Arturo Rodriguez, MD

January 23, 2010

Here is my Lapband Story…

Here is my Lap Band Story…

I was overweight most of my life.  I had tried every diet out there only to gain all the weight back. I was depressed and frustrated.  I had heard so many Weight Loss Surgery success stories and realized that Lapband surgery was my only option for permanent Weight Loss. While researching my options I ran across Dr. Arturo Rodriguez’s website and decided to call.  I was skeptical about traveling outside the U.S. but after a lot of research I was certain that Dr. Arturo Rodriguez was the right doctor for me. 

An important thing I learned in my research was that the experience of your Lap-band Surgeon plays a huge role in your success with Lap-band.  Dr. Arturo Rodriguez has performed thousands more Lap-band Surgeries than any doctor I could find in the U.S.  I decided that if I was going to have this surgery I wanted the best Surgeon to do it!

My experience in Monterrey was amazing!  I was greeted at the airport and taken directly to the hospital.  When we arrived, Dr. Rodriguez and his assistant met my husband and I.  They discussed everything that would take place.  After surgery I was taken to my hospital room.  There was always a nurse to help if I needed.  I have never received such good care in any hospital in the U.S. as I did in Monterrey.

The next day I was picked up and taken to my hotel room and later that evening, one of  Dr. Arturo Rodriguez’s staff came to check on me and take my husband and I around Monterrey.  The next day someone picked us up and drove us to the airport.  We never had to worry about a single thing the entire time we were there.

My life since Lap-band Surgery has changed dramatically. I can play with my boys and not get tired, I’m more outgoing, I wake up and my back doesn’t hurt, and I have endless amounts of energy.  It’s also taught me what true portion control is and given me the skills to lifelong Weight Loss!  I’ve learned what it takes to keep the weight off forever!  Most importantly I have eliminated my chances of acquiring obesity related illnesses. 

I have Dr. Arturo Rodriguez and the Lap-band Surgery to thank for all of this.  It changed my life so much that my Mom even decided to have Gastric Bypass Surgery (by Dr. Arturo Rodriguez of course) and she too has had amazing success losing over 100 lbs and going off many of the medications she was on prior to surgery. In fact, I was so impressed by Dr. Rodriguez and his staff that when the opportunity came to work with them and to help others see the many benefits of this surgery, I jumped at the chance.

I would love to talk to you about how much this amazing Surgery can change your life and why Dr. Arturo Rodriguez is the right Surgeon for you.

shelby

Shelby, Lapband patient, http://www.thebariatric.com

 

Shelby Hashagen

Patient Coordinator / Dr. Arturo Rodriguez

(360) 304-0610

shelby@thebariatric.com

http://www.thebariatric.com

Originally posted 2009-03-25 19:53:23. Republished by Blog Post Promoter

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December 12, 2009

Plastic Surgery after Bariatric Surgery (Lap band, Gastric sleeve or Gastric bypass)

Plastic Surgery after Bariatric Surgery (Lap Band, Gastric sleeve or Gastric Bypass):

I know many individuals that are attracted by the idea of starting over.  It’s important for an individual to discover what they did wrong, and how we can change.  There is a need to lose weight or to keep the weight off successfully, to change your diet, to do some kind of exercise, to get fit and to stay fit by increasing your activity, to look younger, to have a totally new body so you can improve your body image. We are often dissatisfied or discontent with what we have, especially relating to our appearance – we want more or we want to look better!

Plastic Surgery has almost become a necessity for patients that have had a Bariatric procedure such as the lap band, gastric sleeve or gastric bypass.  Patients who have undergone bariatric surgery and are looking for Plastic Surgery should know that they will need more Reconstructive Surgery than just the normal Aesthetic Procedures such as Liposuction. This means that Liposuction (the most frequent plastic surgery among all the population) or a tummy tuck would not be enough, and in most cases they will need a Plastic Surgeon who has experience working with patients that have undergone a Bariatric procedure.

