Checkups key to success of obesity surgery

From Reuters: By Megan Rauscher

Seriously overweight people who undergo gastric bypass surgery to shed pounds should try to make as many scheduled post-op doctors appointments as possible, according to a new study. It shows that follow-up care is a key component of the long-term success of the weight-loss surgery.

With gastric bypass surgery -- the most common method of "bariatric" surgery -- surgeons reduce the size of the stomach, which substantially limits the amount of food a person can eat.

"Weight loss following gastric bypass varies from patient to patient," note Dr. Jon C. Gould and colleagues of the University of Wisconsin in Madison in a report to the annual meeting of the American Society for Bariatric Surgery. Continued and long-term follow-up care at a dedicated bariatric surgery clinic may impact the amount of weight that is lost, they add.

The investigators took a look back at 85 adults who had gastric bypass surgery at their center and found that the results were best in those who attended follow-up appointments for at least 3 years after they had the surgery.

Patients who attended every scheduled post-surgery follow-up appointment for 3 to 4 years lost 74 percent of their excess weight, whereas patients who kept every appointment for only 1 year lost 60 percent of their excess weight. Patients who missed appointments in the first year lost 56 percent of their excess weight.

"Our follow-up routine calls for visits at 2 weeks post-op, 6 weeks post-op, 6 months, and then annually after surgery indefinitely," Gould noted in a telephone interview with Reuters Health. "If we identify problems, we bring people in more often." The follow-up visits include meeting with a dietitian and medical health professional and often a health psychologist.

The most common reason given for missing scheduled appointments after gastric bypass surgery was lack of coverage by the patients' insurance company.

"This study shows that the more you put into bariatric surgery, the more you get out of it," Gould said in a written statement. "Patients must continue to attend their bariatric medical appointments and insurers should provide coverage for these visits."

In 2006 an estimated 177,600 severely obese people in the United States had bariatric surgery, according the American Society for Bariatric Surgery estimates. About 15 million or 1 in 50 adults in the US have morbid obesity, which is associated with a number of other diseases and conditions including type 2 diabetes, heart disease, sleep disturbances, asthma, cancer, and joint problems.

Comedic Take: WLS is the EASY way out!

We have a community game that we play at the LAWLS Neighborhood called Fun Friday. Each Friday one of the Neighbors composes a question and we all join in the fun of answering it. Last week's question from Too Slim Stu was "If you were a stand up comedian, what would be your best three jokes about your surgery and subsequent life??"

This of course resulted in some terrific and funny posts about post-WLS living. One of the best came from our Fitness Diva aka JudyPetite. She's an oldie, but a goody when it comes to WLS - she had stomach stapling in 1986 (21 years ago) and is living at a healthy weight today. With her permission I share her comedic take on WLS - The Easy Way Out!

To read all the responses link here: Fun Friday June 1. And don't be shy - add your funnies here too! After all, if we can't laugh about this LAWLS way of life, who can?

They told me that if I wanted to lose weight I had to eat less and exercise more. Well, I didn’t want to feel deprived, and I hated to exercise! So, I chose “the easy way out.” Yes, friends, I had WLS.

So I check into the hospital and first thing is they give me a series of enemas until “everything runs clear.” As I’m struggling to clean up again and again (and believe me, when you weigh 300 pounds, cleaning up IS a struggle), I’m thinking to myself “Yeah, this is great! What could be easier!”

I have the operation, and now I can take in about 2 ounces of liquid. They put me on a liquid diet. I’m sipping broth – yum! I graduate to sugarfree jello and pudding, oh wow – easy, easy! They okay cream soup – whooppee! Well, the first time I try it, a tiny piece of chicken gets stuck in my tummy and I’m doubled over for hours! Oh, why didn’t I do this before now??

So, I lose a bunch of weight, the hubby approves and of course I get pregnant! Man, how easy can it get – between morning sickness and stuck food, I now know the inside of my commode like a mechanic knows a muffler!

What an easy time I've had! Since my surgery, I've lost weight, gained it back and lost it again. I've had to be admitted from the ER when the scar tissue in my stomach built up to where nothing could get through at all. Here I am, the former 300-pounder, literally starving! I've had hernia surgery, and, after 20 years I still find myself hanging headfirst over the commode a few times a month. Yeah, what a way to take it off, huh?

Every time I see somebody trying to work the gym into their schedule or say no to a second helping of something, I think WHAT’S WRONG WITH THIS PERSON? I mean, why don’t they just gain about 100 pounds so they can qualify for WLS and stop putting themselves through all this agony?

I’ve been at a healthy weight for about the past ten years. I can eat pretty normal now! But I found out that to keep from gaining it back, I have to eat less and exercise more. Yeah, folks – through WLS, I learned THEY were right all along. But just think – I learned it THE EASY WAY!!! (ba-da-BING)

Refresher: WLS High Protein Diet

This is a previously published article I'm pulling forward in response to questions lately about the high protein diet. It was helpful to me to re-read exactly why the high protein diet works - and then recommit my focus to high protein eating. I hope you find this refresher helpful too.

Gastric Bypass Patients Succeed Eating High Protein Diet
By Kaye Bailey

The first rule for successful weight loss and weight maintenance after Weight Loss Surgery (WLS) is Protein First – that means eating protein for three daily meals, and protein must be 50 percent of food intake. Some bariatric centers advise as much as 70 grams of protein a day. The gastric bypass diet should be high-protein, low-carbohydrate and low-volume. This is what successful WLS patients will eat for the rest of their life if they wish to maintain weight loss after surgery.

Animal products are the most nutrient rich source of protein and include fish, poultry and meat. Dairy protein, including eggs, is another excellent source of protein. Nuts and legumes are also good sources of protein, but sometimes difficult for the bariatric patient to consume. Tofu is another remarkable good source of vegetable protein and there are many quality flavorful products on the market for making it easy to incorporate into the diet.

Science is proving that a protein rich diet will prompt weight loss and increase energy. The body contains over fifty-thousand different active proteins all made out of the same building blocks: amino acids. Amino acids are made of carbon, hydrogen, oxygen and nitrogen as well as sulfur, phosphorus and iron. Many diseases – including obesity – indicate an amino acid deficiency.

WLS patients do not have the luxury of eating high-carbohydrate foods. They must eat lean protein or they will get sick, anemic, and weary. Weight loss will cease if patients eat processed carbohydrates instead of lean protein. Dumping or vomiting may also result if patients do not eat lean protein for the first half of every meal.

The distinction must be made between high fat proteins and lean proteins. A gastric bypass patient cannot tolerate high fat proteins such as bacon, fatty beef or sausage products or greasy fried chicken: these foods cause nausea and vomiting. In fact, many WLS patients report even smelling high fat foods, such a fried chicken, makes them nauseous. In addition, these high fat protein rich items are contributors to obesity, clogged arteries and heart disease. High fat foods should be avoided by anyone wishing to control their weight.

Kaye Bailey © 2005 - All Rights Reserved