Brenna (Moderator) - 2:54 PM:
Welcome! Today’s chat Preparing for Gastric Bypass and Lap-Band Surgery will begin shortly. Please start submitting your questions and Woody Denham, MD, will begin answering as soon as we get started. While you are waiting for the chat to begin, feel free to visit the Bariatric Surgery page http://www.northshore.org/bariatric-surgery-services/. As this is a popular chat, Dr. Denham may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated.
Anastasia (Northbrook, IL) - 3:01 PM:
I need to lose one hundred forty pounds. I have IBS, fibromyalgia, and diverticulosis. I am in so much pain, so often that I find it extremely difficult to exercise. I am just starting to look into gastric bypass, lapband/sleeve. What makes one a good candidate for this type of surgery?
Dr. Woody Denham (NorthShore)
Patients who have a body mass index over 40 and who have attempted medical weight loss before are good candidates. Medical weight loss can include self directed diets as well as programs such as Weight Watchers, Jenny Craig, etc... Patients who have a body mass index (BMI) of 35 to 40 and high blood pressure, sleep apnea or diabetes would also be a candidate.
Deb (Highland Park) - 3:04 PM:
I’ve struggled with my weight my entire life. I’ve been on every diet and have had only some success losing weight. I’m currently 221 after already losing 50 and I’ve stalled out. I’m still about 90 pounds more than I should be. I have hypothyroidism, which I think is to blame for alot of my weight issues. Will this help me lose the weight that my hypothyroidism keeps on me?
Dr. Woody Denham (NorthShore)
The success of bariatric surgery depends on the procedure. Each of the operations is expected to allow a patient to lose weight and keep the weight off. Laparoscopic gastric bypass is successful in about 80% of patients long term. Laparoscopic sleeve gastrectomy is successful in about 60% of patients while laparoscopic placement of an adjustable gastric band is successful in 40 to 50% of patients.
Geoff (Chicago) - 3:07 PM:
What is the preparation for this kind of surgery? Is it different for gastric bypass than lap band sense lap band isn't as invasive? How long do you typically have to wait before you can actually have the surgery?
Dr. Woody Denham (NorthShore)
Each of these procedures is done laparoscopically. The work up for any of the surgeries is really the same. Patients need to see a bariatric dietician as well as a psychologist. Patients need to undergo medically supervised weight loss prior to surgery. The time from for this depends on the insurance company. The minimum is 3 months while some companies require 6 or 12 months prior to approving the surgery.
Susan (Evanston) - 3:11 PM:
My daughter is 19 and has type 2 diabetes. Is she too young for gastric bypass? Any complications for teenagers that adults wouldn’t have?
Dr. Woody Denham (NorthShore)
Patients over 18 are candidates for bariatric surgery. There are no known complications that woudl be seen in a teenager and not an adult. With a gastric bypass, she woudl have a 80-90% chance of improving or having resolution of her diabetes if it is type 2.
Ashlie (Oak Park) - 3:14 PM:
I’m 38 female and I’m nearly 350 pounds. I can’t participate in many physical activities without getting tired really fast. I want to lose the weight but I find it difficult to exercise for any length of time. I have been on many diets without much success. I’m considering weight loss surgery but I’m worried about the recovery time. I have small children at home and a husband who works long hours. How long does it take before you can be up and around again?
Dr. Woody Denham (NorthShore)
For over 99% of patients, the surgery is able to be performed laparoscopically. A patient would be in the hospital for 1-2 days. Most patients are able to return to work in 2-3 weeks. You would be able to take care of children within a week. Patients are up and out of bed the night of surgery.
Geoff (Chicago) - 3:18 PM:
Hi again Dr. Denham, so do most insurance companies cover this surgery then?
Dr. Woody Denham (NorthShore)
It really depends on the company and the policy that you have. When we see a patient for evaluation, we call the insurance company and determine what benefits are available. We also determine what requirements are needed to obtain apporoval.
Marie (Evanston) - 3:21 PM:
I’ve been researching weight loss surgery for about a year now. I’m just thinking that it might be a good option for me because I’ve had little success loosing weight on my own. Some of the side effects scare me though, including loosing my hair. Is that normal? Does it grow back? What can you do to prevent it?
Dr. Woody Denham (NorthShore)
Most patients do lose some hair after weight reduction surgery. This occurs about 6 months after the surgery. The hair does grow back.