Patients that have lost a lot of weight after a Bariatric procedure have different personal image concerns and plastic surgery needs.  Before performing any procedure, the doctor must consider your age, your muscle tonicity, the amount of weight loss, the skin laxity or elasticity, the skin excess and the hygiene difficulty.

Frequent Questions among Lap Band Patients

Q: When is the best time to have a Plastic surgery after my Bariatric procedure?

A: The best time for Plastic Procedures for Lap Band patients is after reaching 60% of excess weight loss.

 

Q: Where can I start?

A: You should discuss your needs first, the surgical options and the cost of each procedure with your Plastic Surgeon and at that point, start planning a Plastic Procedure on what you can afford, what you want to improve or what bothers you most.

 

Q: Should I have all plastic surgery done at once?

A:  As a Surgeon I recommend to my patients to schedule plastic surgery in phases and not to have Plastic surgery done all in one procedure.  You have to consider that most of the Plastic surgery completed on a Bariatric patient takes a lot longer than in non-obese patients and this means that the surgery will be 6-8 hrs in the OR under general anesthesia.  There is also more blood loss and many times the patient may need to have a blood transfusion if there is a lot of work needed.

 

Q: How long does it take?

A: The Tummy Tuck takes 2.5 to 6 hrs depending on the patient needs.  The breast Lift takes 3.5 hrs.  A lower body lift takes 3 to 6 Hrs.

 

Q: What is the cost?

A: The cost varies from doctor to doctor but each procedure can cost from 6 up to 10 thousand USD

 

What to expect after Plastic Surgery in Lap band patient

Most of the procedures require a one or two night hospital stay. You will need to be out of work for about 10 days after surgery and you will also have drains for 5 to 7 days.  The patient must also wear a compression garment for several months.  While the scar is healing, the patient will also need oral antibiotics.

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-10-23 08:17:51. Republished by Blog Post Promoter

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December 5, 2009

Life After Gastric Bypass Surgery

Life After Gastric Bypass Surgery

There are a number of important things to consider for patients after they have had Gastric Bypass Surgery. Take some time to read through the information and get informed if you are considering this procedure.

Diet

After having a gastric bypass, the modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss.  Without these necessary changes, such as decreasing or limiting your intake of high-fat, high-sugar foods, you may stop losing weight or even begin to gain weight again.  Limiting high intakes of sugary foods is especially important to decrease the chance of Dumping Syndrome, where these foods move too quickly through the digestive tract into the intestine and can cause cramping, pain and discomfort, among other related symptoms.

Post-surgery dietary guidelines will vary by surgeon. You may hear of other patients who are given different guidelines following their gastric bypass surgery. It is important to remember that every surgeon does not perform the exact same weight loss surgery procedure and that the dietary guidelines will be different for each surgeon and each type of bariatric procedure.

What is most important is that you adhere strictly to your surgeon’s recommended guidelines. The following are some of the dietary guidelines I recommend after a gastric bypass:

  • During 4 weeks you will go on a liquid diet and advance in steps to a puree/baby food type diet for one or two additional weeks and transition to an almost normal (solid food) diet after that.
  • When you start eating solid food it is essential that you chew thoroughly.
  • You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.
  • Don’t drink fluids while eating. They will make you feel full before you have consumed enough food or they will flush down more food than you should be taking in.
  • Omit desserts and other items with sugar listed as one of the first three ingredients.
  • Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.
  • Avoid alcohol.
  • Limit snacking between meals.

Going Back to Work

Your ability to resume pre-surgery levels of activity will vary according to your physical condition, the nature of the activity and the type of gastric bypass you had (open or laparoscopic). Many patients return to full pre-surgery levels of activity within six weeks of an open Gastric Bypass procedure. Patients who have had a minimally invasive laparoscopic procedure may be able to return to these activities within a week.

Birth Control & Pregnancy

It is strongly advised that women of childbearing age use effective forms of birth control during the first 16 to 24 months after a gastric bypass surgery since the fertility increases during weight loss. The added demands pregnancy places on your body and the potential for fetal damage make this a most important requirement.

