Living with Bariatric Surgery: Managing your mind and your weight

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If you're considering weight loss surgery, speak to a surgeon about the different types available to help decide which is best for you.

Discuss preconceptual planning if appropriate. 5mg of folic acid is usually recommended. If the patient intends to become pregnant or informs the GP that they are pregnant they will need review of multivitamins to avoid those with vitamin A in the retinol form. Forceval is usually a safe recommendation if pregnant. Follow current recommendations on managing women with BMI >30 kg/m² if appropriate. A small pouch is created at the top of your stomach, which is then connected to your small intestine. This means it takes less food to make you feel full and you’ll absorb less The bypass routes food through only about 10 feet of the small intestine, instead of the usual 25. This means there is less time and distance for the body to absorb fat and calories.

Results

Consider sending the patient the BOMSS pre-consultation questionnaire for patients prior to their review appointment to identify potential problems. If using this questionnaire ask the patient to bring the completed form with them to the appointment. After gastric bypass, avoid products (including over-the-counter products) that contain a large amount of sucrose, corn syrup, lactose, maltose, fructose, honey or mannitol, as they can result in dumping syndrome. Before having surgery, speak to your surgeon about the possible benefits and risks of the procedure. It is not possible to predict how much weight you will lose. Weight loss tends to be fast in the first 4 months, about 1 stone per month. This then slows down and be stable within the year. It is unlikely that you will reach a BMI of 25 or less. The operation aims to improve your health and weight is only part of this. To achieve the best results, it is important to follow advice about long-term food and lifestyle changes. Commitment

There is a potentially serious risk of malnutrition if the patient receives inadequate follow up or is unable to adhere to the nutritional guidelines. Patients may be at risk of protein malnutrition, which can be caused by vomiting from an overtight gastric band, anastomotic stricture, chronic diarrhoea/malabsorption or insufficient dietary protein or nonadherence with dietary advice. The incidence of iron deficiency anaemia, vitamin D deficiency, B vitamins especially thiamine and B12 deficiency is increased following gastric bypass, sleeve gastrectomy and duodenal switch. Patients who undergo more malabsorptive operations such as a duodenal switch, single anastomosis duodenal ilieal bypass (SADI), or long limb gastric bypass are at additional risk of developing deficiencies in fat soluble vitamins and require long term specialist care. Most GPs are unable to request blood tests for fat soluble vitamins A, E and K or prescribe the appropriate supplements.NICE CG189 guidance on obesity emphasised the importance of regular post-operative follow-up with a minimum of two years in the bariatric surgical service. Following discharge from the bariatric surgical service, “there should be at least annual monitoring of nutritional status and appropriate supplementation according to need following bariatric surgery, as part of a shared care model of chronic disease management”. Some examples of possible shared care models can be found here. Periodically monitor thyroid function and adjust doses on a case-by-case basis. There is no need for preventive adjustment of thyroxine doses.

Bariatric surgery is done in the hospital using general anesthesia. This means you're unconscious during the procedure. Today, most types of bariatric surgery are performed laparoscopically. A laparoscope is a small, tube-shaped instrument with a camera attached. The laparoscope is inserted through small cuts in the belly. The tiny camera on the tip of the laparoscope allows the surgeon to see and operate inside the abdomen without making the traditional large cuts. Laparoscopic surgery can make recovery faster and shorter, but it's not the best option for everyone. The goal of a duodenal switch is to reduce calorie intake and lead to more rapid weight loss. But this type of bariatric surgery also involves the most risks. This diet should be followed by diabetics controlled on diet only or on tablets. If you have a milk allergy this is the best option. SF-36 Short Form-36 questionnaire, IWQOL-Lite Impact of Weight on Quality of Life-Lite questionnaireAdjustable gastric banding (lap band): Gastric banding involves the placement of a permanent silicone band around the stomach. The band reduces the size of the stomach without cutting away any portion of it. This procedure is usually performed laparoscopically. A small port is placed directly underneath the skin so the band can be adjusted. She adds that this suggests women are influenced by society’s perception of the ideal female body, and that being obese is not within this scope. Confirm date and type of procedure, pre-surgical weight, lowest post-surgery weight, and current weight Useful guidance on primary care management of complications post-bariatric surgery for primary care is available here.

As you figure out what foods your body can digest well, continue to explore solid food options and find a diet that is sustainable for you — one that lets you still enjoy your favorite foods, desserts, and drinks in moderation without resulting in pain, nausea, digestive discomfort, or vomiting. Bariatric surgery impacts nutritional intake and after surgery specific dietary changes are recommended, including – small portions, more frequent meals, adequate protein intake, and the addition of daily multivitamin and mineral supplements ( O’Kane, Bettini, Busetto).Australian Institute of Health and Welfare. Overweight & obesity. Overview. Canberra: AIHW; 2020. [cited 2022 Sep 1]