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Obesity is related to many illness such as:

diabetes
heart disease
high cholesterol
sleep apnea
arthritis
fatty liver disease
certain cancers
infertility



Losing weight helps


Weight loss can:

Improve your health.
Reduce your need for prescription medication.
Help you live a longer life.



Why is it so difficult to lose weight?





Bariatric surgery works



Over a decade ago, the National Institutes of Health (NIH) reported that individuals affected by severe obesity are resistant to maintaining weight loss by diet and exercise alone. Currently, the NIH recognizes bariatric surgery as the only effective treatment to combat severe obesity and maintain weight loss in the long term.


Bariatric Surgery Options



We offer two types of bariatric surgical procedures: gastric bypass and sleeve gastrectomy. They are the most common procedures performed in the world and provide the best balance between weight loss and safety. We perform surgery through small incisions (laparoscopically), which has been been shown to reduce pain and enhance recovery.
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(Please note that incision sites may vary depending on procedure.)



Gastric Bypass

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This operation involves surgical division of the stomach to create a gastric pouch, which is about the size of an egg. Next, the small intestine (Roux limb) is surgically connected to the gastric pouch. In doing this, food bypasses the stomach and first portion of the small intestine. The operation is 2-3 hours long typically and has an overall complication rate of 5-10%.

It is important to know that you may no longer take NSAID (non-steroidal anti-inflammatory) medications such as aspirin, ibuprofen, Motrin® or Advil®, since it can increase the chance of developing an ulcer between the gastric pouch and the small intestine.

Gastric bypass surgery typically results 65-70% of excess body weight loss or approximately 100-150 lbs.

Maximal weight loss occurs at 1 year and is only maintained if you adhere to the appropriate diet and exercise regimen.

On average, patients that undergo laparoscopic surgery are hospitalized for 2-3 days and can return to work 2-4 weeks after surgery.

Before surgery, every patient is placed on a specific preoperative diet clinically proven to reduce the size of the liver and make surgery safer. Learn more about this preoperative diet by clicking here.


Sleeve Gastrectomy

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This operation involves surgical division and removal of approximately 80-85% of the stomach. The operation is 1-2 hours long typically and has an overall complication rate of 2-5%.

Sleeve gastrectomy surgery typically results 55-65% of excess body weight loss or approximately 70-100 lbs.

Maximal weight loss occurs at 1 year and is only maintained if you adhere to the appropriate diet and exercise regimen.

On average, patients that undergo laparoscopic surgery are hospitalized for 2-3 days and can return to work 2-4 weeks after surgery.

Before surgery, every patient is placed on a specific preoperative diet clinically proven to reduce the size of the liver and make surgery safer. Learn more about this preoperative diet by clicking here.



Recovery and Follow-up

Gastric bypass and sleeve gastrectomy follow the same recovery plan and diet progression.

2-3 day
hospitalization

2 week follow up in Bariatric Surgery Clinic

2 month follow up in Bariatric Surgery Clinic

6 month and yearly follow-up in the MEND clinic


After being discharged from the hospital you will need to:

Tolerate a liquid diet and stay hydrated (64 fluid ounces daily)

Walk 30-45 minutes daily


Restrictions (for 2-4 weeks):

No heavy lifting (over 10 lbs)

No driving while taking narcotic pain medication

No baths or pools (you may shower)



Life after Surgery

Bariatric surgery requires a lifelong commitment to:

Monitoring your diet
Taking vitamins and supplements
Exercising most days of the week
Medical follow-up




Diet after Surgery



After surgery, you will progress through different stages of a prescribed diet in order to assist in your recovery and help kick start your weight loss. It is important to understand that bariatric surgery may change your tastes, cravings and tolerance for certain foods, which varies from person to person. Vitamin supplementation is also very important after bariatric surgery since you will not be able to absorb certain nutrients.
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The GOAL:
70 grams of protein/day
64 fl oz/day

Small portions
No concentrated sweets
No carbonated drinks




Vitamin Supplementation



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Exercise



It is important to do both cardiovascular and resistance training in order to loss weight and maintain normal bone density. We encourage exercising at least 3 days per week in a structured program. We offer a specialized bariatric conditioning program and personal training services to help guide your training regimen.



Pregnancy



Weight loss can improve your likelihood for becoming pregnant. However, you will need to avoid pregnancy for 12-18 months after surgery as this will be the time when you will maximize your weight loss. We encourage that you use two forms of birth control during this time.


Excess Skin



Maximal weight loss may result in loose and excessive skin that can cause rashes and infections. Plastic surgery can be performed to remove excess skin however it may or may not be a covered benefit. Please check with your insurance carrier for details.


Gallstones



Gallstones may develop during the first 6 months of rapid weight loss. In order to prevent the likelihood of gallstones and gallbladder attacks, we prescribe Actigall®. If your gallbladder has been surgically removed already, then this medication is not necessary.


Weight Regain



Studies have shown that it is normal for most people to regain a small amount of their weight (5-10%) before stabilizing. Ultimately, long-term maintenance of weight-loss is a complex mix of adhering to the appropriate diet and exercise as well as genetics, age, gender, stress and social living conditions. In order for us to help, you must follow up regularly so we can provide you with all of our resources.


Research



Interested in participating in a research study? You may be compensated and will have an important impact on the future of bariatric surgery. Click here for more information and a list of current studies at the University of Michigan. Please note that participating in research will not impact your care in our bariatric surgery program.

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