Bariatric Weight Loss Procedures and the Names They Go By

It's Back to School week here at LivingAfterWLS! I love this time of year - new starts, refresher studies, and back to the art and craft of learning. Yesterday we reviewed the Four Rules of bariatric weight loss surgery. Today, for anyone considering weight loss surgery, for new patients or veterans of surgical weight management I present a brief review of the currently approved surgical procedures and the names they go by.

By Kaye Bailey

The advisory committee for the 2010 Dietary Guidelines for Americans reported grim news earlier this year when they confirmed that currently about two-thirds of American adults and one-third of American children are overweight or obese. The committee warned that Americans must slash their caloric intake and increase physical activity because the obesity epidemic is "the single greatest threat to public health in this century."

Given that discouraging news nearly 300,000 adult Americans will undergo bariatric surgery this year as a means to losing weight and treating chronic morbid obesity. There are at least 35 bariatric surgical procedures approved by the Food and Drug Administration (FDA) for the treatment of obesity. While each procedure is unique they are all generically referred to as Weight Loss Surgery (WLS). The American Society for Metabolic and Bariatric Surgery describes two basic approaches that weight loss surgery takes to achieve change:

Restrictive procedures that decrease food intake with the use of stapling or banding.
 

Malabsorptive procedures that alter digestion causing food to be poorly digested and incompletely absorbed so that it is eliminated in the stool.

Patients seeking surgical help for obesity quickly learn the nomenclature of bariatric medicine and can readily list the names by which different surgical procedures are known. Bariatric procedures are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure, according to the European Association for Endoscopic Surgery, should be tailored to the individual situation. Here we look at the most commonly performed bariatric procedures in the United States and learn the names they go by:

Gastric Bypass Surgery: Since the early 1990s gastric bypass has been the most commonly performed surgical weight loss procedure and the laparoscopic gastric bypass is considered the "gold standard" of bariatric surgery. The public at large often mistakenly calls all bariatric procedures gastric bypass. Gastric bypass is both a restrictive and malabsorptive procedure. Patients refer to it as WLS, GBS, Roux-en-Y Gastric Bypass (RYGB) or simply gastric bypass.

Adjustable Gastric Banding: This procedure, most commonly called lap-band, is restrictive with the use of a prosthetic band placed around the upper part of the stomach, much like a belt. There is no cutting or stapling of the stomach. A tube is connected to the prosthetic band to a small access port that is fixed beneath the abdomen skin. The band is adjusted through this port to help control weight loss outcome. Patients call this procedure banding, lap-band, or gastric banding. They refer to themselves as "Bandsters" or "Bandits".

Sleeve Gastrectomy: This is a purely restrictive procedure meaning there is no intestinal bypass. The sleeve gastrectomy is rapidly emerging as a reasonable alternative to adjustable gastric banding and other stapling procedures with patients favoring it over the malabsorptive procedures. Among patients the procedure is often called "gastric sleeve" or "the sleeve" and patients of this procedure refer to themselves as "sleevesters".

Laparoscopic vs. Open Procedure: Laparoscopic procedures are used for a variety of general surgeries and in the last decade have become the predominant technique for many surgical procedures. When a laparoscopic operation is performed a small video camera is inserted into the abdomen through small incisions made in the abdominal wall. The surgeon views the procedure on a separate video monitor. Laparoscopic procedures are considered less invasive than open procedures that require one long incision to open the abdomen. Studies indicate patients having had laparoscopic weight loss surgery experience less pain after surgery resulting in easier breathing and lung function and higher overall oxygen levels. In addition laparoscopy patients have fewer wound complications such as infection or hernia, and they tend to return to quickly to pre-surgical levels of activity.

Kaye Bailey (c) 2010 - All Rights Reserved

To learn how to make the most of these procedures,
take a look at this featured article from the  5 Day Pouch Test website:

Three Keys to Lasting Weight Loss Surgery Success 

Nearly a quarter-million people in the United States will undergo weight loss surgery this year to arrest their morbid obesity and lose weight. In spite of the drastic nature of gastric surgeries not all patients will reach a healthy weight and some may eventually regain weight they lost initially with surgery.  Read more

2009 All Star Award - Email Newsletters

We have just learned that LivingAfterWLS has been awarded the Constant Contact 2009 All Star Award for Excellence in Email Marketing! That means the emails we provided to our LivingAfterWLS community free of charge meet the highest standards of excellence in the email marketing industry! I am so pleased with this and thrilled that we can continue to share with you, our loyal readers, quality material of interest, meeting the high standards you have come to expect. It is a beautiful day in the LivingAfterWLS Neighborhood!

