Post-Bariatric Surgery Guidelines Can Boost Your Odds of Success
New guidelines released by the Endocrine Society aim to help bariatric surgery patients avoid some common post-surgery pitfalls, including weight regain, nutritional deficiencies and the progression or development of any diseases related to obesity. The guidelines appear in the November 2010 issue of the Journal of Clinical Endocrinology & Metabolism.
The expert panel calls for:
A Multidisciplinary Team Approach
All bariatric surgery patients should receive follow-up care from a multidisciplinary team of experts that includes a primary care physician, endocrinologist and gastroenterologist. This team can work together to help prevent weight regain, and provide guidance about options when and if weight regain should occur.
"Many people have a hope that surgery is the magic bullet and will cure their weight problems forever," says Jacqueline Stark Odom, PhD, the director of psychology at Beaumont Weight Control Center in Royal Oak, Michigan, and a member of the editorial advisory board for the Consumer Guide to Bariatric Surgery. "That is wishful thinking [and] we are seeing weight regain due to people taking a passive approach toward lifestyle change."
Dr. Odom adds that "the importance of a multidisciplinary team approach is critical to short- and long-term success for bariatric patients."
While some bariatric surgeries can help reverse diabetes or allow people to cut back on their diabetes medications, weight regain may cause diabetes to recur or worsen. Other diseases associated with obesity and post-surgery weight gain may include polycystic ovarian syndrome, metabolic bone disease, fatty liver disease, gout, high blood pressure and sleep apnea.
Intensive Nutritional Education
All bariatric surgery patients, including those who have undergone Lap Band or Realize Band surgery, should participate in nutrition educational programs, and they should be followed closely to prevent, detect or treat nutritional deficiencies. This is essential among those who had malabsorptive surgeries such as gastric bypass. Malabsorptive surgeries increase the risk for nutritional shortfalls because they block the absorption of food nutrients. Such shortfalls can affect bone health and may necessitate supplements of calcium and vitamin D to prevent bone loss, for example. A yearly bone density test can help you stay one step ahead of bone loss and fractures, and regular blood tests can determine if your body is lacking any specific nutrients. For more information, visit our comprehensive article on bariatric surgery nutritional supplements.
Post-bariatric follow-up care can also help troubleshoot vomiting and dumping syndrome (intense nausea and cramping when the contents of your stomach are "dumped" into your small intestine too quickly). These unpleasant side effects tend to occur after bariatric surgery as your body gets used to its new, smaller stomach. Your doctor can teach you about trigger foods to avoid, and provide other helpful tips such as not drinking within a half-hour of eating.
The Endocrine Society plans to focus future research on assessing just how effective intensive postoperative nutritional and endocrine care are in the reduction of morbidity and mortality from obesity-associated chronic diseases.
Shawn M. Garber, MD, FACS, FASMBS
Spencer A. Holover, MD, FACS, FASMBS
John D. Angstadt, MD, FACS, FASMBS
Eric A. Sommer, MD
Nikhilesh Sekhar, MD, FACS, FASMBS
The New York Bariatric Group
275 Seventh Avenue
New York, NY 10001
NYU Medical Center
530 First Avenue
New York City, NY 10016
The Valley Hospital's Center for Metabolic and Weight Loss Surgery - Columbia University
579 Franklin Turnpike
Ridgewood, NJ 07450