Long-Term Follow-Up

Although the short-term effects of weight loss surgery are well understood, there are still some questions to be answered about the long-term effects on nutrition and body systems. Nutritional deficiencies that occur over the course of many years are well known if you don’t take the recommended supplements. You will take supplements of Vitamins and Minerals (such as calcium and iron) for life and have a full blood work test done at least once every year.

Support Groups

The widespread use of support groups has provided weight loss surgery patients an excellent opportunity to discuss their various issues.  Most learn, from example, that weight loss surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on their emotional well-being. Most surgeons have support groups in place to assist you with short-term and long-term questions and needs. I highly recommend enrolling into a support group.

Be cautious when turning to message boards as they are full of doctor’s coordinators or brokers more concerned with increasing business in their direction than providing support. You have to be aware of their presence and not allow them to manipulate you; they are only interested in gossiping or scaring you when you are only looking for the right answers.

Most bariatric surgeons who frequently perform weight loss surgery will tell you that ongoing post-surgical support helps produce the greatest level of success for their patients.

Arturo Rodríguez, MD

Bariatric Surgeon

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-10-26 07:45:58. Republished by Blog Post Promoter

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July 20, 2009

Why My Weight Loss Procedure Can Fail?

Why My Weight Loss Procedure Can Fail?

The first and most important step to minimize the chances of failure from a Bariatric procedure and to increase your success rate is to be well informed about each one of the surgeries before you choose any of them.

What should you know about Weight Loss Surgery?

  • How does each procedure work? How will they assist in weight loss?
  • What should you expect from the Lap Band, Gastric Sleeve, or Gastric Bypass procedures, in terms of weight loss and/or Type 2 Diabetes
  • The difference in short and long-term benefits for each procedure
  • The operative risks and complication rates for each procedure
  • How much follow-up and support will you need for each procedure
  • How much of the Total Patient Care (TPC) program services will you need
  • What kind of adjustments will you need following surgery?
  • What kind of commitment is expected from you, for each procedure
  • What should you expect from the Doctor or Bariatric Group that you choose
  • The surgical options you have for each of the procedures in case of a failure
  • Finally, the cost of each procedure

What should you know about the Doctor or Bariatric Group?

You have to be well informed about the Doctors and medical team performing the Lap Band, the Gastric Sleeve or the Gastric Bypass.  Choose your surgeon and medical team wisely in order to ensure the best results for your weight loss success.

  • Ask about their education and training credentials if you are planning to go to a Latin Country. Look for Medical Degrees in Private Colleges like Monterrey Tech, University of Monterrey, or LaSalle School of Medicine, or other reputable medical universities.
  • Ask about where they received their Surgical Training. There can be a big difference in the treatment you will receive between doctors trained in well-known Private Hospitals, rather than in the Social Governmental Health Care System.
  • Ask about their Diplomas. Did they have to write a Medical Tests to join the Medical Society or Surgeon group, or did they just pay a subscription fee to become a member?
  • Check the number of Revision Surgeries they have been involved with. This may give you an indication of the quality of their work.
  • Check their Surgical Staff for credentials and experience. Consider the Anesthesiologist and any other assistant surgeons. It is important that they have experience in Bariatric surgery.
  • Double-check the Ethics and Professionalism of their Promoters or Coordinators.
  • Finally, check the Follow Up and Support they would provide you after your surgery.

Diet Rules to Follow (Regardless of the Weight Loss Procedure you Choose)

For any weight loss method to be successful and effective, you have to make some healthy lifestyle choices regarding the foods that you eat.  Bariatric surgery is an effective way to increase the rate of weight loss, but the best results can only happen when you make healthy choices.  After Bariatric surgery, you will feel full with a smaller amount of food – make sure to choose foods with the most nutritional value to help you on the journey to a new, healthier you!

