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What's Right for You?

The decision to have bariatric surgery can be one of the biggest choices you and your family will make. While bariatric surgery offers many benefits, there are also some risks and potential complications that you need to know about. Successfully maintaining weight loss also means making major changes to your lifestyle and eating habits.

Do you qualify as a candidate?

Bariatric surgery is not an option for all overweight people. There are certain physical requirements that must be met to qualify for surgery:

  • You must be at least 100 pounds above your ideal body weight.
  • Your body mass index (BMI) must be 35 or higher with medical problems that are related to obesity.

Along with physical requirements, you will need to have a complete work up to determine if you’re a good candidate. This includes a psychological evaluation, laboratory blood work, a sleep study, and cardiology evaluation among other tests. You will also need to keep your clinic appointments with the bariatric team. All of these steps need to be completed before   the bariatric team can clear you for surgery.

Are you ready?

Tests and measurements are not the only qualifications for surgery. Bariatric surgery is not a simple fix for maintaining a healthy weight. You need to be dedicated to making major lifestyle changes in order to achieve your goals and remain healthy. To be successful you will need to change eating habits with the help of a dietitian. You will also need to include more physical activity in your daily life. A physical therapist can help show you how, but you must be committed.

Ask yourself:

  • Am I willing to change how I eat with the help of my dietitian?
  • Will I be able to commit to being more active every day?
  • Have I thought about the risks of undergoing surgery?
  • Do I meet the physical requirements for surgery?
  • Will I be able to attend all of my bariatric clinic appointments?
  • Am I ready to spend months participating in the process leading up to surgery?
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Nationwide Children’s offers three options for bariatric surgery:

  • Gastric bypass surgery
  • Gastric sleeve surgery
  • Adjustable gastric banding

All surgical options can help you feel full faster by restricting the quantity of food that can be eaten at once. But, each has its own advantages and disadvantages that are important in choosing the surgery that is right for you. Your doctor may have suggestions based on your personal medical history or other criteria as well.

Gastric bypass surgery

How does the surgery work?

Gastric bypassGastric bypass surgery involves creating a small stomach pouch. Your surgeon will staple the top portion of the stomach closed, separating it from the lower portion of the stomach. He or she then brings up the small intestine and joins it to the pouch. After surgery, the food you eat will go into this small pouch that has been created and then travel directly into your small intestine. Because the newly formed gastric pouch is small compared to your normal stomach, the food you eat will make you feel full more quickly.

How long will surgery take?

The gastric bypass surgery generally takes between two and three hours. Your overall hospital stay usually is between two and three days. However, these times can vary from patient to patient.

What are the advantages?

Gastric bypass delivers excellent results. Patients often have rapid improvement of medical problems associated with unhealthy weight. Those who have undergone gastric bypass surgery generally lose from 0.5 to 1 pound per day following surgery. In the first one to two years following surgery, most people lose an average of two-thirds of their extra weight. For example, someone who originally weighed 300 pounds, with an ideal weight of 150 pounds, can expect to lose about 100 pounds. Keep in mind that your weight loss will depend on how well you follow your diet and exercise program after surgery.

What are the disadvantages and risks?

While gastric bypass can have many advantages, it is still major surgery with several well recognized complications. These complications can include drainage at the surgical site, trouble swallowing, wound infection, bleeding, pneumonia, abscess, gastric leak, ulcer or hernia.

Gastric sleeve surgery

How does surgery work?

Gastric sleeveDuring gastric sleeve surgery, your stomach is stapled to create a new shape similar to a sleeve or tube. Then, around 80 percent of the stomach is removed. Therefore, the stomach will be much smaller after surgery, enabling you to feel full sooner and for a longer period of time.

How long will surgery take?

The procedure itself takes about two hours. It is performed laparoscopically, so it requires only small incisions. Gastric sleeve patients typically remain in the hospital an average of one to two days.

What are the advantages?

The gastric sleeve surgery is considered a less complicated alternative to the gastric bypass surgery. It has a lower risk of complications, including malnutrition. Most patients experience a significant weight loss and improvement in obseity-related illness.

What are the disadvantages and risks?

The gastric sleeve surgery is still a fairly new procedure for teens. Few scientific studies have been performed that examine long-term outcomes. Ongoing studies should provide more information in the future. Surgical risks are similar to other bariatric operations. They include leaks, blood clots and infection. The gastric sleeve surgery is not reversible.  

Adjustable Gastric Banding

How does surgery work?

Adjustable gastric bandThis procedure uses a circular balloon band that is placed around the top of the stomach. The band creates a small stomach pouch that works to restrict the amount of food the stomach can hold. The size of the band can be adjusted by your doctor in follow-up visits. The doctor inflates or deflates the balloon using water through a port placed just under the skin.

How long will surgery take?

The adjustable gastric band procedure takes about one hour. It is performed laparoscopically, so there is no large incision. There is typically a one-day hospital stay for this procedure.

What are the advantages?

This procedure has several advantages over other gastric options. The surgery itself usually offers a quicker recovery time. The placement of the adjustable gastric band has a lower risk of complications than other procedures. The band can also be adjusted or even removed in the future.

What are the disadvantages?

The gastric band typically leads to slower weight loss than other gastric procedures. You will also need to have more frequent follow-up visits with your doctor. During these visits, he or she may make adjustments to your band by inflating or deflating the balloon.

Recovery

What can I expect when recovering from surgery?

Special care will be needed right after surgery while still in the hospital. You will generally begin feeling better by the second day after surgery. Exact timing of your discharge from the hospital will vary depending on your medical condition.

Gastric bypass or gastric sleeve patients who live more than 100 miles from Nationwide Children’s are strongly encouraged to consider staying at the Ronald McDonald House located across the street from the hospital for the first week following discharge. The Ronald McDonald House is a home-away-from-home for families and patients receiving care at Nationwide Children’s. This facility will allow your team to monitor your progress and address any problems immediately if they develop.

After you are able to return home, you will likely be on a special liquid diet until instructed by the team. You will also need to participate in physical activity to aid in the recovery process. Your team will inform you of your personal activity goals before returning home after the surgery. It is very important you attend follow-up appointments in the clinic following surgery. At these follow-up appointments, you will meet with a doctor or nurse practitioner, dietitian, physical therapist, social worker and psychologist. How often you have appointments will vary depending on your condition.

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Let’s Get Started

1. Please provide your email address: *
2. Have you ever been, or are you currently a patient of Nationwide Children’s Hospital? *
3. Enter your height: *
4. Enter your weight: *
5. What is your Date of Birth? *  
6. Provide your gender: *
7. Do you have any of the following health conditons?


Take their Word for It!

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Abigail, Age 16

“The road to weight loss is a long and hard journey. It takes hard work and determination to succeed, but sometimes we still need help. Never be afraid to ask, and if you fall along the way, pick yourself back up and know that it will be worth it in the end."
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Ashley, Age 18

“Dr. Michalsky kept us informed and checked on us daily, he was amazing, he even took a picture of my stomach! He is an AWESOME doctor! I’m glad he was the one who did the surgery. Thank You!”
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Nikisha, Age 26

“When I first came to the Center for Healthy Weight and Nutrition, Dr. Eneli inspired me from the start. She told me that underneath, I had a BEAUTIFUL figure. She is very inspirational.”