Most people who seek weight loss surgery have struggled for many years to control their eating, and have experienced increasing health limitations, self-consciousness and discrimination. People see weight loss surgery as their last chance for a better, more normal life. While hopeful fantasies about an alternative future make it hard to contemplate the risk of failure, some patients experience considerable emotional or physical problems. This book offers insight into the realities of living with weight loss surgery, and practical exercises help you think through your emotional readiness, social circumstances and eating habits that could determine the success of surgery.
Active preparation for surgery by making psychological and lifestyle changes puts you in the best position to achieve better health and emotional wellbeing.
Cut Down to Size is the first book to focus on the psychological and social aspects of weight loss surgery and will be of interest to health professionals as well as anyone contemplating weight loss surgery. By sharing the experiences of other bariatric patients, the reader can appreciate the nature of life after surgery and make a judgement about their capacity to cope with these demands. Follow "Why Love Matters" but amend to Royal; 2 Line drawings, black and white; 2 Tables, black and white; 3 Illustrations, black and white. Since completing her training at University College London she has specialised in working with people with physical health problems.
For the past eight years her primary interest has been in the psychological impact of obesity and weight loss surgery. Free Returns We hope you are delighted with everything you buy from us. However, if you are not, we will refund or replace your order up to 30 days after purchase. Terms and exclusions apply; find out more from our Returns and Refunds Policy.
Using the numeric pain scale, you will be asked to rate your pain on a scale of 1 to 10 with 10 being the worst pain you have ever felt. We want your pain to be 5 or less. Most patients will have a small tube to allow drainage of any accumulated fluids from the abdomen. This is a safety measure, and it is usually removed before you are discharged from the hospital.
As with any major surgery, you are at risk for surgical side effects, including blood clots.
Statistically, the risk of death during these procedures is less than one percent. Your doctors will have already carefully assessed you for risks and prepared accordingly. You will be required to walk the evening of your surgery.
General FAQs about bariatric surgery | University of Iowa Hospitals & Clinics
You will be sore, but this is the best way to speed up your recovery. Walk every two to four hours in the hospital, and at home after discharge. Patients who do this feel remarkably well one week following surgery. It has to make up the difference by burning reserves or unused tissues.
Your body will tend to burn any unused muscle before it begins to burn the fat it has saved up. If you do not exercise daily, your body will consume your unused muscle, and you will lose muscle mass and strength. Many patients are hesitant about exercising after surgery, but exercise is an essential component of post-surgical success. Exercise actually begins on the afternoon of surgery--the patient must be able to get out of bed and walk.
The goal is to walk a little farther the next day, and progressively farther each day after that, including the first few weeks at home. Patients are often released from medical restrictions and encouraged to begin exercising about two weeks after surgery, limited only by the level of wound discomfort.
The type of exercise is dictated by the patient's overall condition. Some patients who have severe knee problems can't walk well, but can swim or bicycle. Many patients begin with low stress forms of exercise and are encouraged to progress to more vigorous activity when they are able. Contact your original surgeon. He or she is most familiar with your medical history and can make recommendations based on knowledge of your surgical procedure and body.
In some surgical procedures, the stomach is left in place with its blood supply intact. In some cases it may shrink a bit and its lining the mucosa may atrophy, but for the most part it remains unchanged. Though it does not receive or process food, the lower stomach still contributes to the function of the intestines by absorbing Vitamin B12, and affects hormone balance and motility of the intestines in ways that are not entirely known.
This can vary by surgical procedure and surgeon. In the Roux-en-Y gastric bypass, the stomach pouch is created at one ounce or less in size 15 to 20 cc. In the first few months it is rather stiff due to natural surgical inflammation. About 6 to 12 months after surgery, the stomach pouch can expand and will become more expandable as swelling subsides. Many patients end up with a meal capacity of ounces per meal per day.