  • Follow the Diet Steps recommended by your Doctor or the Nutritionist after surgery.
  • Chewing very well will help to maintain the pouch size, preventing stomach stretching and decreasing the risk of blockages and reflux in the esophagus or stomach.
  • Eat 6 small meals a day.
  • Eat slowly; take your time at the table.
  • Preferably, hydrate or drink beverages between meals.
  • Avoid Gastric Irritants like Alcohol, Coffee, Hot or Spicy, Vinegar, Soy Sauce or other Acid Beverages.
  • Limit high calorie foods like chocolate, cream and full-fat dairy products.

Failure Features Characteristically observed with Bariatric Procedures

These “failures” can be a result of a number of different circumstances or actions, or may develop slowly over time.  Therefore, it is important to have regular follow-ups to monitor your weight loss and the status of your lap band, sleeve or gastric pouch.  Remember: If you have any concerns, don’t be afraid to ask your doctor.

  • Big Gastric Pouches
  • Mega- esophagus
  • Wide Gastric Sleeve
  • Excessive tightness of the Gastric Band
  • Wide outlet of the Bypass Gastro-Yeyuno
  • Very Short common limb of the Gastric Bypass

 

Arturo Rodríguez, MD

http://www.thebariatric.com

Originally posted 2008-07-10 23:25:31. Republished by Blog Post Promoter

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What If my Bariatric Procedure Fails?

What If my Bariatric Procedure Fails?

Patients can have minor or large complications after a Lap Band, Gastric sleeve or Gastric Bypass procedure.  Many patients may need another surgery to correct the complications, which can cost them more money. However,  medical complications are not always a result of a bariatric procedure failure.  A Weight Loss Procedure is classified as a failure if the procedure is no longer working.

When a Bariatric Procedure Fails for a patient, there are several different consequences to be considered.  They include the emotional, economical, and physical impacts of the failure.  

What are the emotional consequences of Procedure Failure?

Depending on the type of procedure (Lap Band, Gastric Sleeve or Gastric Bypass), the patient may regain all the weight back again. This can be emotionally devastating because it gives the patient the feeling that he or she has thrown away money for nothing.  They feel anger towards the doctor and themselves, and during this whole process, their health and life could be at risk due to the complications. It is important for patients to know they are not alone. It is also important that they take positive action to address the situation, since this increases the probability of succeeding in the future. 

 What happens after a Procedure Failure?

We can say a Bariatric Procedure is no longer working when the patient has regained all the weight originally lost. This means that the patient needs a new procedure called Revision Surgery. The need for a revision surgery after a procedure has failed may jeopardize the health or life of the patient, as the complication rate increases from 2% to 25%. In addition, it will cost additional money for the revision surgery.

The chances for success for a second, different, Bariatric Surgery are lower then the first time, and the morbidity increases up to 25% depending on the revision procedure to be done. This is in part because the doctor has to be able to finish a new Weight Loss Procedure over the scar tissue and be able to repair what went wrong in the first place. The decision as to which will be the chosen bariatric surgery for the second time will depend on the type of surgery first performed.

How can a patient succeed after Revision surgery?

The patient must be careful to avoid any mistakes made before that may have influenced the development of complications.  It is very important that you ask your doctor and yourself questions like:

  • Why didn’t the first procedure work for me?
  • Which procedure works for me best after failing the first time?
  • Am I going to be able to follow the rules for success with the procedure I am choosing?
  • How much help will I get from the doctor and his staff after revision surgery?
  • Am I looking only for the best price I can get, or for the procedure that can work best for me?

You have to analyze both the pros and cons for any procedure that you are considering, especially when considering a second procedure or revision surgery. You have more chances to succeed if you keep in mind what went wrong the first time, in order to develop a plan for success in the future.

 

Arturo Rodríguez, MD

http://www.thebariatric.com/

http://www.bandstersforum.com/

Originally posted 2008-07-27 21:53:21. Republished by Blog Post Promoter

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Old Treatments For Weight Loss Are New For Diabetes

Old Treatments for Weight Loss are New for Diabetes

Approximately 22% of adults in the United States and 35% of the adults in Mexico have been diagnosed with Type 2 Diabetes, which is the type that also accounts for 95% of all Diabetes cases.  About 60% of obese patients have Metabolic Syndrome (Type 2 Diabetes, High Blood Pressure and High Cholesterol) and 20% of people over 65 years are Diabetic in the US.  With an estimated over 300 million affected individuals by 2025, the lifetime risk of developing type 2 Diabetes will approximate 20%.

