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Bariatric Surgery

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At WVU Medicine Children’s, our Bariatric Surgery program is designed to help children and adolescents overcome obesity through a wide range of support services. Childhood obesity affects nearly twenty percent of the population nationwide. Our group of highly trained experts are ready to help your family achieve a healthier lifestyle. Childhood obesity presents a multifaceted challenge, significantly heightening the likelihood of various severe health complications including diabetes, disability, heart disease, and mental health disorders. For children who have attempted weight-loss approaches without success, weight-loss surgery could be a viable treatment. When paired with lifestyle modifications, this intervention can offer children and adolescents improved health outcomes.

Motivation and Family Support • Having bariatric surgery is a major decision that will affect the rest of your life. You need to be motivated and show commitment throughout this process. Family support and taking part in your work of the weight treatment will be a vital part of your success. We ask that the same support person – usually a parent or close family member – comes to all clinic visits with you. This person must commit to supporting you before, during, and after surgery. • Family members can provide support by giving healthy foods, helping with exercise, giving daily praise, and having a healthy lifestyle themselves. • Your support person should be familiar with the before-surgery and after-surgery diets and know what problems to look out for.

Insurance Information Before starting the bariatric surgery program, we need to find out if bariatric surgery is covered under your insurance policy. While many insurance companies will cover weight loss surgery, patients are often required to pay for some of the costs in the form of copays, deductibles, and coinsurance. You need to know what part of the bill you will have to pay ahead of time. Check your coverage for the medically supervised weight management program leading up to surgery as well as the surgery itself. This includes monthly visits with our medical providers, registered dietitians, and psychologists.

Bariatric Surgery Procedures

The Laparoscopic Sleeve Gastrectomy, often called the “sleeve,” is performed by removing approximately 80% of the stomach. The remaining stomach is the size and shape of a banana.

How It Works The new stomach holds less food and liquid, helping reduce the amount of food and calories consumed. By removing the portion of the stomach that produces most of the “hunger hormone,” the surgery impacts the metabolism. It decreases hunger and increases fullness. The body can reach and maintain a healthier weight and control blood sugar.

Advantages

  • Technically simple and shorter surgery time
  • Relatively short hospital stays of about one or two days
  • Back to work and school in about two weeks
  • Effective weight loss and improvement in obesity-associated medical conditions
  • Disadvantages
  • Non-reversible procedure
  • May worsen or cause new onset reflux or heartburn
  • Potential for long-term vitamin deficiencies

The Roux-en-Y Gastric Bypass, often called “gastric bypass,” is performed by dividing the stomach into a small top portion (pouch) that is the size of an egg. The larger part of the stomach is bypassed and no longer stores or digests food. The small intestine is also divided and connected to the new stomach pouch, allowing food to bypass part of the small intestine.

How It Works The new stomach pouch is smaller and holds less food and liquid, helping reduce the amount of food and calories that are consumed. Additionally, food does not come into contact with the first part of the small intestine, which results in decreased absorption of calories and nutrients. The surgery also causes hormonal changes that decrease hunger, increase fullness, and allow the body to reach and maintain a healthy weight.

Advantages

  • Reliable and long-lasting weight loss and improvement in obesity-associated medical conditions
  • Can help improve reflux (heartburn)

Disadvantages

  • Technically more complex when compared to sleeve gastrectomy
  • More vitamin and mineral deficiencies compared to the sleeve gastrectomy
  • Risk for small bowel complications and obstruction
  • Risk of developing ulcers
  • May cause “dumping syndrome,” a feeling of sickness after eating or drinking, especially with sweets

Bariatric surgery procedures are extremely safe. Complication rates are lower than common operations such as gallbladder removal, hysterectomy, and hip replacement. Still, it is important to be aware of possible complications so you can help identify signs of a problem. You can also take steps to help prevent some of these things.

Complications that can occur in the first few weeks after surgery include:

  • Bleeding
  • Infection of the wound, bladder infection, pneumonia, skin infection
  • Bowel obstruction or blockage
  • Leaking of stomach acid, bacteria, or digestive enzymes into the abdominal cavity
  • Blood clots (also called deep-vein thrombosis and pulmonary embolus)
  • Need for further surgery

Although death has occurred after all types of bariatric surgery, this is very unlikely to happen.

Complications than can occur months to years after surgery include:

  • Vitamin and mineral deficiencies
  • Ulcers and narrowing at the connection of the stomach and the small intestine
  • Heartburn
  • Changes to alcohol digestion
  • Changes in food preferences
  • Weight regain
  • Depression

It is very important to quit smoking or using tobacco before having weight loss surgery. Smoking or chewing tobacco lowers blood flow to tissues. This can slow the healing after surgery. Smoking can also increase your risk of blood clots, ulcers, and pneumonia.

