Losing Weight with Gastric Bypass Surgery

How does the gastric bypass help you lose weight? What are the health benefits? How long is the recovery? These three questions are always top of mind for our gastric bypass patients.  If you’re considering gastric bypass surgery to help you lose weight, here are a few important facts to know.

Gastric Bypass Surgery Helps You Eat Less & Absorb Fewer Calories

Gastric bypass surgery helps patients lose weight by creating a small stomach pouch and rerouting the path food takes so you feel full faster and absorb fewer calories. After surgery, the food “bypasses” a large section of the stomach and part of the small intestine, creating an early sense of fullness in your stomach. This approach, which is restrictive (restricts the amount of food) and malabsorptive (reduces the amount of calories absorbed), helps jumpstart weight loss. The gastric bypass procedure also reduces the amount of ghrelin (hunger hormone) in your stomach resulting in less overall hunger. 

Many Patients Experience Health Benefits After Gastric Bypass Surgery

Patients who undergo gastric bypass surgery typically lose around 60-80% of their excess body weight. Along with losing weight, gastric bypass surgery can also result in the resolution of obesity-related medical conditions such as: 

Recovery After Losing Weight with Gastric Bypass Surgery

On average, patients usually stay in the hospital 1-2 days following a gastric bypass procedure, and are encouraged to be up and walking as soon as they are able to after surgery. Before patients leave the hospital, the NJBC surgical team will make sure that you are tolerating liquids, your pain is managed and you are comfortable moving around. 

As with any surgery there are side effects and risks to weight loss procedures. To read more about side effects and risks associated with the gastric bypass, visit our Side Effects & Risks page.

If you have more questions about  gastric bypass surgery give us a call at 908-481-1270.

*Metabolic and bariatric surgery. (2018, October). In the American Society for Metabolic and Bariatric Surgery. Retrieved November 10, 2020, from https://asmbs.org/resources/metabolic-and-bariatric-surgery

Loose Abdominal Skin After Bariatric Surgery

After losing a significant amount of weight with bariatric surgery, some patients may have loose skin – specifically around the lower part of the belly. This is not uncommon. Loose or sagging skin around the abdomen can occur when you lose weight and the skin does not have the elasticity it needs to shrink back to your new shape. 

Before gastric sleeve or bypass, I often tell patients that predicting who may or may not develop excess abdominal skin after weight loss is difficult. Factors that contribute to this condition are age, underlying medical issues, tissue disorders, and losing a significant amount of weight. 

While strength-based training exercises can help tone muscles in some cases, no amount of exercise will get rid of sagging or excessive hanging skin caused by significant weight loss. To treat this condition, the surgeons at New Jersey Bariatric Center can perform a panniculectomy, a surgical procedure to remove excess or sagging skin.

How a Panniculectomy works

During a panniculectomy the excess skin, or pannus is removed from your lower belly. Once the excess skin is trimmed, the remaining skin is pulled together and sutured, and the belly button is typically re-positioned in a similar location on the abdomen. The procedure takes between 2-3 hours and usually involves a 1-2 night stay in the hospital.  

Is it the same as a Tummy Tuck?

You may be thinking that a panniculectomy sounds similar to a tummy tuck but there are some key differences. Both procedures rid the excess skin that hangs down over the pelvic region and thighs. Except a tummy tuck is for aesthetic purposes while a panniculectomy is often considered a medical necessity. For example, if the excess skin is causing a recurrent rash, fungal infections, and it limits your mobility. Another difference is that a tummy tuck removes the excess skin and tightens the abdominal muscles under the skin in most cases. A panniculectomy removes just the excess skin, and treats medical issues. 

Is a Panniculectomy right for me?

This procedure may be a good option for you if excess abdominal skin is affecting your day- to-day activities and your overall well being. If the skin is causing pain, discomfort or infections, and it has been 18-24 months since your weight loss surgery, make an appointment with your surgeon to discuss how a panniculectomy can help.

For more questions, call us at 908-481-1270.

Marijuana, Smoking and Weight Loss Surgery

Now that the state of New Jersey legalized the use of recreational marijuana for adults, several patients have asked how using marijuana can affect their weight loss surgery journey.

To start, the use of marijuana should be discussed with your surgeon. Smoking, whether it’s cigarettes or marijuana, is a health risk that can lead to lung and heart complications both during and after bariatric surgery as well as long-term health consequences. Marijuana itself can alter clotting factors in our blood, making our bodies more prone to developing clots which can lead to heart attacks and strokes. Your surgeon will discuss these risks and how to safely prepare for surgery.