There is an increased interest world-wide for surgical procedures that improve Type 2 Diabetes and Metabolic Syndrome.  Many Bariatric or Weight Loss Surgeons are asked about their experience in this matter for the better understanding and treatment of this disease.  We now know after years of Gastrointestinal Weight Loss procedures, that there are two main effects achieved through bariatric surgery: one is the Bariatric Effect (successful weight loss), and the second is the Metabolic Effect (a positive change in features of Metabolic Syndrome).

People that are overweight or obese will see improvement in blood sugar levels when they lose weight. Except with the Gastric Band, other gastrointestinal weight loss procedures (Gastric Bypass, Duodenal Bypass, Gastric Sleeve, Duodenal Switch or Bilio-Pancreatic Diversion) can promote an improvement in blood sugar levels long before there is significant weight loss.  Often the improvement can be seen just days after the surgery.

Improvement of blood sugar levels for people with type 2 Diabetes can be very successful for those that receive the Gastric Band (50% of the cases), the Gastric Bypass (70%), the Gastric Sleeve (85%) or the Duodenal Exclusion Procedures with or without Sleeve (92%). Patients that need insulin, and those that have been Diabetic for a longer period of time, are more resistant to blood sugar improvements.  However, the gastric procedures have still been shown to help these patients.

There are different explanations about the Metabolic Effect.  In the gastric bypass, this effect is related to the nature of the malabsortive procedures. The Duodenal exclusion is related to the secretion changes of the Ghrelin Factor (Hunger Factor) and other Neuro-hormonal factors called Incretins as the GIP (gastric inhibitory peptide), GLP-1 (glucagon like peptide) and the YY peptide. In operated patients where the stomach and the duodenum are excluded, the increase in Incretin secretion has a direct effect on lowering the Sugar Insulin Resistance, promoting the Growth of the BETA Pancreatic Cells that produces insulin and also for the improvement of the sugar-insulin action.  For individuals with a BMI 35 or less, we observed lower weight loss with the malabsortive procedures, but the metabolic effect remained the same as seen in heavier patients.  This indicates that the procedures are very effective for improving blood sugar levels.  In the Gastric Sleeve, the effect is related to the removal of 80% of the stomach. 

Both obese patients and those with Type 2 Diabetes should discuss with the surgeon each procedure’s surgical risk, the rate of bariatric and metabolic effect, and the long-term co-morbidities that each surgical option has before deciding on any of them.

Dr. Arturo Rodriguez
http://www.thebariatric.com

Originally posted 2008-05-19 19:15:45. Republished by Blog Post Promoter

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Simplified Gastric Bypass

Simplified Gastric Bypass

What is Gastric Bypass Surgery?

The Gastric Bypass is considered as the “gold standard” of Weight Loss Surgery by the American Society of Metabolic and Bariatric Surgeons (ASMBS).  Roux-n-Y Gastric Bypass Surgery (RYGB) is the most commonly practiced weight loss surgery world wide.

The Gastric Bypass is also considered by the SAGES and ASMBS as the most complex and technically challenging procedure to be done by laparoscopy and requires a large number of operations to achieve competency.

Open RYGB as treatment for obesity was introduced by Dr. Mason and Dr. Ito in 1967. The first Laparoscopic RYGB was performed in 1994 by Dr. Wittgrove following the surgical steps of the open surgery.

The Simplified Gastric Bypass was developed by Dr. Almino Ramos in Sao Paulo, Brazil and was called Simplified Laparoscopic Gastric Bypass consisting in simplifying and standardizing the surgical steps of the traditional Gastric Bypass in a way that it can be done in the superior half of the abdomen easily, by trained Bariatric Surgeons with less operative time (average of 75 minutes) and with more efficiency.  Today, thousands of patients are operated by this technique all over the world.

