those for allergies, diabetes, depression, high blood pressure, epilepsy, birth control, and more. If you are concerned about your medication causing weight gain, speak with your doctor.

Health conditions

You may have health conditions that cause you to hold onto weight. You may have problems with your thyroid, such as hypothyroidism. Polycystic ovary syndrome (PCOS) is known to cause insulin resistance and because it messes with an individual’s hormones, it may lead to fat accumulation.

Yo-Yo dieting

If you are constantly trying the latest diet trend, it may be more difficult for you to lose weight and maintain that weight loss in the long-term. Yo-yo dieting (losing weight and gaining it back again) can be detrimental to your health for a number of reasons. You may lose muscle and gain fat, change your gut health, increase your appetite, and increase your chances of harmful diseases like heart disease and diabetes. It can also be incredibly frustrating to be in a cycling of losing a lot of weight and then gaining it all back. Instead of following fad diets, it’s best to follow a nutrient-rich diet, exercise regularly, manage stress, and get plenty of sleep.

This is in no way a comprehensive list. There are countless other reasons you may be unable to lose weight. It’s best to speak with your doctor to determine a healthy weight-loss plan. There may be factors outside of your control, such as genetics, causing you to hold onto excess weight. If a healthy diet and regular exercise have repeatedly not worked for you, it may be time to reach out to a Lap-Band® Surgeon here.

Are you ready to consider weight-loss surgery? There is plenty of research to comb through, so we’ve created a quick guide to help you understand your options before making your choice.

Gastric bypass

The Roux-en-Y Gastric Bypass (gastric bypass) procedure consists of two components, requiring cutting and rerouting of the organs and hundreds of staples. First, the top of the stomach is divided from the rest of the stomach, which creates a small stomach pouch. Then, the first portion of the small intestine is divided. The stomach pouch created in the first step is attached to the bottom end of the small intestine that was just divided. Finally, the remaining portion of the divided intestine is attached to a different portion of the small intestine. This means that stomach acids and digestive enzymes will eventually mix with ingested food.

After surgery, the stomach pouch is smaller, which means that smaller meals (and fewer calories) are consumed. Because one segment of the small intestine doesn’t have food going through it, it is presumed that overall, there is less calorie and nutrient absorption, requiring expensive supplements. Gut hormones change in response to the new food stream, which can promote the feeling of fullness and suppress appetite. These changes provide advantages such as long-term, significant weight loss, increased energy, and maintenance of weight loss.

Sleeve gastrectomy

The Laparoscopic Sleeve Gastrectomy, or “the sleeve,” removes 80% of the stomach. The remainder of the stomach is approximately the size of a banana. The procedure is irreversible and involves cutting and stapling the stomach. The smaller size of the stomach means it can hold much less, so food consumption is significantly limited. Gut hormones are also changed, which can induce feelings of fullness, curb appetite, and control blood sugar.

In the sleeve gastrectomy procedure, the intestines do not need to be rerouted, unlike with gastric bypass surgery. However, patients will experience a similar change to gut hormones, which can increase feelings of fullness and suppress appetite. The sleeve results in fairly quick and significant weight-loss. Patients must stay in the hospital to recover for approximately two days. Patients who undergo this surgery are at risk for malnutrition and require long-term supplements and vitamins to avoid possible deficiencies.

Lap-Band® (gastric banding)

The Lap-Band Procedure the safest of all bariatric procedures with the lowest complication and mortality rates. It is a much simpler procedure when compared to gastric bypass and the gastric sleeve. An inflatable band is placed around the upper portion of the stomach. The band creates another, smaller stomach above the band, while the stomach below remains intact. The smaller stomach allows the patient to feel fuller faster and to stay full longer. The band is easily adjusted by filling the band with sterile saline (injected through a port under the skin). This in turn adjusts the size of the stomach opening. This leads to weight-loss that is gradual and lasting. Unlike gastric bypass, food is digested and absorbed normally, so typically only a multivitamin is required. The band is both reversible and non-anatomy altering.  

Pros and cons

There are pros and cons to each bariatric procedure. Gastric bypass surgery and the gastric sleeve are much more complicated than the Lap-Band Procedure. A more complicated procedure requires a longer hospital stay, whereas the Lap-Band Procedure is performed in about one hour and patients can go home soon after. The Lap-Band is also the only procedure that is non-anatomy altering and can be reversed.

With gastric bypass surgery and the gastric sleeve, there is the risk for vitamin and mineral deficiencies, typically in vitamin B12, iron, calcium, and folate. Because the procedures aren’t reversible, patients may need to take supplements for the remainder of their lives.

To learn more about your options, talk to a Lap-Band Surgeon.

Sources:

• ASMBS Informed Consent for Laparoscopic Adjustable Gastric Band
• ASMBS Informed Consent for Informed Consent for Laparoscopic Roux-en-Y Gastric Bypass
• ASMBS Informed Consent for Laparoscopic Vertical Sleeve Gastrectomy

Body Mass Index (BMI) is an easily calculable number if you know your height and weight. Despite it being so easy to calculate, there is a lot of controversy surrounding BMI. Many people don’t know what it means or understand its importance. It’s an important number to know, and it’s important to understand what it means for you.

What is BMI?

Body Mass Index measures your weight in relation to your height. It’s a good indicator of whether or not your weight is in a healthy range for your height. Knowing this number helps you and your doctor to understand if you may be at risk for developing certain health conditions or diseases.

It’s important to find a healthy weight for your body. A high BMI may put you at risk for Type 2 Diabetes, heart problems, and certain musculoskeletal problems, whereas a significantly low BMI may mean it is more likely for you to develop osteoporosis, anemia, or malnutrition. A general rule is that a BMI below 18.5 is categorized as underweight and anything above 25.0 is categorized as overweight (above 30.0 is categorized as obese). A healthy weight falls into the range of 18.5 and 24.9, which is where you want your BMI to be.