Marijuana Use when Planning for Weight Loss Surgery

Marijuana use has been studied extensively, and when it is smoked or eaten as edibles, chemicals called cannabinoids are released into the body and can cause increased heart rate, high blood pressure and heart rhythm abnormalities. Transitioning from smoking marijuana to oral formulations, such as edibles or extracts, may lessen the risk of airway compromise and decrease the chances of systemic issues during and after surgery, but must  be discussed with your doctor prior to surgery.

Marijuana Use after Weight Loss Surgery

There is not enough research available to have a definitive answer to how marijuana use will affect you after your weight loss surgery whether it’s gastric sleeve, bypass or band. In a small, study at a an academic center participants were followed up to 2 years after their gastric sleeve or gastric bypass procedures and the excess weight lost after surgery measured by BMI did not differ significantly between marijuana users and non-users. Even with the findings in this small study, it’s still important to understand that marijuana use is a health risk. 

If you are planning to have weight loss surgery or have had weight loss surgery and have more questions regarding marijuana use related to your weight loss journey, give us a call at 908-481-1270.

Sources

  1. Haskins IN, Amdur R, Vaziri K. The effect of smoking on bariatric surgical outcomes. Surgical Endoscopy.  2014;28(11):3074-3080. doi:10.1007/s00464-014-3581
  2. Haskins IN, Nowacki AS, Khorgami Z, et al. Should recent smoking be a contraindication for sleeve gastrectomy? Surgery for Obesity and Related Diseases. 2017;13(7):1130-1135. Doi: 10.1016/j.soard.2017.02.028
  3. Shockcor N, Adnan SM, Siegel A, Wise E, Zafar SN, Kligman M. Marijuana use does not affect the outcomes of bariatric surgery. Surg Endosc. 2021 Mar;35(3):1264-1268. doi: 10.1007/s00464-020-07497-5. Epub 2020 Mar 12. PMID: 32166550.

Tackling Childhood Obesity Together

Adult obesity and childhood obesity rates have continued to rise over the past 20 years. Because obesity can pose immediate and future health risks, parents and caregivers are looking for answers to how they can help their children live a healthier and happier life. . 

In the United States, 1 in 5 children or about 19% struggle with obesity. In New Jersey, 14% of children ages 10 through 17 have obesity, which is defined as having a body mass index (BMI) of 30 or greater. Just like adults, children who have obesity are more likely to become adults with obesity and are at a higher risk of developing other chronic health issues such type 2 diabetes, hypertension, joint problems and more. 

Research shows that COVID-19 has not only increased the likelihood of childhood obesity, but actually worsened the severity of the disease. This is due to a decrease in physical activity and extracurricular activities, increase in screen time, family financial constraints limiting access to healthy foods and,, the increase of stress and fear of contracting COVID-19. 

As a parent, how can you tackle childhood obesity and help your child live a healthier life? Here are some tips. 

Encourage healthy eating habits

Nutrition is essential for overall health as well as  growth and development. Eating healthy as a family is important to keep everyone healthy and happy. Keep the primary focus on lean proteins and high fiber fruits and vegetables. Check out our blog for dietitian-approved, delicious recipes that the whole family will enjoy. Try preparing new and healthy recipes together or making a healthier version of your child’s favorite food.

Increase movement

Children aged 6-17 should get around 60 minutes or more of activity daily. This will help strengthen their bones, build muscles and encourage a healthy weight. Motivate your child(ren) to get outside and move around daily. That can be anything from running, walking, swimming to playing basketball, soccer, rock climbing and more. Help them find an activity that they enjoy. Or, even better, increase movement as a family. Take nightly walks after dinner. Try hiking or biking on the weekends. It’s a great opportunity to spend more quality time as a family while increasing your daily movement and offering support to your child. 

Decrease screen time

Another way to encourage children to move more is to limit the amount of time they spend in front of their screens. On average, children aged 8-12 spend 4-6 hours watching or using screens and teenagers spend up to 9 hours a day on screen. Allow them to use their phones, laptops and video games after they’ve done school work and played an activity. Or even limit screen use to the weekends only. They can use their screen time to find healthy recipes they may want to try or a movement based video game. Challenge your child to use screen time productively. For example, finding a fun and engaging exercise video or attending a live, virtual Zoom exercise class. Find a routine that works for you and keeps everyone healthy and happy.

How a Medical Team Can Help 

Sometimes, no matter how hard you try to help your child, the excess weight doesn’t come off. It could be because of the body’s set point. This is when our body is working against us in order to maintain its set point -- a weight range, usually within 5 or 10 pounds, that our body fights very hard to maintain. When our body detects that we’re consuming fewer calories, our stomach sends signals to our brain to eat more -- we’ll even start to feel more hungry. You can read more about the set point theory here

You may be able to help your child reverse this vicious cycle with bariatric surgery or non-surgical weight loss methods. New Jersey Bariatric Center is a part of Robert Wood Johnson’s Adolescent Bariatric Surgery Research Study. The goal of this study is to establish the efficacy of bariatric surgery to adolescent patients between the ages of 15-18 years old. The study will evaluate improvement in comorbid conditions, quality of life, and lower BMI over a 2-year time span. You can read more about the study here

Make an appointment to speak with one of our fellowship trained bariatric surgeons to help you find the best solution. Call us today at 908-481-1270.

