Weight Loss Surgery Presentation from the Utah Center for Minimally Invasive and Bariatric Surgery

Weight Loss Surgery

Catherine Beck M.D. and Jeffrey Eakin M.D.

ABOUT US

Dr. Catherine Beck

Dr. Jeffrey Eakin

Center for Minimally Invasive and Bariatric Surgery

Jordan Valley Medical Center

www.cmibs.com

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FOR STARTERS

Dr. Catherine Beck

Dr. Jeffrey Eakin

Center for Minimally Invasive and Bariatric Surgery

Jordan Valley Medical Center

www.cmibs.com

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Section 1

Taking the first step

Congratulations...because reading or hearing this material is the first step toward loosing weight and

changing your life!

Commitment is necessary for such a big change, and it starts with small steps and the decision to change.

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Section 2

Why loose weight•Not just for appearances

•Everyone has their own reason

•Often people do it to:

• feel better

•be able to be more active with kids

•have more energy

•be healthier

• respond and fix a new medical problem

• live longer

•stop taking medications

•decrease the need for so many doctor’s appointment

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BMI

Dr. Catherine Beck

Dr. Jeffrey Eakin

Center for Minimally Invasive and Bariatric Surgery

Jordan Valley Medical Center

www.cmibs.com

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Section 1

What is BMI?

BMI is short for body mass index

Basically...it is your weight divided by your height

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Section 2

Sample BMI calculation

Example Calculation

If a patient is 5’5” tall and they weigh 275 lbs

BMI = 45.8

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Section 3

What is my BMI?

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Section 4

Same for definitions men and women

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WEIGHT LOSS OPTIONS

Dr. Catherine Beck

Dr. Jeffrey Eakin

Center for Minimally Invasive and Bariatric Surgery

Jordan Valley Medical Center

www.cmibs.com

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Section 1

4 Main Options

•Diet

•Exercise

•Medically supervised weight loss

•Weight loss (bariatric) surgery

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Section 2

Diets

•Diets don’t work

•“Diet” implies a transient state of being = short term fix

•Need complete change of lifestyle

•Many people have medical illnesses limiting their abil-ity to exercise - like arthritis

•Overweight individuals often embarrassed to exercise of join a gym

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Section 3

Motivation and Habits

Motivation

is what gets you started;

Habit

is what keeps you going

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Section 4

Diets

•Studies show high rate of weight regain

•no singular diet has been proven to be be best

•Diets (on average) only produce an 8 pound weight loss

•Only sustained over a 2 year period

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Section 5

Diets and exercise

•Successful diets and exercise are done in tandem

•Should lose of one pound per week

•Thus, over 3 months = 12 pound weight loss

•That is successful!

•But...usually frustrates patients because it’s slow

•Almost doesn’t feel worth the hard work

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Section 6

4 Main Options copy

•Diet

•Exercise

•Medically supervised weight loss

•Weight loss (bariatric) surgery

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Section 7

Medically supervised weight loss

•Regular appointment with:

•medical weight loss physician

•registered dietitian

•Techniques used:

•behavioral changes

•prescriptions medications

•

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Section 8

Medically supervised weight loss

•Treatment focuses on:

•educations...what to eat and how to exercise

•stimulus control...break old habits

•cognitive restructuring...retraining the brain

•goal setting...where are you going...1 lb. a week

•self monitoring...keeping a journal...or mobile app

•contracting...commitment

•social support...family, friends and other patients

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Section 9

Medically supervised weight loss

•Can achieve:

•10% weight loss (400 lbs = 40 lbs)

•25% excess body weight loss (400 lbs = 50 lbs)

•duration loss depends on duration of treatment

•Weight loss of merely 5% can improvement illnesses

•So if 100 pounds overweight...losing 5 pounds can im-prove some of your medical problems!

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Section 10

Bariatric surgery

•Diet

•Exercise

•Medically supervised weight loss

•Weight loss (bariatric) surgery

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Section 11

Surgical weight loss for Obesity realted illnesses

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Diabetes

Hypertension

Coronary artery disease

Heart Disease

Arthritis

Daytime tiredness from sleep apnea

Section 12

Weight loss (bariatric) surgery results

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weight loss of 50-60% excess body weight

Reduction in death from cancers (especially

colon and breast cancers)60%

Reduction death from heart disease 60%

Reduction in death from diabetes 90%

Section 13

Weight loss (bariatric) surgery results

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diabetes gone and off meds 75%