Nathan (Wilmette, IL) - 3:24 PM:
How do you know which weight loss surgery is the best one for you? When is lap band better than gastric bypass? Or sleeve and the others? I guess I don’t understand the difference between them.
Dr. Woody Denham (NorthShore)
This is an important question. Each surgery is different. From the effectiveness standpoint, byapsses are the best operation, then gastric sleeve and then lap band. Lap band surgery is the safest while gastric bypass and sleeve gastrectomy have higher risk. When a patient is seen in clinic, we discuss each of the procedures and the risks and benefits for an individual patient. For instance, a gastric bypass has the best results with improvement / resolution of type 2 diabetes, so a patient with type 2 diabetes should really consider the gastric bypass.
Laura (Glenview) - 3:29 PM:
My problem has always been portion control. Does bariatric surgery actually physically prevent you from eating too much? Or are you still capable of doing it?
Dr. Woody Denham (NorthShore)
The weight reduction surgery will really prevent someone from eating too much. Over time, the amount one eats will increase some. Most patients are not able to eat the same size portions that they may be eating now.
Laura (Glenview) - 3:32 PM:
How do you know how much you can eat?
Dr. Woody Denham (NorthShore)
We ask patients to eat about one cup of food per meal. We want patients to focus on protein first and then good fruits and vegetables. When patients eat this much, they are full. They are usually not hungry between meals.
Geoff (Chicago) - 3:33 PM:
Last one. So if you do lose weight during the waiting period before surgery, has it happened the insurance company would not pay for the surgery?
Dr. Woody Denham (NorthShore)
You can ask as many as you wish. The weight (which gives us BMI) that we use is the one that we record on the first clinic visit. If a patient qualifies that day, the insurance company will not deny the surgery even with subsequent weight loss.
Jon (Evanston) - 3:37 PM:
After gastric bypass, how quickly can you expect to start seeing results? So like after the first two months? How long do you keep losing weight?
Dr. Woody Denham (NorthShore)
The weight loss after gastric bypass is more rapid at the beginning. Most patients lose rapidly for the first 3-6 months. The weight loss will slow down after that but continue for 12 to 14 months after the surgery.
Ben (Wilmette, IL) - 3:40 PM:
Are there any foods you can't eat anymore after surgery?
Dr. Woody Denham (NorthShore)
We instruct patients to concentrate on proteins first. We ask that patients not drink carbonated beverages. Patients should avoid concentrated sweets after surgery. Most fruits and vegetables will work well.
Ed (Winnetka) - 3:45 PM:
Is there an age limit for surgery? I’m nearly 60. Does it have the same results for older patients? Is it safe for older patients?
Dr. Woody Denham (NorthShore)
It is safe for older patients. There is not really an age limit, it is based on the health of the patient. As patients get older, it is more difficult to lose weight. That being said, I have many patients in their 60s and up to the early 70s who have undergone weight reduction surgery, and they are losing weight and doing well.
Shawna (Chi) - 3:49 PM:
I have type 2 diabetes. Is it true that your diabetes can go into remission after sugergy? Does this happen to everyone who has the surgery?
Dr. Woody Denham (NorthShore)
Laparoscopic gatric bypass is the best operation for diabetes. About 70-90% of patients with type 2 diabetes have significant improvement or resolution of their diabetes. It does not happen for all patients.
Brenna (Moderator) - 3:50 PM:
There are approximately 10 minutes left in this chat. Please submit your final questions.
Brenna (Moderator) - 3:50 PM:
There are approximately 10 minutes left in this chat. Please submit your final questions.
Ben (Wilmette) - 3:52 PM:
Why can’t you drink and eat at the same time after weight loss surgery? Is that true forever? Or only immediately after the surgery? Is this with all weight loss surgery options or just gastric bypass?
Dr. Woody Denham (NorthShore)
This is the recommendation with all weight loss surgery. We want the food that people are eating to stay in the small pouch that is made. If people are drinking at the same time, they will often wash the food through and eat more. In addition, we want the food to stay so that there is limited hunger between meals.
Jon (Evanston) - 3:56 PM:
When should you start exercising again? Are there any exercises you won't be able to do anymore?
Dr. Woody Denham (NorthShore)
You can start exercise about 2 weeks after surgery. Patients can walk the day after surgery. Any exercises are ok after weight reduction surgery.
Brenna (Moderator) - 4:00 PM:
Thank you for your wonderful participation in today's chat. A transcript of the chat will be made available later today. For more information on Bariatric Surgery here at NorthShore, please visit http://www.northshore.org/bariatric-surgery-services/