What Am I Eating? Creamy Vegetable Soup

My family and I have recently started making soup. Not only is it a healthy and hearty meal, but it’s a great way to keep my kids occupied and learning about nutrition now that we are indoors more often. One of our favorite soups is a creamy roasted carrot soup. 

I start off by roasting my carrots in olive oil and a few of my favorite seasonings like salt, pepper and coriander. Ginger is a great addition to the recipe if you like the flavor. Then I let the carrots cool, chop them into smaller pieces and add them to a saucepan with some riced cauliflower and low-sodium vegetable stock. Traditional creamy soup recipes will call for heavy cream or half and half, but we omit those and just use the stock. Finally, I use an immersion blender to blend together the vegetable mixture. 

It turns into a delicious and creamy, antioxidant-packed, vegetable-filled soup that even my kids love. We really enjoy this recipe and we often try new combinations of vegetables and seasonings. 

Recovery After Weight Loss Surgery

“How long is the recovery after bariatric surgery?” is one of the most frequently asked questions I hear from patients when they’re thinking about weight loss surgery, whether it’s gastric sleeve or gastric bypass procedure. They want to know what to expect - both in the hospital and when they return home.  Below is all the information you need to know about recovery after bariatric surgery.

Hospital Recovery

The length of time you stay in the hospital depends on the type of weight loss procedure you undergo. After the gastric sleeve, I tell patients to expect to stay in the hospital for approximately one day.  For the gastric bypass, it’s one to two days. Once out of surgery, patients are encouraged to be up and walking as soon as they  are able to do so - usually within a few hours. Moving around and walking  helps with overall recovery. Before leaving the hospital our goal is to make sure you are comfortable walking around, drinking fluids and that your pain is controlled.  

Pain Management 

Some patients may experience pain after surgery. Pain after surgery usually comes from two different sources: incisions in the skin or an internal discomfort that is usually associated with gas. Pain can be difficult to predict as each person has a different threshold. Some patients may experience moderate to low levels of pain while others may experience high levels. NJBC performs weight loss surgery laparoscopically so the incisions are very small. Smaller incisions usually mean less pain,  with most  patients who experience discomfort report it being gone in three to four days. 

At-Home Recovery

Once you leave the hospital it’s important to follow the post-surgery instructions provided. This will help enhance your recovery and minimize complications. At New Jersey Bariatric Center we advise patients to wait at least three to four weeks after surgery before doing any rigorous activity or heavy lifting (no more than fifteen pounds). That’s the average time for the healing of the muscle layers to occur. 

Diet and Exercise

The changes to the anatomy of your stomach will require new eating habits. Immediately following surgery you will be on a liquid diet, then move on to soft foods, and finally progressing to regular foods. The general guidelines for the post-operative diet include eating protein first, eating slowly, chewing thoroughly, not drinking fluids while eating, avoiding liquid calories, limiting snacking and learning portion control. Our registered dietitians will provide you with a specific food plan so you know when each of these stages start. 

Many New Jersey Bariatric Center patients are able to resume activity and exercise two weeks after surgery. The level of exercise will depend on your physical condition and the nature of the activity. Always start with walking. As you recover, you will be able to do more like walking uphill, walking faster and maybe, eventually running. Exercise is strongly encouraged as it increases your sense of wellbeing and minimizes muscle breakdown. For more information on exercise post-surgery, check out this link. 

Resuming  Regular Activities

Returning to work

Returning to work will also vary from person to person depending on the type of work you do. If your job involves sitting at a computer or a desk, some of our patients can go back to work three to five days after surgery. If you do strenuous or physical labor as part of your job, it’s best to wait four weeks before returning. You should be physically able to return to work between 1 week and 3 weeks after surgery.

Driving

Driving should be avoided until you are no longer taking prescription pain medication and you feel comfortable moving around. If driving is resumed too early, sudden braking or movements may strain your core abdominal wall muscles and can delay recovery. It’s important to give your body time to heal. As you progress in your recovery, start off with short distance, low speed drives and once you feel comfortable extend the distance. 

Sex

Many patients ask when it would be safe to resume sexual activity after surgery. When patients ask this question there is a general concern about affecting the surgical area and the staples in the abdomen. First, it’s important to give your body time to heal. Generally, sexual activity can be resumed when you feel comfortable doing so. Some patients may be able to engage in sexual activity within a week after weight loss surgery, others may elect to wait a few weeks. Listen to your body and avoid any strenuous activity. 

