Weight Loss Surgery

Two of the most popular weight loss surgeries performed today, the sleeve gastrectomy and lap band procedures seek to achieve the same goal, minimize the size of the stomach. How each procedure does this is unique.

• Lap band surgery restricts food consumption by separating the stomach into two pouches. The stomach is not cut, but “separated” through the application of a gastric band. Food first enters a small upper pouch, which feels full more quickly. It then passes to the lower pouch where digestion occurs.
• Sleeve gastrectomy resizes the stomach to about 25% of its current capacity at the time of surgery. This maintains a single “pouch” for food to fill and be digested and is therefore known to not only reduce appetite but stimulate changes in gut hormones that can help control blood sugar.

Lap band surgery and gastrectomy surgery are the two most common bariatric procedures for weight loss. In lap band surgery, the doctor carefully places an adjustable band around the top area of the stomach. This reduces the capacity of the stomach to hold food. The gastrectomy procedure is more comprehensive in that it removes more than 50 percent of the stomach, revising it to a small, sleeve-shaped organ. The goal is the same, but the approach is different. 

Dr. Jacob performs both of these procedures and is very careful in his patient-selection process. He will determine the best weight loss procedure for you based on certain criteria. Generally, lap band surgery is performed in cases of BMI over 30 but not higher than 40. Gastrectomy, on the other hand, may be a better option for you if you've been diagnosed as morbidly obese, meaning that your BMI is over 40 and you have one or more health problems as a result. 

Chances are, if you're considering weight loss surgery, you've had little consistent success with traditional weight management habits. It might sound contradictory to dial in your diet and exercise before undergoing bariatric surgery but it's beneficial. Making small changes to your daily lifestyle before surgery can help you transition more aptly after your procedure. Dr. Jacob can discuss his recommendations related to your daily caloric intake and activity level, but some general tips for preparing for surgery include:

• Begin eating as you will eat after surgery. In this way, we mean to slow down when you eat and chew your food more than you are used to. After bariatric surgery, your digestion will be quite different because you'll have fewer digestive enzymes and less gastric acid working to break down your food. Without them, your chewing becomes immensely important to your digestive process. 
• Develop an eating schedule before surgery. After your procedure, you may be advised to eat a small meal every three to four hours. If your current eating habits are to snack frequently or eat fewer, bigger meals, your transition could be difficult. It's beneficial to ease yourself into it starting before surgery. Because you'll need to eat every few hours, it's also helpful to plan ahead. You'll need to have healthy food options with you at all times to prevent unnecessary hunger and stress.
• Begin building a list of ways that you can cope with stress that do not include food. Many of the reasons people overeat relate more to emotional comfort or boredom. It can help to work with a qualified therapist to identify other ways to manage the factors that can lead to overeating.
• Hydrate, hydrate, hydrate! After surgery, you'll be limited in the amount of fluid you can take in at one time. To prevent discomfort, you'll sip water all day long. It can take time to develop this habit of sipping water several times every hour, and we mean every hour. Going an hour without drinking after surgery can quickly lead to dehydration, which we want to avoid. 
• Don't drink when you eat. Your prime real estate in your tummy will be extremely limited after surgery and it's important to give priority to protein. To avoid reducing your already-limited stomach space, keep all meals food-focused, not beverage-focused. 

You may be able to return to work within a week of your gastrectomy procedure. That said, this will depend on a few different factors. The type of work that you do is one. We want to make sure you're well enough to maintain comfort and sustained energy for your day before we clear you for work. If your job is quite strenuous, you'll most likely need more time off. Your overall healing process will also influence how much time you will need off from work and other activities. It's important that your body is allowed to heal at its own pace. Doing too much too soon could prolong the transition process, which should feel exciting and gratifying. 

Surgical recovery is measured in two ways. First, we look at your return to everyday activities. Then, we look at your complete recovery. While you may be back to most of your normal activities within a week or two of surgery, your stomach will still be healing for many weeks. After about one month, you may be able to increase your level of activity to include more strenuous work and exercise. 

As it pertains to recovery, lap band surgery is considered easier. You may regain comfort sooner and be able to resume normal activities more quickly. However, you'll need to prepare for some massive dietary restrictions to help your stomach get used to its new size and capacity. For the first week after this procedure, diet is limited to clear liquids. After one week, it may be possible to add other liquids. Gradually, you can add in soft foods like mashed potatoes and scrambled eggs, then small amounts of foods that require more chewing. 

We want you to achieve success with your post-surgery weight loss and quality of life! Dr. Jacob and our experienced team are here to answer questions, follow-up with you, and support you through your exciting transformation.