What sets us apart from other medical centers?
At CHRIAS and American Surgery Center, we acknowledge that weight-loss is a complex process with many aspects apart from the physical weight. That’s why we offer a multidisciplinary program to ensure patients not only lose weight, but also maintain their new weight and experience a higher quality of life. Turning to CHRIAS and American Surgery Center for your weight-loss procedure means access to a designated care manager to lean on for support throughout the process—from the first consultation to the weeks following the bariatric surgery.
Our team of six experienced surgeons are committed to excellence in patient care. Here, they answer the most-frequently asked questions about bariatric surgery and the risks, benefits and improved quality of life that can come along with it.
-Dr. Isaias Irgau, MD, Founder, CHRIAS
-Kemal Erkan, Chairman, American Surgery Center
What Are the Types of Bariatric Surgery and When Should Someone Consider Surgery as the Best Option?
Picture a fuel indicator in a car. If the indicator says you’re out of gas, you fill the tank. If the indicator is faulty, it might tell you the tank is empty when it’s actually full. Those struggling with morbid obesity are fighting a biology that drives them to eat despite the fact that they have enough food—they’re dealing with a faulty indicator. Bariatric surgery has been proven to be the most effective tool to fight morbid obesity. Those with chronic morbid obesity often need a tool as effective as surgery to help them not only lose weight—but maintain that loss throughout their lives.
All bariatric surgery involves some rearranging or changing of the digestive tract. The procedure that’s been around since the 1950s is Gastric Bypass. With Gastric Bypass, we make the stomach smaller—the size of an egg or a fist. Then, we rearrange the small intestine so that a portion is brought up and connected to the stomach. The result is a smaller stomach that receives the food. Then, rather than passing through the whole small intestine, it immediately enters the lower portion of the small intestine. By bypassing the portion of the intestine where most of digestion occurs, it causes the food to digest slowly and not be completely reabsorbed. The ideal result is an urge to eat less, and a body which gains less weight from the food that is eaten. For decades, Gastric Bypass Surgery was the standard and most common procedure, and still has some advantages including decreased risk of heartburn and diabetes.
Today, though, the most common procedure is Gastric Sleeve. There are long-term implications of rerouting the intestine, and for younger people struggling with obesity, it’s not always the best option. If you’re going to live another 50 or 60 years post-procedure, the risk of experiencing complications increases significantly. Gastric Sleeve can be an equally powerful and effective procedure, but doesn’t involve rerouting the intestine. We’re still working on the digestive tract, but all we do during Gastric Sleeve procedures is reshape the stomach. When we’ve completed the Gastric Sleeve operation, the stomach goes from being round to looking more like a banana.
Gastric Sleeve results in less risk of many long-term complications. By not rerouting the intestine, we cut out the risks of malnutrition, ulcers and other potential problems. For weight-loss results, we see similar numbers between the Gastric Bypass and Gastric Sleeve procedures.
We talk about Gastric Bypass as a final stop. The Gastric Sleeve can be a midway procedure. If there are problems in the future (like troubles with heartburn, for example) we can always change the sleeve to a bypass with a Revision procedure. You can’t move backwards and change the bypass into a sleeve. Gastric Bypass is a more final procedure. Once it’s done, there are very few avenues to change things if complications do arise.
The Gastric Band procedure was extremely popular when it first came about as an alternative to gastric bypass surgery. This procedure is reversible since the band can be removed. However, it can be unpredictable and interfere with the quality of life. Some patients experience difficulty eating afterwards, and often have to have the band loosened or tightened. The emergence of the Gastric Sleeve procedure as an alternative to Gastric Bypass has decreased the demand for the band. We do still see patients with the band doing well, but the procedure is becoming less common.
Gastric Balloon is the least invasive procedure, and is recommended for class 1 and class 2 obesity, and not necessarily for those struggling with morbid obesity. This procedure is nonsurgical and reversible. The balloon is inserted endoscopically and is removed after 6 months.
What Risks & Complications Are Possible?
Bariatric surgery has become an extremely safe procedure thanks to modern medicine. The complex surgeries like gastric bypass and gastric sleeve procedures have the same safety profiles as gall bladder surgery or hysterectomies. Having said that, it’s still important to cover potential risks and complications. Just like with any medical procedure, it is vital that we as medical professionals be prepared for any problems that could potentially arise—no matter how uncommon. We like to break down the potential risks and complications of bariatric surgery into two categories: short-term and long-term.
Short-Term risks include infection. As with any surgical procedure, there’s a possibility that during a slow healing process a leakage can occur leading to infection. This is an extremely rare event in programs like ours with a long history and enough experience to achieve extreme levels of safety. If an infection does occur, we can take care of it. Infections like this happen very soon after the procedure, so we educate our patients on the symptoms and emphasize the importance of calling if they experience anything that could indicate a complication. Blood clots are another short-term risk, but we take measures like blood-thinning medications to reduce this risk.
Important long-term risks include malnutrition, vitamin deficiency, acid reflux and bowel blockage. After Gastric Bypass, the body doesn’t fully reabsorb the food it takes in. This is great for weight loss, but it can open patients to risk of vitamin deficiencies and malnutrition. With the help of daily vitamins and consistent blood work, we can prevent and control any potential deficiencies.