LivingAfterWLS publishes three inspiring email newsletters that promote personal responsibility and positive self-empowerment as a means to succeed long-term with surgical weight loss. They are free to email subscribers whom we treat with respect and privacy never selling our list.

You Have Arrived is our flagship newsletter published twice monthly. You will find inspiring and motivational articles in addition to topics on nutrition, fitness, healthy cooking and bariatric news.

Recipe of the Week is our once weekly cooking and nutrition newsletter. Each week you will find great family friendly recipes using fresh healthy ingredients that will please your palate and enhance your well being while being mindful of the specific need of surgical weight loss patients.

Free 2009 Best of Cooking with Kaye Download
21-Page Download; 28 of your favorite Kaye recipes from 2009

Download Now

5 Day Pouch Test Bulletin is our monthly motivational newsletter that supports our back to basics program, the 5 Day Pouch Test. This program is for those who feel they are not fully using their weight loss surgery tool and is useful for those who have stalled weight loss, or perhaps regained some weight.

Sign up for Award Winning LivingAfterWLS Newsletters

LivingAfterWLS
Email and Website Privacy Policy

We have created this email privacy policy to demonstrate our firm commitment to your privacy and the protection of your information.

Why did you receive an email from us?

If you received a mailing from us, (a) your email address is either listed with us as someone who has expressly shared this address for the purpose of receiving information in the future ("opt-in"), or (b) you have registered or purchased or otherwise have an existing relationship with us. We respect your time and attention by controlling the frequency of our mailings.

How we protect your privacy:

We use security measures to protect against the loss, misuse and alteration of data used by our system.

Sharing and Usage

We will never share, sell, or rent individual personal information with anyone without your advance permission or unless ordered by a court of law. Information submitted to us is only available to employees managing this information for purposes of contacting you or sending you emails based on your request for information and to contracted service providers for purposes of providing services relating to our communications with you.

How can you stop receiving email from us?

Each email sent contains an easy, automated way for you to cease receiving email from us, or to change your expressed interests. If you wish to do this, simply follow the instructions at the end of any email.

If you have received unwanted, unsolicited email sent via this system or purporting to be sent via this system, please forward a copy of that email with your comments to abuse@constantcontact.com for review.

Four Things You Must Know about Weight Regain After WLS

This article was published in the January 10, 2010 You Have Arrived Newsletter (subscribe here for free) and has generated much conversation in the LivingAfterWLS Neighborhood. Here is the full article and Link Here to follow the conversation and join us!

Weight Gain After Weight Loss Surgery:
Four Things You MUST Know
by Kaye Bailey Copyright 2010 - All Rights Reserved

I was born with the disease obesity and by the time I was out of college it had advanced to morbid obesity. At age 33 my disease was treated with laparoscopic gastric bypass surgery which affected a loss of weight that put my disease, morbid obesity, in remission. Three years later I suffered a relapse of my disease with a weight gain of 20 pounds. Through dietary and lifestyle compliance, much like a person with heart disease who suffers a relapse, I was able to put my disease, obesity, back in remission. I will always have the disease of morbid obesity and am fortunate that I was able, at a young age, to be treated with the best medically available option.

The Facts:

* Obesity is a disease.
* Weight loss puts the disease in remission.
* Weight gain puts the disease in relapse.
* Like most diseases, victims of obesity are responsible to make dietary and lifestyle changes that work with medical treatment to keep our disease in remission.
* Like most diseases, relapses occur, obesity manifests relapse in weight gain.
* We are not the disease, we have the disease.

My Four Truths:

Regain Is Likely: It is generally believed that 80% of people who undergo WLS will experience relapse (weight gain) of 10-30 pounds depending upon initial weight loss. It is further believed that 20% will relapse to their former weight and possibly gain more as the disease of morbid obesity advances. This relapse can be the result of failed gastric surgery (the surgery was improperly performed); a non-compliant patient who does not evolve their eating and exercise habits; the active intestine becoming more efficient at absorbing calories; and potential stomach pouch stretch. Statistics are not available indicating which patient regains weight for what reason.