Recovery after bariatric surgery is different for each person because everyone heals differently, so allow yourself time to adjust to your new lifestyle. New Jersey Bariatric Center staff will be there for you every step of the way. Whenever you have a question or concern, you can always reach out to us for the answers. 

Check out our blog for more information on life after bariatric surgery.

New Study Shows Weight Loss in Young Adults with Obesity May Lower Mortality Risk by up to 50%

 

Losing weight in early adulthood, between ages 25 and 40, may help you live longer according to recent research out of Boston University’s School of Public Health. The study looked at whether losing weight after a history of obesity in early adulthood could show a reduction in mortality risk later in life. 

 

The researchers analyzed data from more than 24,000 individuals who participated in the National Health and Nutrition Examination Survey (NHANES). Lead investigators recorded the weight of participants between the ages of 40 and 74, asked what their weight was 10 years earlier, and what their weight was at age 25. The researchers found that moving from a BMI in the obese category (BMI of 30-34.9) in young adulthood, to one in the overweight category later in life (BMI of 25-29.9), showed a 54% reduction in mortality risk compared to maintaining an obese  BMI over the same period of time. 

Achieving  a healthy weight can also reduce the severity and prevalence of obesity-related diseases like type 2 diabetes, hypertension and sleep apnea. The results from this study shows how positive changes to our health can possibly change our lives. 

Small changes can make a big difference.  At New Jersey Bariatric Center, we understand that losing weight and keeping it off, is not as simple as balancing calories. We understand that obesity is a disease, and certain factors, like your body’s set point, can prevent you from losing weight. The first step to your weight loss journey is contacting us to discuss your weight loss options. Whether it’s through weight loss surgery like gastric sleeve or gastric bypass, medical weight loss or nutritional counseling, getting to a healthy weight should be an important and empowering journey for everyone. 

 

Source:
Xie W, Lundberg DJ, Collins JM, et al. Association of Weight Loss Between Early Adulthood and Midlife With All-Cause Mortality Risk in the US. JAMA Netw Open. 2020;3(8):e2013448. doi:10.1001/jamanetworkopen.2020.13448

 

Weight Loss Surgery, Gas & Body Odor

After weight loss surgery, some patients report experiencing an increase in gas and a difference in their normal body odor.  While this is expected, it can make one feel self conscious and have an impact on your social interactions. If you are experiencing gas and body odor after bariatric surgery, you are not alone.

Whether you’ve had gastric sleeve or gastric bypass, the body undergoes various hormonal changes,  particularly how it processes the food you take in. This can lead to increased levels of gas production or body odor.  The important thing to remember is that you’re not alone and once you identify the triggers that contribute to these nuisances, steps can be taken to limit or avoid them.

Gas

With normal day-to-day functions that produce energy, the human body also produces sulfur containing gases. These gases are the flatulence we expel. The amount and smell may vary depending on the type and quantity of food you eat. For example, eating fried, fatty foods may trigger more flatulence in some individuals, and others may find that eating a certain vegetable or legume may play a role. In order to decrease gas production, let’s take a look at certain factors that may play a role in gas formation.

Triggers for increased gas

Foods and swallowed air can trigger increased gas. Foods that are known for increased gas production include beans and certain dairy products. After weight loss surgery, you may find that you need to relearn which foods are more palatable and less gas producing. This may take some trial and error until you figure out which items you should avoid to minimize gas production. 

Swallowed air can also be a factor. Some people have a tendency to swallow air while drinking, eating or talking. This is an involuntary action, but can contribute to an increased amount of gas production. To limit the amount of swallowed air while eating, try chewing slowly.

Certain medications may help reduce the odor associated with flatulence, however, we recommend talking with your surgeon before starting any new medication.  

Body Odor

Our body gets glucose from carbohydrates such as breads and bread products, sweets, fruits and certain vegetables. After having weight loss surgery, your diet changes dramatically compared to what it was before, especially with your carbohydrate intake. The decrease in carbohydrates and thereby glucose, forces your body to look to other sources for energy - namely fats. 

The fat breakdown for energy causes the odor that you may notice within the first few weeks to months after surgery, especially when your body is acclimating to your new diet. As your body adapts, it becomes more efficient in metabolizing the fats and removal of  its byproducts, such as ketones, thereby decreasing body odor.  

During this transition period, there are several ways to limit body odor  - brush your teeth several times a day, use sugar free gum and apply deodorant more often. Gas and body odor after bariatric surgery will improve when the weight loss stabilizes after 6-9 months.   

At New Jersey Bariatric Center, our team of surgeons, dietitian and support staff are here to help you during these changes. For more information, call us at 908-481-1270.