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Hello and welcome to the Bryan Bariatric Advantage Information
Session.
This video will answer common questions
about weight loss surgery and the process
leading up to surgery.
Our program includes surgeons, a dietitian,
and nurse practitioners.
Together, we will prepare and support you
through this process to help you achieve your goals.
My name is Tara and I am the nurse practitioner
who will guide you as you prepare for your surgery
and in your follow up care.
During this video, you'll also hear
from our surgeons about how weight loss surgery works
and the different types of surgeries.
As well as our dietitian and a mental health professional
about their roles to help you on your weight loss journey.
Obesity is a chronic disease that
can take a significant toll on your health.
There are several serious medical conditions
linked to obesity, such as high blood pressure, type 2
diabetes, sleep apnea, and joint pain.
Obesity can also affect a person's ability
to perform regular daily activities.
There are many factors that influence obesity.
One of the factors is the environment.
This includes our Western diet that is high in processed,
prepackaged foods, fried foods, and sugar.
We have become a society of convenience
and are more sedentary in our jobs and our daily lives.
Medications and genetics are also a contributing factor
to obesity.
To be considered a candidate for surgery,
we use a measurement called BMI, or Body Mass Index.
This is the ratio of weight to height.
Insurance companies that cover weight loss surgery
use this in the consideration to qualify for surgery.
Bariatric surgery may be a treatment option for patients
with a BMI greater than 40.
Patients with a BMI greater than 35
can be considered if they have conditions
such as high blood pressure, sleep apnea, or diabetes.
These are conditions that have shown improvement
after weight loss surgery.
Patients should have a history of attempting
to lose weight without achieving or maintaining
beneficial weight loss.
Bryan Bariatric Advantage is part of the Bryan Medical
Center.
We are the only hospital in Lincoln accredited
as a center of excellence for bariatric surgery
through the Metabolic and Bariatric Surgery Accreditation
and Quality Improvement Program.
The value of having surgery at a center of excellence
is knowing that you're being taken care
of at a facility that has gone through a rigorous review
process.
Accreditation requires that we maintain the resources
and uphold the standards of practice for bariatric surgery.
We have also been designated with Blue Cross Blue Shield
Blue's Distinction Plus and as a United Health Care
Center of Excellence.
These are very distinguished designations only
awarded to programs with a proven history of delivering
exceptional care and results.
To understand how weight loss surgery works,
it is helpful to know about the normal digestive process.
After food is chewed and swallowed,
it moves down the esophagus to the stomach.
This is where digestive juices start breaking down
the food we've eaten.
The food then travels through the stomach
to the small intestine, or bile, and other digestive enzymes
continue to break down food.
In the small intestine, nutrients from food
are absorbed.
At Bryan, bariatric surgery is done laparoscopically
whenever possible.
The benefits of laparoscopic surgery
include faster recovery time, less pain, and lower risk
of hernias and infections.
This procedure can be done with traditional laparoscopic
surgery or with a state of the art robot that replicates
the surgeon's hand movements.
Gastric sleeve is the most popular bariatric surgery
due to its potential for significant weight loss
and low risk of complications.
With this surgery, we remove about 80% of the stomach
so that it looks like a long tube or sleeve.
The reduced stomach size helps you feel full faster
and this decreases your appetite.
The small intestine remains intact to absorb
the nutrients your body needs.
Advantages of gastric sleeve surgery
include potential for significant weight loss
similar to gastric bypass surgery, no rerouting
of the intestinal tract which can cause short and long term
problems.
Nutrients and vitamins continue to be absorbed by your body
and secretion of the hunger hormone
is reduced, making you feel less hungry.
Disadvantages of gastric sleeve surgery
include the risk of a leak, which
is when the gastric contents leak out of the stomach
and into the abdominal cavity.
There's also the possibility of increased acid reflux.
And the procedure is not reversible.
As with any surgery, there are risks.
These can include side effects of anesthesia.
And if people aren't active enough after surgery,
blood clots in the legs and lungs.
The most common side effects are nausea and vomiting,
dehydration, gas, and bloating, temporary hair thinning
or loss, constipation, and depression.
With lap band surgery an inflatable band
is placed at the top of the stomach
to create a small pouch.
This decrease in the size of the stomach
allows you to feel fuller faster.