The staples used on the stomach and the intestines are very tiny in comparison to the staples you use in the office. Because titanium and stainless steel are inert in the body, they usually do not cause any problems in the long run. It's normal not to have an appetite for the first three months after weight-loss surgery.
If you are able to consume liquids reasonably well, your appetite should increase with time. Most pills or capsules are small enough to pass through the new stomach pouch. Initially, your doctor may suggest that medications be taken in liquid, crushed or capsule form.
Cut Down to Size Achieving success with weight loss surgery
Patients can return to normal sexual intimacy when wound healing and discomfort permit. Many patients experience a drop in desire for about six weeks. It is strongly recommended that women wait at least two years after the surgery before a pregnancy. Approximately 18 months to two years post-operatively, your body will be fairly stable from a weight and nutrition standpoint and you should be able to carry a normally nourished fetus.
You should consult your surgeon as you plan for pregnancy. Both men and women generally respond well to this surgery. In general, men lose weight slightly faster than women do. Patients are highly encouraged to stop smoking at least three months before surgery.
Smoking increases the risk of lung problems after surgery, can reduce the rate of healing, increases rates of infection, and interferes with blood supply to the healing tissues. Patients may wonder about this early after the surgery when they are losing 20 to 40 pounds per month, or when they've lost more than pounds and they're still losing weight. Two things happen to allow weight to stabilize.
First, a patient's ongoing metabolic needs calories burned decrease as the body sheds excess pounds. Second, there is a natural progressive increase in calorie and nutrient intake over the months following weight-loss surgery. The stomach pouch and attached small intestine learn to work together better, and there is some expansion in pouch size over a period of months.
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The bottom line is that, in the absence of a surgical complication, patients are very unlikely to lose weight to the point of malnutrition. Many people heavy enough to meet the surgical criteria for weight-loss surgery have stretched their skin beyond the point from which it can snap back. Some patients choose to have plastic surgery to remove loose or excess skin after they have lost their excess weight. Insurance generally does not pay for this type of surgery often seen as elective. However, some do pay for certain types of surgery to remove excess skin when complications arise from these excess skin folds.
While exercise is good in so many other ways and is highly recommended, unfortunately many patients may still be left with loose skin. Most patients say no. In fact, for the first four to six weeks patients have almost no appetite. Over the next several months the appetite returns, but it tends not to be a ravenous "eat everything in the cupboard" type of hunger. This is usually caused by the types of food you're consuming, especially starches rice, pasta, potatoes. Be sure not to drink liquid with food since liquid tends to wash food out of the pouch.
Your doctor will determine whether medications for blood pressure, diabetes, etc. For meds that need to be continued, the vast majority can be swallowed, absorbed and work the same as before weight-loss surgery. Usually no change in dosage is required. NSAIDs may create ulcers in the small pouch or the attached bowel.
If you have gastric bypass you may take Tylenol. Most diuretic medicines make the kidneys lose potassium. With the dramatically reduced intake experienced by most weight-loss surgery patients, they are not able to take in enough potassium from food to compensate.
When potassium levels get too low, it can lead to fatal heart problems. A hernia is a weakness in the muscle wall through which an organ usually small bowel can advance. Approximately 20 percent of patients develop a hernia. Most of these patients require a repair of the herniated tissue. The use of a reinforcing mesh to support the repair is common.
The chance of an abdominal hernia after laparoscopic surgery is less than one percent. Many patients experience some hair loss or thinning after surgery. This usually occurs between the fourth and the eighth month after surgery. Consistent intake of protein at mealtime is the most important prevention method. Most patients experience natural hair re-growth after the initial period of loss. Scar tissue, or adhesions, is formed inside the abdomen after surgery or injury.
Eating Behaviour Predicts Weight Loss Six Months after Bariatric Surgery: A Longitudinal Study
Adhesions can form with any surgery in the abdomen. For most patients, these are not extensive enough to cause problems. Some patients have a type of yeast present on the surface of their skin, intestine or vagina at the time of surgery. This leads to overgrowth in certain circumstances.