Dr. Anita Courcoulas, chief of minimally invasive bariatric and general surgery at the University of Pittsburgh Medical Center said, "Regaining weight down the road is a common phenomenon for weight loss patients. These patients need to be educated and prepared for it if it happens."

2. 100% Conviction: It is my experience that 100% of patients who take to the operating table for the treatment of their disease say, "I'm not going to be one of "those people" who gain weight after surgery." You can bet the farm I said that - and imagine my embarrassment and shame when I did in fact become one of "those people." At the time I didn't understand my disease had relapsed, in part because I had loosened my newly evolved eating and exercise habits, but also because my body has a disease that wants to store excess fat. I thought I gained weight because I was a failure at surgery . Just one more diet I couldn't get right.

I am not alone in my feelings of failure over weight regain. Dr. Courcoulas said, "These are people who feel that they have failed at everything they tried in their lives. If they feel that they are failing surgery, they're embarrassed and they don't want to come back for help." How sad for us. When a cancer patient suffers a relapse do they take it as a personal failure? I sure hope not.

Popular media perpetuates the belief that weight gain equals failure. WLS celebrities are splashed across mainstream media and tabloids alike for weight regain. But the celebrity with cancer who suffers relapse? Charity benefits are hosted bearing their name and their bravery is lauded. With a relapse in obesity the celebrity becomes the brunt of jokes for late night comedians. No wonder we don't want to become one of "those people" but statistics are not on our side
3. I Am Not Obese. Since kindergarten the word "fat" defined me and I actually thought that was who I was because "You are fat" and "I am fat" were constant words in my world. By about age 40 I finally figured out that I am not fat. I have obesity, a disease. Have you heard a heart attack patient say, "I am heart disease" or a leukemia patient say, "I am cancer"? We are not the disease! We have a disease that is part of the whole person that makes us the wonderfully unique and powerful person we are. I must actively engage in mindful thinking daily to assure myself the things that I am that are not about my disease. The old self-loathing talk is much easier to indulge, we are so much more comfortable with it than self-kindness. But please join me in stepping out of your comfort zone and celebrating all the brilliant wonderful things that define you. You are not these disease. You are lovely spectacular beautiful you.
4. Relapse to Remission: Just like other disease, obesity relapse can be put into remission. There is hope! As noted above there are (at least) four reasons for relapse including: failed gastric surgery (the surgery was improperly performed); a non-compliant patient who does not evolve their eating and exercise habits; the active intestine becoming more efficient at absorbing calories; and potential stomach pouch stretch. Keeping in mind that statistically weight regain is likely, that you are not a failure, and that you are not the disease, you can pragmatically go about mapping a plan to fight your relapse.

* Seek medical help and treatment: you are fighting a killer disease
* Assess your eating and exercise evolution and return to the lifestyle prescribed at the time of surgery
* Educate yourself on nutrition, physical and spiritual health so they may work in harmony to heal your body
* Seek support, family, friends, community, and fellow patients to help maintain your personal motivation
* Educate others to stop the ignorance and blame and promote the understanding of this illness we are fighting


Struggling with Regain? Try Kaye's 5 Day Pouch Test - Get the Owner's Manual

Participant Request: Your Personal WLS Experience

Hello Neighbors!

I am appealing to you for help with a book being developed by Tricia Greaves, owner/president of "Be Totally Free". She is the founder of a program to address issues of weight control, weight loss and eating disorders. Her work is very good and very much aligned with our LivingAfterWLS Empowerment Philosophy. As part of her growing body of work and support network she is researching weight loss surgery.

You are invited to participate in the survey and contribute to this exciting project. I have done the survey and I trust that Ms. Greaves will treat our topic with utmost sensitivity, accuracy, and kindness.

Click here: Weight Loss Surgery: Your Personal Experience

Neither myself or LivingAfterWLS is affiliated with Be Totally Free, or Ms. Greaves and we will not receive compensation for your participation. However, I do ask that you mention the LAWLS Neighborhood as part of your response to Question 8 about your support network. I do not think we can ever over-emphasize the value of support in this life long journey.

Thanks for taking a moment from your busy day to help build on the growing body of information about our very unique way of life.

CHEERS!
Kaye