The Simplified Gastric Bypass technique involves a gastric stapling, and its division (forming the gastroplasty, new gastric chamber or pouch), lowering the gastric capacity by 90% (20-30cc). The Gastric Bypass is done ante-colic (the open way was retro-colic, meaning that was done behind the transverse colon) and as far as 1.5 to 2 m (the small bowel has 4 to 7 m in length).  At the end of the procedure, the gastroplasty is connected with the deviated intestinal limb (gastrojejunostomy) by stapling and suturing them, to allow the food to pass again.

What are the Risks of Gastric Bypass Surgery?

International literature describes an average of 10% of cases with complications (morbidity), and a 2% mortality rate.  Anastomotic leak is the most serious complication of gastric bypass procedure and is associated with increased morbidity and mortality.  The ideal treatment is prevention by meticulous operatory technique and pre and postoperative care.  The leaks that are likely to result in mortality (about 15%) are those for which the patient manifests a high systemic inflammatory response, and is closely related with a high BMI, with fever, increased leukocyte count and heart rate and also signs of organ failure.

How does the Gastric Bypass Work?

This operation involves two effects: predominant gastric restriction, and intestinal malabsorption.  The food arrives at the new stomach (gastroplasty) and promotes distention on the walls of the pouch, inducing satiety and fullness with small amounts of food.  Then the food passes slowly through the calibrated gastrojejunostomy of 11 mm and proceeds for digestion (1.5 to 2m after the new formed gastric pouch).  When the fullness sensation of the small chamber is exceeded, pain or vomiting can occur.

After a Gastric  Bypass, the liquids with high concentration of carbs will not be totally absorbed, especially during the first year.  This may result in “dumping syndrome” where the food moves too quickly into the small intestine.  Symptoms include bowel irritation, abdominal pain, diarrhea, and increased heart rate with palpitation and sweating.

What happens post-op (after surgery)?

Most of the patients are discharged from the hospital within 48 to 72 hours after the operation. The complete return to normal activities occurs in about one week.  During 4 weeks following the operation, the patient should consume a liquid diet, and advance in a stepwise way to a puree/baby food type diet for one or two additional weeks, eventually evolving to an almost normal diet by the fourth week.  In this operation there is a need to supplement vitamins and minerals. Iron must be followed by regular I.V. tests and reposition is usually needed.

Who  would benefit from a Gastric Bypass?

  • Patients with a metabolic disease (Type 2 diabetes, high blood pressure, hyper-lypidemia)
  • Persons with any degree of binge eating disorder
  • Moderate risk patients (few co-morbidities)
  • High expectations (those who need to lose weight, up to 80% EWL [excess weight loss])
  • Low to moderate patient commitment

 

Arturo Rodriguez, MD

http://www.thebariatric.com

Originally posted 2008-07-03 07:48:58. Republished by Blog Post Promoter

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What is the Best Surgical Weight Loss Procedure for Me?

What is the Best Surgical Weight Loss Procedure for Me?

I hear this question all the time and there is no single answer for every person. You have to find your own answer by asking some questions like:

Is the cost of the procedure an issue that will influence my decision on which procedure to have?
Am I looking for a simple or complex bariatric procedure?
Am I looking for the safest procedure?
Am I going to be able to follow the rules for success with the procedure I am choosing?
How much help will I get from the doctor and his staff after any of the Weight Loss Procedures?
Which of the Weight Loss Procedure fits my life style better? 

You have to be well informed about all the surgical Weight Loss Options in order to have the answers, but it is also very important for you to know about the doctors that perform the surgies (the Lap Band, Gastric Sleeve or Gastric Bypass), their bariatric experience, their surgical staff, the experience they have in revision surgeries, the ethics and professionalism of the promoters and the Weight Loss follow up and support  that they will provide for you after your surgery.

