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For some struggling with obesity, bariatric surgery offers hope after a lifelong struggle with weight loss.
Surgery is the answer for some people, but others benefit from non-surgical bariatric treatment.
Brad Geiger, executive director at the Providence Digestive Health Institute in Oregon, explains that bariatric treatment is never about weight loss alone -- it’s about the life-changing effects losing weight can have.
Amy had struggled with her weight for most of her life. Although there were times when she successfully shed the pounds, eventually she would gain them back. Still, she was convinced her battle was hers to bear.
Then one day she decided she couldn’t do it alone. That was the day Amy (who asked that we not use her full name) and her husband both chose to have gastric bypass surgery at Providence Center for Weight Management in Portland, Oregon. Twelve months after surgery, Amy has dropped 85 pounds and counting. Her husband has lost over 60 pounds, so far.
“My energy level is so much better, I sleep better, and I’m more active,” said Amy. “The biggest change has been my mindset. I feel I’m a better version of me.”
What is gastric bypass surgery?
Gastric bypass, also called Roux-en-Y gastric bypass, is one of the most common weight-loss surgeries performed in the United States. During surgery, the surgeon creates a small pouch at the top of the stomach and then reroutes the small intestine so that it connects to the pouch instead of the larger stomach. Typically, the surgery takes less than three hours and most patients remain in the hospital for one or two days.
Gastric bypass isn’t the only type of weight-loss surgery. There are several types of bariatric surgery, each one offering something different depending on a patient’s needs and preferences. Here are a few options for bariatric surgery:
- The sleeve gastrectomy requires removing nearly 75% of the stomach, leaving a narrow tube, like the shape of a banana. Unlike gastric bypass, this surgery doesn’t reroute the intestines. Although the stomach is significantly smaller, it works as it did before surgery. The difference is patients feel less hungry and are full after eating less food.
- The adjustable gastric band doesn’t require making the stomach smaller or rerouting the intestine. Instead, a band is placed around the upper part of the stomach, dividing it into a small upper pouch and a larger pouch below the band. The small upper pouch limits the amount of food so that patients feel full after eating less food.
- A more complex procedure is the duodenal switch, which entails removing 60-70% of a patient’s stomach and also bypassing a portion of the small intestine. The result is greater weight loss by reducing the number of calories absorbed, but also, a reduction in nutrient absorption. Patients who choose this surgery must take vitamin supplements for the rest of their lives.
Who qualifies for bariatric surgery?
You may be considered for bariatric surgery if your body mass index (BMI) is at least 40 or more. You may also qualify if your BMI is at least 35 and you have serious weight-related medical problems, such as Type 2 diabetes, high blood pressure, sleep apnea and asthma.
Health benefits to weight loss
Losing a lot of weight after bariatric surgery comes with major life-changing changes. Not only does losing weight help self-esteem and confidence, but it’s a kick-start for getting more active and ultimately, healthier, which could mean lowering your blood pressure and cholesterol, improving sleep or reducing your risks for cancer and liver disease. And because obesity goes hand-in-hand with Type 2 diabetes, losing weight can help keep the disease under control.
Amy is an excellent example of what’s possible. In addition to losing weight, she wanted to get off her diabetes and high blood pressure medications. “I hope to be off everything but vitamins,” she said. Four months after bariatric surgery, Amy had stopped taking her blood pressure medications and two of her diabetes medications.
According to the Centers for Disease Control and Prevention, even a modest weight loss of 5-10% of your body weight can greatly improve your health, especially improving blood pressure, cholesterol levels, and blood sugars.
“For patients who have already undergone bariatric surgery at our facility, weight isn’t always their biggest priority,” says Mashay White, metabolic and bariatric surgery coordinator at Covenant Health in Lubbock, Texas. “Most patients focus on their overall health and what losing weight means for them; whether it’s getting off many medications due to their co-morbidities [medical conditions], being able to get rid of their oxygen or CPAP, being able to increase their activity level and enjoy doing more with their loved ones. I call it a journey, because it truly is,” she said.
It takes a plan and a team
Bariatric surgery is successful for people who struggle with losing weight on their own, want to feel better and improve their health. Recent data shared by the Providence Digestive Health Institute shows that many patients who choose bariatric surgery lose more than 100 pounds. “That’s life-changing,” says Brad Geiger, executive director at the Digestive Health Institute in Oregon.
But it takes more than surgery to achieve weight-loss goals and keep them throughout life. A successful weight-loss effort takes a supportive program, a lot of effort and sometimes encouragement from peers who are on the same journey. Dietitians, endocrinologists, behavioral health specialists, as well as doctors and nurses are also important in helping patients set their weight-loss and health goals, and providing the tools and support they need to get there.
But not everyone who seeks help chooses surgery. There are many nonsurgical plans and programs that can be very effective in helping people lose weight, and keep it off. The choice is personal. “We work to find the right option for our patients,” says Geiger, “we take a personalized approach.”
Although most patients who seek help at Covenant Health have already tried other weight loss programs or diets, they’re encouraged to try other options before surgery. “This especially applies to those who need to lose weight to qualify for surgery, or for insurance purposes where they may require a three to six-month physician-supervised program before surgical approval,” says White.
In the same way patients pursuing weight loss through bariatric surgery are supported with a team and resources, so are patients who want to try nonsurgical options. In addition to working closely with a care team who helps them establish goals and a plan of action, patients can attend classes, and are encouraged to start exercise and healthy eating programs, such as HMR (Health Management Resources).
Non-surgical weight loss options
There are a variety of non-surgical approaches to weight loss. Talk to your doctor about finding the best fit for your needs. Here are some options to consider:
- Exercise and coaching services
- Behavioral counseling
- Nutrition services, including classes that focus on good eating habits
- Structured weight management programs
In some locations, Providence has partnered with HMR to offer additional weight-loss options.
The HMR program is a simple, nutritionally complete plan offering support through expert health coaches, digital resources or in-clinic services. HMR uses ready-to-eat meals and shakes to achieve fast weight loss while helping you develop the skills to maintain weight loss on a long-term basis.
Finding support during COVID-19 pandemic
Weight-loss programs like the ones offered by Providence and Covenant Health provide in-person visits and small, group-based classes to encourage peer-to-peer support. However, during the COVID-19 pandemic, patients are encouraged to schedule virtual appointments when possible, and attend online classes and peer groups.
Patients visiting our facilities will find staff following strict safety guidelines, including implementing the seven safety steps.
Where to find a weight-loss program in your area
The Center for Weight Management in Portland offers surgical and nonsurgical weight-loss programs, such as HMR. You can learn more about weight-loss surgery or nonsurgical approaches at one of their free educational seminars.
Find a doctor
Considering bariatric surgery or a nonsurgical program to help you lose weight? Our weight-loss programs vary by region and facility. If you’re considering bariatric surgery or a non-surgical program to help you lose weight, you can find a doctor for you in our provider directory. You can also access Providence Express Care Virtual for a full range of healthcare services.
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*HMR is a subsidiary of Providence St Joseph Health. Providence St Joseph Health receives a financial benefit in association with the purchase of HMR products.
Bariatric services at Covenant Health offers both surgical and nonsurgical options, as well as education resources and support groups. Find out more at Covenant Health.