Controversy

There is controversy surrounding BMI and how it is interpreted. While it’s a good measurement, it is not perfect. It does not take other factors into consideration, such as age, sex, muscle mass, and ethnicity. For instance, men tend to have less body fat than women even if they have the same BMI. Additionally, a muscular individual may have a very high BMI due to their muscle mass, not a high level of body fatness. BMI must be interpreted differently for the elderly population and teens/young adults. 

While BMI is an important number, your doctor must conduct a variety of other health assessments to determine your health and risk of certain diseases. A variety of other tests can be used to measure body fatness as well, such as skinfold thickness measurements, MRI or CT scans, and hydrodensitometry.

Bariatric surgery

BMI is a reliable measurement used by individuals in the medical field. BMI helps determine if you are overweight enough to qualify for bariatric procedures, such as the Lap-Band® Program. The Lap-Band System is the only FDA-approved laparoscopic weight-loss device approved for people with lower BMIs (30+). Lap-Band patients with a lower BMI lose an average of 75% of their excess weight in the first year and 70% in the second year.¹ In addition to taking your BMI into consideration, there are other qualifications individuals must meet in order to be eligible for the minimally invasive, safe, non-anatomy altering surgery.

¹ Robert Michaelson, Diane K. Murphy, Todd M. Gross, and Scott M. Whitcup. LAP-BAND® for Lower BMI: 2-Year Results from the Multicenter Pivotal Study. Obesity (2013) 21:1148–1158.

Chances are, if you’ve done any sort of research about how to lose weight—whether you searched for recipes or physical activity plans—you’ve gotten more than a few ads promising weight-loss cures. Anything that promises you will lose weight “overnight” or lose a significant amount of weight in just one week is a lofty claim, and an unsafe one at that. 

Five-bite diet

The Five-Bite Diet is exactly what it sounds like. The diet consists of skipping breakfast and only eating five bites for lunch and five bites for dinner. An eating plan that severely restricts your caloric intake is unsafe. Failing to eat enough calories not only prevents individuals from meeting their nutrient requirements for optimal functioning, it can lead to an unhealthy relationship with food and cause your body to go into starvation mode. This can lead to numerous other harmful effects. 

Waist trainers

If you follow popular celebrities in Hollywood like the Kardashians, you’ve probably heard about waist trainers. The waist trainer is a modern take on the corset, and users wear it for several hours per day to lose weight and change their body shape. Not only are they restricting and uncomfortable, they can make it difficult to breathe. They can even damage your internal organs and bones, leading to pain and indigestion. This “quick fix” won’t lead to long-term weight loss.

Portable infrared saunas 

The claim is that by sitting in a portable infrared sauna every day, you can increase your metabolic rate. In fact, sitting in a sauna for prolonged periods is not recommended and can actually cause dehydration. Not only that, but the weight lost is usually only water weight. Sauna suits are also not recommended. 

Surrounding yourself by the color blue

There’s information floating around that the color blue can make food seem unappealing and can actually suppress your appetite. There are even blue-tinted glasses sold on the market as appetite suppressants.  

Stay away from any “magic” pills or creams sold over the counter that promise “unbelievable weight loss!”. Chances are, if it sounds too good to be true, it probably is. Throw out those odd beliefs about losing weight by smelling fruit or watching yourself in a mirror as you eat, and talk to your doctor about an exercise regimen, eating plan, or weight-loss procedure like the non-anatomy altering Lap-Band® Program that works for you and your lifestyle. 

Are you ready to make your goals and resolutions for the new year? 2021 is almost here, and we’re all hoping for a better year than 2020. Many people were forced to switch up their exercise routines and struggled to stay focused on their health and wellness goals. You may want to refocus on your health goals in 2021. Only an estimated 8% of individuals accomplish the resolutions and goals they set for themselves at the start of the year. We have some tips to help you make attainable New Year’s resolutions.

Triggers and bad habits

Before you finalize your resolution, list out what you believe to be your bad habits and your triggers. What triggers you to skip workouts or overeat? Be thorough and be tough on yourself. Then, target these behaviors with the resolutions you make. This may mean giving things up. However, targeting these behaviors will help you find success.

Be realistic

If you want to make a weight-loss resolution, be realistic about it. Together with your doctor, come up with a realistic and safe weight-loss goal. Don’t make unreasonable weight-loss goals. It will set you up for failure. Give yourself plenty of time to achieve your resolution. Small steps go a long way. Work on smaller goals that will contribute to the larger, long-term goal. 

Do what you love

If you are resolving to lose weight and exercise more in 2021, find a way to make the process something you enjoy. For instance, if you want to exercise more, find an activity you love. Don’t make a resolution to start running if you hate running. Resolve to try some new activities to find what you enjoy doing. Maybe it’s kickboxing or maybe it’s yoga. Experiment! The same goes for food. There are plenty of superfoods out there that may not be your cup of tea. If you hate spinach, try another leafy green. Make accommodations to find what works best for you!

Be specific

Your resolutions should be specific and measurable. Whenever possible, add a timeline or number to your resolution. For instance:

• I will exercise 3 times per week
• I will lose 30 pounds by the end of the year
• I will eat vegetables with at least one meal per day

Making goals specific—and less ambiguous—makes them easier to measure and follow, and it will help you avoid bending the rules.

Give yourself time

Achieving your resolution requires the time and space to work at it. Schedule time to work on your resolution, and check in on your progress regularly. Maybe you do a weekly weigh-in, or maybe every month you review your food journal to look for patterns and changes. Consistency is key in reaching your goal. For more weight-loss advice, see our other blogs.