Helpful Facts About Weight Loss Surgery

  • There is no ideal Weight Loss Procedure that works for every person.  Everyday we do more revision surgeries because of Lap Band, Gastric Sleeve and Gastric Bypass failures.
  • Gastric Sleeve is the Weight Loss Procedure that results in the best response for patients with Type 2 Diabetes, Hypertension and Hyper-Cholesterol (the Metabolic Effect).
  • The Lap band is the simpler and cheapest among the Weight Loss Procedures.
  • It is not true that if you are very heavy you will need to have the most drastic procedure.
  • Young or elderly patients can have the Lap Band, the Gastric Sleeve or the Gastric Bypass.
  • The doctor’s experience influences the outcome of the Weight Loss Procedures.
  • The patient´s eating behavior can modify the outcome of any of the Weight Loss Procedures.
  • The open message boards have very many doctors’ coordinators trying to send patients their way and might confused patient’s right decisions.}
  •  The procedure with lowest surgical risk is the Lap Band.
  • The procedure with the most surgical risk is the Duodenal Switch, followed by the Gastric Bypass.
  • The average hospital stay following the Lap Band procedure is one night.
  • The average hospital stay following the Gastric Sleeve procedure is two nights.
  • The average hospital stay following the Gastric Bypass procedure is three nights.
  • The Lap band needs to be “filled” periodically in order to provide optimum weight loss results.
  • A person with a Gastric Bypass will need nutritional supplements for life to avoid deficiencies.
  • You should avoid alcohol with any bariatric procedure, due to high risk of getting an ulcer.

 

Dr. Arturo Rodriguez
Bariatric Surgeon
http://www.thebariatric.com
http://www.bandstersforum.com

Originally posted 2008-06-26 00:34:53. Republished by Blog Post Promoter

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Obesity: Is Fast Food Responsible?

Obesity: Is Fast Food Responsible?

The reasons for obesity are multiple and complex.  Despite conventional wisdom, it is not simply a result of overeating.  Research has shown that in many cases, the significant underlying cause of morbid obesity is genetic. Studies have demonstrated that once the problem is established, efforts such as dieting and exercise programs have a limited ability to provide effective long-term relief.  

Science continues to search for answers but, until the disease is better understood, the control of excess weight is something patients must work at for their entire lives.  That is why it is very important to understand that all current medical interventions, including the Lap Band, Gastric Sleeve and Gastric Bypass procedures should not be considered medical cures. Rather, they are attempts to reduce the effects of excessive weight and alleviate the serious physical, emotional and social consequences of the disease.  

Contributing Factors  

The underlying causes of severe obesity are not known.  There are many factors that contribute to the development of obesity including genetic, hereditary, metabolic, environmental, and eating disorders.  There are also certain medical conditions that may result in some special type of obesity, such as the long term intake of steroids and some diseases such as hypothyroidism and hyper-adrenalism

Genetic Factors  

Numerous scientific studies have established that your genes play an important role in your tendency towards excess weight gain.  The body weights of adopted children show no correlation with the body weights of their adoptive parents, who feed them and teach them how to eat.  However, their weight does have an 80 percent correlation with their genetic parents, whom they have never met.  As well, identical twins with identical genes, show a much higher similarity of body weights than do fraternal twins.

Certain groups of people, such as the Pima Indian tribe in Arizona and the growing Mexican-American population have shown a very high incidence of severe obesity. They also have significantly higher rates of diabetes and heart disease than other ethnic groups.  

We probably have a number of genes directly related to weight.  Just as some genes determine eye color or height, others can affect the appetite by increasing the amount of secretion of the Ghrelin Factor by the stomach, or the ability to feel full, satisfied, or have an early age-related change in metabolism. Our fat-storing ability, and our natural activity levels may even be affected by some predetermined gene. 

