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Bariatric Surgery

Bariatric Surgery

From several surgical options to a wide array of benefits, there are many things to think about when considering bariatric surgery. In fact, the decision to undergo this type of surgery could be one of the biggest decisions you and your family will make. The Center for Healthy Weight and Nutrition team at Nationwide Children’s Hospital is here to help you along your way. The articles below provide answers to some of the questions you may have and an overview of the options available at Nationwide Children’s Hospital.

Bariatric surgery, also known as weight-loss surgery, is an effective treatment for individuals who are considered severely obese (typically a minimum of 100 pounds above their ideal body weight). There are several types of bariatric surgeries, including gastric bypass, gastric sleeve and adjustable gastric band. All bariatric surgeries make changes to your digestive system which result in significant weight loss.

Nomal digestion

Normal digestionThe digestive system is composed of a long, twisting tube that is designed to absorb nutrients and calories. This system consists of the mouth (where digestion starts), the esophagus, stomach, small intestinal and large intestine. Along the way a complex set of muscles move food through the digestive tract while you eat. Cells within the various parts of the digestive system make enzymes and hormones that break down the food you eat and allow the body to absorb protein sugar and fat.

What does bariatric surgery do?

Bariatric surgery changes the way you digest food. Although there are a number of different types of bariatric operations, they are all designed to reduce the size of your stomach which results in limiting the amount of food you can eat. Some surgeries do this by creating a small gastric pouch that is separated from the remaining stomach (i.e. gastric bypass) while others restrict the amount of food by actually removing a large part of the stomach (i.e. gastric sleeve). Another method is places a band around the top of the stomach (i.e. gastric band). This procedures make it possible to feel full while eating less food.

  • Gastric bypass

    Gastric bypass

  • Gastric sleeve

    Gastric sleeve

  • Adjustable band

    Adjustable gastric band

In addition to restricting the size of the stomach as described above, some bariatric surgeries also use the process of malabsorption (i.e. gastric bypass). In the case of gastric bypass, malabsorption occurs because a section of the small intestine is connected to the newly formed gastric pouch. By doing so, food “bypasses” about 30% of the small intestine which reduces the amounts of nutrients that are absorbed from the food you eat. This can further reduce the number of calories your body uses. It also affects the nutrients and vitamins absorbed from food. Most people who have bariatric surgery take vitamin supplements to avoid complications this can cause.

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Many of the changes made possible by bariatric surgery can’t be measured in numbers. Here are some of the real-life differences that weight loss surgery can make in your life. After surgery you can:

  • Stop sitting on the sidelines. It will be easier to participate in sports than before surgery.
  • Be comfortable in public seats. Seating at movie theaters and on airplanes will no longer be a source of frustration.
  • Ditch the special table. You will be able to sit at a regular desk in class instead of a table in the back.
  • Take awesome senior photos. Your confidence and health will be reflected in the photos you take for graduation announcements.
  • Spend less time tracking medicines. Many health conditions improve with weight loss, freeing you sometimes from taking daily or several medicines.
  • Be more outgoing. You’ll be able to participate in more activities and may feel happier about how you look and feel after surgery. This can give you confidence to participate in things you used to dread — like school dances or after-school clubs.
  • Get better grades. It’s important to be able to focus on learning when in class. When you’re confident and feel good about yourself, it usually makes it easier to concentrate on learning without thinking about other concerns.
  • Look forward to summer. You may no longer dread going to the beach, or worry about getting hot and sweaty doing simple things.
  • Shop for clothes at more stores. You will be able to buy clothes at the same places that your friends and classmates shop.
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Success in achieving better health cannot be achieved through surgery alone. Maintaining weight loss after surgery depends on your ability to continue to make the lifestyle changes that you did while preparing for surgery. Our team will continue to work with you on a personal eating and exercise program that works for you.

Eating for life

Adopting healthy eating is important to maintaining a healthy weight. Prior to surgery, you will meet monthly with a dietitian. Together you will develop a personal eating program that includes learning to make good food choices and appropriate serving sizes. You will begin to adopt these changes before surgery.

After surgery, portion sizes will be more important than ever. Your stomach will be smaller and, you will need to eat much smaller portions than before. As a result, your dietitian will recommend you eat five to six high-protein meals each day to maintain a healthy amount of energy intake every day. It is very important you follow this recommendation. Water is another key ingredient for your health. You should drink 64 oz. of water every day. You will also take daily multivitamins. With help from your dietitian, you will learn to be successful and maintain good nutrition for life.