No longer have high blood pressure 60%

No longer have sleep apnea 80%

No longer have high cholesterol 60%

Section 14

What to expect after deciding to pursue surgery

Team Approach

Two Bariatric Surgeons

•Dr. Catherine Beck

•Dr. Jeffrey Eakin

Medical Weight loss Specialist

•Dr. Gayle Stewart

Registered Dietitian

• Ariel Miller RD

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Section 15

Process before weight loss surgery

•Insurance Verification

•Initial visit with the surgeon...best operation

•Psychologic assessment

•3 - 6 month medically supervised weight loss

•Insurance approval, pre-op diet, surgery scheduling

•1 - 2 day hospital stay

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Section 16

Process before weight loss surgery

•Follow-up schedule after surgery:

•2 weeks

•4 weeks

•Every 3 month for 2 years

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Section 17

Psychological asessment before surgery

•Why the psychology assessment?

•Insurances require it

•It ensures you resources available to make a com-plete change in lifestyle

•Ensures you can handle major changes after surgery

•Rule out illness (e.g. drug and alcohol abuse

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Section 18

Why the 3 - 6 month period of weight loss?

•Most insurances require a trial period of weight loss

•It ensures you have the education and tools to have successful weight loss.

•Unfortunately everyone can “eat through any surgery.”

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Section 19

Visits before surgery

•Visit with surgeon

•Dietitian evaluation

•Psychology evaluation

•Physical therapy evaluation

•Medical weight loss counseling

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Section 20

Scopes before surgery

•Possible colonoscopy

•Upper endoscopy

•Possible reflux and acid testing

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Section 21

Tests before surgery

•Chest x ray

•X-ray of esophagus and stomach

•Blood draws

•EKG

•Study of esophagus and how it works

•Possibly mammogram

•Ultrasound to look for gallstones

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Section 22

Things to stop before surgery

•Smoking cessation...never again!

•Cessation of hormonal birth control

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Section 23

Things to stop before surgery

Did we mention smoking cessation?

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Section 24

You can do it for a new “me”

•Feels like:

•A lot of work

•Enormous commitment and

•A lot of appointments

•...It is

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Section 25

You can do it for a new “me”

•We want you to be safe and be successful!

•Guide you through each step so its not overwhelming

•Your heaviest weight will be at your first appointment

•You can do it!

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WHO QUALIFIES FOR WEIGHT LOSS (BARIATRIC) SURGERY

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Section 1

Am I a candidate for weight loss surgery

If you make the decision to go with surgical solutions...how do you know if you qualify?

Requirements to Qualify for Bariatric Surgery

•BMI > 35 with 2 or obesity related illnesses

•BMI >40 with or without obesity related illness

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Section 2

Obesity realted illnesses

High blood pressure

Diabetes

Weight bearing arthritis

Cardiovascular disease

Obstructive sleep apnea

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Section 3

Obesity realted illnesses

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Diabetes

Hypertension

Coronary artery disease

Heart Disease

Arthritis

Daytime tiredness from sleep apnea

Section 4

Other illnesses related to obesity

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high blood pressure high cholesterol

Diabetes Sleep apnea

pulmonary hypertension Thyroid Disease

Heart Disease Back Pain

Osteoarthritis depression

infertility/PCOS gallstones

uterine cancer breast cancer

esophageal cancer cancer gallbladder cancer cancer

colon and rectum cancer kidney cancer

thyroid cancer liver disease

Section 5

Same for definitions men and women

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Section 6

Cost for weight loss surgery

•Different plans = different coverage and requirements

•Some say...“one surgery per lifetime” limitations

•There are self pay options

•Our team will takes care of all of this

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Types of weight loss (bariatric) surgery

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Section 1

Laparoscopic Gastric Banding

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Section 2

Advantages of laparoscopic Gastric Banding

•Excess body weight loss 40%

•Stomach is not cut or stapled

•No new connections ( e.g. between stomach and bowel)

•Short hospital stay

•Reversible and adjustable

•Low risk of vitamin deficiencies

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Section 3

What is laparoscopic Gastric Banding

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Section 4

Disadvantages of Laparoscopic Gastric Banding

•Slower weight loss

•Foreign body implantation (chance for infection)

•Band can slip and erode into stomach

•May cause damage to (hole in) esophagus

•Requires strict compliance

•Requires constant follow-up

•Highest rate of reoperation

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Section 5

Laparoscopic sleeve gastrectomy

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Section 6

Advantages of laparoscopic sleeve gastrectomy

•Decreased the amount of food that can be eaten

•Helps brain response to hunger

•Helps hormonal response to hunger

•Weight loss similar to gastric bypass

•No foreign body

•No new connections (like in gastric bypass)

•Short 1 Day Hospital Stay

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Section 7

What is a laparoscopic sleeve gastrectomy

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