Environmental Factors

Environmental and genetic factors are obviously closely intertwined.  If you have a genetic predisposition toward obesity, then the modern American lifestyle and environment may make controlling weight more difficult.  Fast food, long days sitting at a desk or in front of a TV screen or monitor, and suburban neighborhoods that require cars all magnify hereditary factors such as metabolism and efficient fat storage.   For those suffering from morbid obesity, anything less than a total change in environment usually results in failure to reach and maintain a healthy body weight.  

Metabolism

We used to think of weight gain or loss as only a function of calories ingested and then burned. Take in more calories than you burn, gain weight; burn more calories than you ingest, lose weight. But now we know the equation isn’t that simple.  Obesity researchers now talk about a theory called the “set point,” a sort of Thermostat in the brain that makes people resistant to either weight gain or loss. If you try to override the set point by drastically cutting your calorie intake, your brain responds by lowering metabolism and slowing activity. You then gain back any weight you’ve lost.

Eating Disorders & Medical Conditions

Weight loss surgery is not a cure for eating disorders. And there are medical conditions, such as hypothyroidism, that can also cause weight gain. That’s why it’s important that you work along with your doctor to find out whether you have any conditions that should be treated with medication and counseling.

 

Arturo Rodriguez, MD

http://www.thebariatric.com

Originally posted 2008-04-23 14:06:19. Republished by Blog Post Promoter

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June 24, 2009

Bariatric Procedures: Being More than Fans

Bariatric Procedures: Being More than Fans

The last 10 years I have been very busy participating in a lot of meetings around the world.  I have found, unfortunately, that we have spent such a long time discussing what procedures are the best for treating obesity that we have forgotten the main point, the core of any of the procedures’ success: the patient.

We all look like fans of a football team, cheering for their favorite team.  Some doctors cheer for the Gastric bypass as the best and only option to cure obesity. Then we have the doctors that prefer the lapband as the first option. In another corner, there are the doctors that promote the Gastric sleeve as the new treatment for obesity and Type 2 Diabetes.

There are several good medical reasons involved in the doctor’s preferences for one procedure over the other but also their preferences points toward which procedure the doctor feels more comfortable performing or is more skilful.  In Mexico, we have to add to this discussion, the place were the doctor was trained, for instance, if he was trained in the Mexican Health Care System they will know very little about the Lap band and would prefer to perform the Gastric Sleeve or the Gastric Bypass.  This is because the Lap band is not yet available for the government hospitals.  This means that these doctors started with Bariatric procedures such as the Gastric Bypass 3-4 years ago, and the Gastric Sleeve 1-2 years ago.

I personally recommend the Lap band as the first option. There is less risk for operatory complications involved, it is less expensive and it’s adjustable.   You don’t have to be overly obese to have the Lap Band.  You can have Lap band revision in case the lapband fails the first time or jump to any of the other procedures available including the Duodenal Switch. The Lap-band also helps in the control of co-morbidities related to obesity such as high blood pressure or Diabetes in almost 6 out of 10 patients.

The arguments against having the Lap band as the first option are valid with patients that have difficult behavioral control such as alcohol abuse. Arguments are also valid for patients that don’t like the idea of having lapband fills done periodically or when there isn’t a doctor or center to do the fills close to where they live.  The arguments against the Lapband that are not valid, are erosion rates (less than 2 %), slippage (less than 4 %), or obtaining insufficient weight loss as a strong argument for deciding on other surgical options such as the Gastric sleeve or Gastric Bypass.

There are no “complication free” bariatric procedures.  With any bariatric procedure there are advantages and disadvantages.  We also found that with all bariatric procedures, there is a chance for insufficient weight loss and a chance that patients may need revision surgery. Mean percent excess weight loss at five years ranged from 48 to 74 % after Gastric Bypass and from 50 to 60% after Vertical Banded Gastroplasty, the same results are for the Gastric Sleeve.

However, with all this in mind, we must remember that the best and most effective procedure will ultimately depend on the individual patient that is looking for a weight loss procedure.  The patient and doctor must work together to discover all the facts and make the best informed decision in order to be successful. Don´t rush your decision – get informed!

 

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-11-13 22:11:41. Republished by Blog Post Promoter

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