One downfall of the Gastric Sleeve is that some may develop heartburn or acid reflux post-procedure, which isn’t as common with Gastric Bypass. There are steps to treat this condition, and with consistent follow-up, physicians can help treat symptoms.
Can’t I Just Take a Weight-Loss Medication to Lose Weight?
Weight-loss medications like Ozempic can certainly be beneficial in your weight-loss journey. However, they are often marketed as a one-step simple solution guaranteeing results without risks. We know as metabolic specialists that such a solution doesn’t exist.
Morbid obesity is a chronic illness and an extremely difficult issue to tackle. Both weight loss drugs and bariatric surgery are potential solutions that are appropriate in certain circumstances. A decade ago, you’d be lucky to find a medication that offers 5%-10% weight-loss. Today, we have medications which can result in up to 25% weight-loss. Those results don’t happen in every patient, but as metabolic specialists, we see this as a viable option in certain circumstances. The major downfall of medication is that a patient must remain on the medication indefinitely for that weight loss to be maintained. When people stop taking medication, studies show that the weight tends to come back. Medication can cost up to $2,500 a month, which isn’t realistic for every patient.
These results can also take up to 68 weeks to fully materialize. Oftentimes, our bariatric patients at CHRIAS don’t have that amount of time to lose. They’re already at a severe point in their health that demands intervention. In more severe cases, bariatric surgery is the more common and often more powerful tool.
How much weight can I expect to lose?
With a variety of factors to consider, it’s impossible to predict exact weight-loss. However, there are plenty of statistics to give patients an idea of how much weight can possibly be lost with surgery and our weight-loss program post-procedure. On average, people lose approximately 75% of excess weight within a year after a gastric bypass. The gastric sleeve procedure can produce similar results.
Dramatic results are dependent on factors outside of the operation itself. Genetic makeup, food intake, exercise frequency and intensity, metabolic rate and more factors can impact weight-loss results. We support patients in a variety of ways post-procedure to help them lose and maintain a healthy weight including support groups and follow-up consultations.
What can I expect after surgery to maintain health and weight-loss?
The phase after your operation is an important piece of the journey. From the days following the procedure to long-term weight management, our programs are made to not only help patients lose weight, but also keep it off and experience a higher quality of life. Most of our bariatric procedures are outpatient procedures. After gastric sleeve or gastric bypass surgery, most patients can expect to be back home the same day.
In the days that follow, patients are placed on a liquid diet. After surgery, it’s important to get plenty of fluids and stay well-hydrated. Liquids like water, Crystal Light, decaffeinated tea and light soup are all acceptable. An all-liquid diet may seem difficult, and people worry about that. But you won’t experience any hunger in the early stages after bariatric surgery. During the early stages, it’s also important to exercise. That doesn’t mean go to the gym and sweat it out—but movement can enhance recovery. The level of exercise is dependent on the patient’s individual needs, but going for short walks post-procedure is a good start.
Medical monitoring is also an important part of the post-surgery phase. We want to see patients at CHRIAS to check on any changes, but we also want them to follow up with their primary care physicians. Often, when patients start seeing impressive results, they neglect the follow-up process which could lead to new problems down the road. Many patients, for example, are on blood sugar or blood pressure medication before the operation. Once they begin to lose a substantial amount of weight, their blood pressure and blood sugar begin to balance out. Your doctor may need to adjust your medication based on the positive results of your surgery. Bariatric surgery shouldn’t be about exchanging one illness for another. Without consistent follow-up, it’s impossible for medical professionals to prevent issues before they arise.
How can I expect bariatric surgery to improve my overall quality of life?
From diabetes and hypertension to sleep apnea and joint pain, obesity can cause a variety of complications and ailments. Bariatric surgery—by assisting patients in losing dramatic amounts of excess weight—can offer relief from a wide range of burdens and comorbidities. Looking at the top causes of mortality in the United States like cardiovascular disease, metabolic diseases like Type 2 Diabetes and a variety of cancers—many of these issues can be linked to obesity.
For many people in the United States, living a longer and healthier life is dependent upon weight-loss. Many patients can decrease their dosage or stop taking medication for things like high blood pressure, diabetes, hypertension, sleep apnea and more. Along with improved physical wellbeing, there’s a feeling of liberation from these conditions.
Often, people who struggle with obesity also struggle with their sexual health. Whether it’s psychological issues related to body image or physical limitations, sexual health is generally increased after bariatric surgery. Many people don’t realize the connection between morbid obesity and hormonal imbalance. A healthy sex life is inherently linked to overall health and is an important aspect of physical and mental wellbeing that obesity often negatively impacts.
Another aspect of morbid obesity is the social stigma. Physical weight tends to come along with mental weight from negative societal perceptions. Those struggling with obesity often also struggle with increased rates of anxiety and depression. Even as we fight to reduce negative stigma, the effect they have on those currently struggling with obesity is undeniable. Once patients lose weight, it often has a positive impact on their mental and social health as well.
Where can I look to learn more about bariatric surgery?
CHRIAS offers a variety of resources for both current and potential patients. One of our best resources is our YouTube channel, where we post Bariatric Friday live streams, Q&A’s with one of our experienced surgeons and more information related to the obesity epidemic and bariatric procedures.
Our website is another great resource for those hoping to learn more about bariatric surgery.
What’s this?
This content is made possible by our partner. It is not written by and does not necessarily reflect the attitude, views, or opinions of the Delaware Today editorial staff.