The band is filled with saline to make it larger or smaller
as needed for each patient.
The advantages of lap band surgery
include it's less invasive, the body
continues to absorb the nutrients it needs so there's
no vitamin, mineral, or protein deficiencies
due to malabsorption, there's no rerouting
of the intestinal tract, and the band
can be removed at any time.
The disadvantages of lap band surgery
include slower and less weight loss
than other bariatric surgeries.
A foreign object, the lap band, is placed in the body.
There's a risk of the band moving or breaking
down, which may result in needing a second surgery.
A risk of mechanical failure of the band.
The possibility of saline leaking from the band,
and the need for routine follow up for band adjustment.
Gastric bypass surgery reroutes food
passed most of the stomach and part of the small intestine.
A new small stomach is created.
This limits the amount of food a person can eat.
The small bowel is divided and one end
is attached to the new stomach pouch.
The other end of the small intestine,
which is still connected to the non-functional end
of the stomach, is then reconnected farther down
the intestinal tract, allowing digestive enzymes
to mix with food, creating less absorption of calories
and nutrients.
The advantages of gastric bypass surgery
include faster initial weight loss, a potential
for significant weight loss, improve control of diabetes,
and in some cases, reduces or even eliminates
the need for diabetic medications.
The disadvantages of gastric bypass surgery
include the risk of developing ulcers, hernias, and bowel
obstructions malnutrition, vitamin deficiencies,
and sometimes anemia.
Also, the size of the gastric pouch
can increase, causing weight regain.
It is important to understand that bariatric surgery is
a tool for weight loss.
It's not a fix for obesity.
Maintaining weight loss takes commitment
and personal responsibility.
Long term success depends mostly on a person's motivation,
knowledge, and lifestyle behaviors.
We will help you prepare for surgery
in a way that focuses on reaching your long term goals
and meeting your insurance requirements.
We start with a one on one consultation
with the surgeon or a nurse practitioner.
We will discuss your medical history
and make sure that surgery is safe and appropriate for you.
We will also visit about other evaluations
and medical clearances that you may need.
These can include, but are not limited
to a psychological evaluation, exercise consultation,
and a pulmonary clearance.
Insurance may require three, six, or up to 12 months
of medical weight management.
At these appointments, you will learn
what types of diet and lifestyle changes
will help you achieve the best results after surgery.
We will monitor your ongoing medical conditions
and work with other members of your health care team
to coordinate your care.
Our team at Bryan Counseling Center
will help you prepare mentally and emotionally
for your surgery.
Everyone has some level of stress
if they are having surgery.
With weight loss surgery, this can go beyond the procedure
because of the many changes you will be making in your life
before and after surgery.
This includes diet, exercise, and lifestyle habits.
Through a series of two to three visits,
we will evaluate your readiness for surgery.
During these visits, we will discuss your health and life
history, ways you manage daily stress,
and your support system.
We will also look at your coping skills
for the upcoming changes in your life
and direct you towards developing
the skills you need to succeed.
My role here as a dietitian is to prepare my patients
for surgery by educating you on the basics of nutrition
and the behavior and diet changes necessary to succeed.
After an initial nutrition assessment,
will meet monthly to talk about key items
important to your success.
We will identify where you struggle with food,
develop a plan and monitor your progress.
Depending on your surgery, you will have a specific diet plan
to follow.
You'll go through what we call a diet progression.
This allows your stomach to heal after surgery
and also can help avoid issues such as nausea and vomiting.
As your diet progresses, we recommend a lower carb diet
with an emphasis on getting an adequate amount of protein.
After surgery, I meet with patients
routinely to ensure their long term success.
Follow up after surgery will help with your weight loss
success and your overall health.
It's important to us that we continue
to work with you after surgery.
We even offer a monthly support group and a monthly newsletter.
At Bryan Bariatric Advantage, our surgeons,
nurse practitioners, and dietitians
are here to support you.
This along with your lifelong commitment
to healthy eating, lifestyle changes,
and regular physical activity are the keys
to your long term weight loss.
When you choose Bryan Bariatric Advantage,
you become part of our family.
We're here to help you achieve your goals.
From your first appointment to years after surgery
we're excited to guide and assist you
through this transformation.
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