Exercising for life

Another important component to health is regular exercise. During your regular visits before surgery, you will meet with a physical therapist or trainer. You will work together to find options for physical activity that you can use every day. It will be important to begin increased physical activity before surgery.

Following surgery and, after a period of recovery you will want to restart your daily exercise. Small increases in exercise can improve flexibility, range of motion and balance. It can also lower your chance of injury and soreness. Staying physically active will help you maintain a healthy weight. It will also lower your risk for a variety of health problems. Increasing physical activity also means spending less time doing low-energy activities like playing video games or watching TV. Instead, you can choose fun, active options to help you live a healthy lifestyle.

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Weight loss surgery (bariatric surgery) can bring many health benefits. Being extremely overweight as a teenager or young adult can cause many serious health problems. It also increases the chance you will remain extremely overweight as an adult and at increased risk of even more serious health problems. . Bariatric surgery in teenagers can help prevent or even reverse the damage these diseases can have on your body. Surgery can lead to improvement of a wide range of conditions including:

  • High blood pressure
  • Obstructive sleep apnea
  • Type 2 diabetes
  • Respiratory problems
  • Gastroesophageal reflux (heartburn)
  • High cholesterol
  • Liver disease
  • Irregular menstrual periods
  • Polycystic ovarian syndrome

Bariatric surgery can also lead to improvements in other aspects of your health and well-being. Other benefits may include:

  • Weight loss. One of the most obvious, but important, benefits of bariatric surgery is weight loss. Often those who undergo surgery have had difficulty achieving and maintaining weight loss in the past. Bariatric surgery combined with changes to nutrition and exercise can lead to weight loss that you can maintain.
  • Decreased need for medicines. As weight-related conditions improve, most patients are able to reduce or even stop needing medicine associated with their health conditions.
  • Improved self-esteem. Bariatric surgery patients often feel better about themselves after surgery.
  • Increased energy. After surgery you will often find yourself being able to do activities with much more ease than you could before.
  • Improved quality of life. Weight loss surgery can lead to improvement of many aspects of your life including social, emotional and physical health.
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Undergoing bariatric surgery is a big decision. Bariatric surgery is considered major surgery and has several potential complications that all patients need to know about. Complications may vary from minor problems to more serious conditions that require medical attention from the bariatric surgery team. Surgical complications that may occur soon after the operation may include some of the following.

  • Drainage at the surgical site
  • Nausea or vomiting
  • Wound infection
  • Bleeding
  • Pneumonia
  • Gastric leak
  • Ulcer
  • Deep vein thrombosis

Post-surgery complications

Some other complications may occur months after the operation. These may include:

  • Gallstones. Gallstones are common in people who lose weight rapidly. People undergoing bariatric surgery will be given medicine for three months after surgery that will help prevent the formation of gallstones.
  • Loose skin. Flabby skin can develop in in some areas of the body after losing large amounts of weight. Common areas include the stomach, thighs, neck and the underside of arms. Many patients choose to undergo plastic surgery to fix this problem. Your medical team can help you make arrangements when the time is right for this type of surgery. Usually, it is best performed after you have lost all your weight. This is typically 2-4 years depending on the operation you had.
  • Dumping syndrome. Also known as rapid gastric emptying, dumping syndrome can occur when all or part of the stomach is removed through surgery. Common symptoms include abdominal discomfort, nausea, vomiting and diarrhea.
  • Vitamin deficiencies. Bariatric surgery affects how nutrients are absorbed from your food or your nutrient intake. In some cases, this can lead to vitamin deficiencies after surgery. After surgery, you are encouraged to take daily vitamins to help prevent this complication. No matter which operation you have, it is important to take supplemental vitamins and to have your vitamin levels checked regularly.
  • Hair loss. Hair loss can be a side effect of rapid weight loss. Generally, it is caused by not getting enough protein and getting less zinc in your diet. Usually this side effect ends once weight loss begins to reach the desired goal, as long as you have a high-protein diet and take vitamin supplements.
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Interested in learning more? Simply fill out the form below to receive emails with information about the bariatric surgery program at Nationwide Children’s and a call from our bariatric surgery coordinator who can help answer any questions you may have.

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