Metabolic & Bariatric Surgery PATIENT GUIDE

Jennifer Hudson, Post-Bariatric Procedure

Pre-Bariatric Procedure

muschealth.org/weight-loss-surgery | 804-773-3143 | facebook.com/MUSCWeightLossSurgery 2 About Metabolic & Bariatric Surgery

Understand your surgery Feel good about your decision Bariatric surgery is an operation that If you’ve been trying to lose and maintain creates a smaller stomach, which will weight but you haven’t had any luck, you reduce the amount of food you can take in may need to alter the complex relationship and/or reduce the absorption of calories. your body has with food and its Metabolic surgery often causes hormonal metabolism. Bariatric surgery helps reset changes resulting in reduction of appetite. Surgery is performed using minimally weight. New research indicates that some invasive (laparoscopic) techniques, which types of bariatric surgery (gastric bypass, may decrease surgery-related discomfort, sleeve gastrectomy and duodenal switch) reduce time and cost with the hospital stay, have metabolic impacts that enable a and allow you to return earlier to a full, new lower body weight. By altering the productive lifestyle. Bariatric surgery is the anatomy of the stomach and/or intestine, date, resulting in sustainable and significant resulting in decreased appetite, increased weight loss along with resolution of weight- feelings of fullness, increased metabolism related health conditions in up to 80% and healthier food preferences. of people.

Obesity puts your health at risk Shared decision-making Living with excess weight has been shown The best way to reach an informed to put your health at risk, which increases decision is to engage in an open and frank as your obesity becomes more severe. discussion with your doctor in which you Obesity dramatically increases the risk can express your concerns, explore all your of type 2 diabetes, high blood pressure, options and have your questions answered. high levels of triglycerides, heart disease No single procedure is right for everyone. and stroke, arthritis, and obstructive sleep Discuss the surgical options during your apnea. Higher body weights are also surgeon consultation so you can come to associated with cancer and early death. an informed agreement about which is Without the medical intervention that the best choice for you. You should feel bariatric surgery provides, many patients confident that you understand everything with severe obesity are not successful in fully and that together, you and your managing their weight and related doctor are making the decision that is best health conditions. for you. 3 About Metabolic & Bariatric Surgery

Weigh your options Know the potential In addition to weight loss, bariatric and metabolic complications procedures have also been shown to potentially As with any surgical improve several medical conditions, and reduce risk procedure, bariatric and of premature death. Your doctor will help you place metabolic surgery may the surgical risks in perspective based on your own present risks such as adverse health and medical status and weigh them against reactions to medication, what you stand to gain. infection, problems with anesthesia, excessive Are you a candidate for bariatric surgery? bleeding, breathing problems, or blood clots in legs or Criteria for qualifying for weight loss surgery typically lungs. All bariatric surgeries center around calculating how much excess weight carry risk for leak at the you are carrying or your current Body Mass staple lines, gallstones from Index (BMI). weight loss, and stricture/ stenosis, and/or death. QYou are more than 100 pounds over your ideal Gastric bypass patients are body weight. more at risk for ulcer at the connection between stomach QYou have a BMI of over 40 kg/m2. and intestine, and are at long term risk of a hernia and small QYou have a BMI of over 35 kg/m2 and are bowel obstruction. Sleeve gastrectomy patients are at as high blood pressure or diabetes, related to risk of severe reflux (GERD), being severely overweight. especially if they have reflux prior to surgery. QYou are unable to achieve a healthy body weight for a sustained period of time, even though you The risk for serious have tried other methods to lose weight. complications depends on the type of surgery, your medical MUSC has an Adolescent Bariatric Surgery Program condition and your age, as for patients over 13 years old who meet program well as the surgeon’s and requirements and work with an adolescent weight anesthesiologist’s experience. management program to prepare for surgery. 4 Types of Procedures

Procedure Procedure Image Mechanism of Weight Loss

Sleeve QRemoves ~80% of the stomach without operating on your intestines Gastrectomy QRestricts how much you can eat at one time and reduces appetite by changing gut hormones

QExpected weight loss: 50-70% of excess weight

QPreexisting reflux (GERD) may get worse

QPreferred operation for adolescents seeking surgery

Gastric QCreates a small pouch which is about 85% smaller than the size of your current stomach Bypass and bypasses part of your small intestine QRestricts how much you can eat at one time and reduces appetite by changing gut hormones

QExpected weight loss: 60-75% of excess weight

QConsidered as an anti-reflux procedure due to likelihood of resolving GERD

QCreates a sleeve gastrectomy first then creates Duodenal intestinal malabsorption by bypassing large portion Switch of your small intestines QRestricts how much you can eat at one time and reduces appetite by changing gut hormones QDietary fat not absorbed fully so requires additional fat-soluble vitamin supplements QExpected weight loss: 70-80% of excess weight QComplex surgical procedure to be done only by experienced bariatric surgeons QPreferred procedure for those with a BMI>50 and diabetes Contact Information

T Karl Byrne, MD Medical Director, Bariatric Surgeon

Rana Pullatt, MD Director of Robotic Surgery, Bariatric Surgeon

Aaron Lesher, MD Adolescent Bariatric Surgeon

Colston Edgerton, MD Bariatric Surgeon

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