You must quit smoking at least eight weeks before surgery, and you should not start smoking after surgery.

If you need help quitting, talk to your primary care provider. You can also call 1-800-QUIT-NOW (1-800-784-8669) or visit www.smokefree.gov.

Alcohol is not recommended after bariatric surgery. Alcohol contains calories, but minimal nutrition and can work against your weight loss goal. The absorption of alcohol also changes after gastric sleeve or gastric bypass surgery because an enzyme in the stomach that helps to digest alcohol is greatly reduced. Alcohol can be absorbed more quickly into the body, meaning patients can reach a higher blood alcohol level and maintain it for a longer time after surgery. Alcohol use may increase after surgery in some patients, and they can develop alcohol dependence. We recommend that patients do not drink any alcohol after bariatric surgery. If patients do choose to drink alcohol, we strongly urge that they do not drive, even after one drink.

Q: Is it safe to get pregnant after I have bariatric surgery? A: Yes! In fact, many women have healthier pregnancies and easier deliveries after bariatric surgery. Their children also have a reduced risk of obesity.

Q: How long should I wait after having surgery before I get pregnant? A: It is recommended that you wait at least 18 to 24 months after having surgery before becoming pregnant. This allows you to achieve your maximum weight loss and reach a stable weight before pregnancy. It also allows your medical team to monitor your nutritional status and make sure you don’t have any nutritional deficiencies that could negatively impact a pregnancy.

Q: I’ve never been able to get pregnant before surgery. I don’t have to worry about preventing pregnancy after surgery, do I? ** **A: Women can experience a boost in fertility immediately following bariatric surgery. This means it becomes much easier to become pregnant if you have unprotected sex. It is extremely important that all bariatric surgery patients take steps to prevent pregnancy for the first 18 to 24 months after surgery.

Q: What is the best way to prevent pregnancy after surgery? A: The best way to prevent pregnancy is to not have sex. Other steps you can take include using a long-acting form of birth control, such as an IUD or subdermal implant, along with a barrier form of birth control like a condom. Birth control pills may not work as well in patients who have had bariatric surgery.

Birth Control at WVU Medicine Children’s Hospital We want to help you be smart about birth control and achieve your goals. It is important to know your options and talk with a doctor or nurse about what is best for you. We can prescribe several types of birth control in the Bariatric Clinic, or we can refer you to the WVU Medicine Children’s Adolescent and Young Adult Medicine for a more comprehensive offering. If you would like to find out more or start a new method of birth control, we encourage you to call 304-598-4835.

  • Bariatric clinic visits: six consecutive, monthly visits for medically supervised weight loss and preparation for surgery
  • Blood tests
  • Psychology assessment
  • Sleep study
  • Cardiology evaluation
  • Birth control counseling (females only)
  • Contrast X-ray of the upper gastrointestinal tract
  • Pre-admission visit with surgery department/anesthesia

You will meet with the Family Weight Management program – Bariatric team every month to prepare you for weight loss surgery and life after surgery. Each session will last X minutes.

Monthly visits will be with Family Weight Management physicians, psychologists, and dieticians.

The WVU Medicine Family Weight Management program – Bariatric team and most insurance companies require that you come to at least six-monthly clinic visits in a row before having bariatric surgery.

Missing your monthly appointments without rescheduling, or skipping one or more months, may slow sending information to your insurance company for approval of your surgery. This will move back your surgery date

You are required to attend frequent follow-up visits in the first 12 months after bariatric surgery. During this time, we will monitor for any medical complications of the surgery, track your weight loss, and help you adjust to the dietary and lifestyle changes necessary after your procedure. After the first 12 months, visits decrease in frequency, although you are always welcome to schedule additional visits as needed.

Required Visits 2 weeks post-op 1-month post-op 3 months post-op 6 months post-op 9 months post-op 12 months post-op 18 months post-op 2 years post-op 3 years post-op 4 years post-op 5 years post-op*

Bariatric surgery can change the way your body absorbs prescriptions and over-the-counter medications. You will need to avoid certain medications after surgery, but you will be asked to take other medicines for the rest of your life. Also, as your obesity-related health conditions improve, your medication doses may change. It is important to discuss your medication regimen with your doctor before and after your surgery. Keep reading for tips and information on taking medications after surgery.

For the first 4 to 6 weeks after surgery, you should avoid swallowing large capsules or tablets. These pills can be difficult to swallow and can become stuck in your gut as your body is healing. Medications should be small tablets (check with your bariatric team to know what is safe), capsules that can be opened, chewable, liquid, crushable, sublingual, transdermal, or injectable form.

1 Medical Center Drive Morgantown, WV 26506
304-598-1111


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