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Bariatric surgery

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Read Cindy’s blog about her weight-loss journey at

For many people, the new year brings a renewal of weight-loss goals—whether that means shedding a few extra holiday pounds, getting in shape for swimsuit season, or improving overall health and wellness. But for some people, even the best diet plans and exercise regimens aren't effective for losing weight and keeping it off.

Sound familiar? If you are overweight and struggle with weight loss, bariatric surgery may be an option. Brian C. Gary, MD, a general surgeon with The Jackson Clinic, offers a minimally invasive laparoscopic vertical gastric sleeve surgery that has proved successful in helping people lose weight.

About obesity

Obesity is a complex and chronic metabolic disease. It occurs when fat has accumulated to the extent that a person's health is impaired. People with a body mass index (BMI) of 30 or above are considered obese. A variety of factors may contribute to obesity, including genetic, environmental, behavioral, psychological, physiological and metabolic influences.

"Some people have all of those factors, some people have a few, but they all contribute to why we may be obese as a nation," Dr. Gary said.

Regardless of the cause, many serious health conditions are related to obesity, including pulmonary disease, nonalcoholic fatty liver disease, gynecologic abnormalities, osteoarthritis, skin conditions, gout, depression, stroke, gastroesophageal reflux disease, cardiometabolic syndrome, severe pancreatitis, cancer, phlebitis and even premature death.

Bariatric surgery may lessen the severity of many of these conditions, and it can also help patients achieve increased self-confidence and enhanced productivity, giving them the ability to spend more time on physical activities. For those who qualify and are willing to make permanent choices that lead to a healthier lifestyle, the procedure can be lifesaving and life-changing.

What is gastric sleeve surgery?

In short, gastric sleeve surgery removes a portion of the stomach to create a new tube-shaped stomach about the size of a banana. With such a large portion of the stomach gone, patients feel full much faster and thus consume less food.

"Now that we've seen the success of the gastric sleeve surgery over the last 10 years—of its efficacy and safety—I believe it is a good thing to bring to the people of our city and the River Region," said Dr. Gary. Unlike gastric banding surgery, which uses a band to constrict the stomach, vertical sleeve gastrectomy does not involve inserting a foreign object into the body.

"The fear I have with the band is, it is a foreign object, which gives us more of a possibility for risks and complications," Dr. Gary explained.

The average hospital stay after vertical sleeve gastrectomy is 1 to 2 days. "In most cases, the stay is 23 hours and you'll go home the next day," Dr. Gary said.

Recovery from vertical sleeve gastrectomy will take time and patience. Because of the drastically reduced size of the stomach, the diet is very strict.

"It is important that we rethink food, because the stomach is a muscle and it can be stretched out," Dr. Gary said. "The surgery is set up so you will feel full sooner and eat fewer calories. You must be dedicated to a complete lifestyle change so we can set you up for a lifetime of success."

As the body heals from the surgery, patients may experience discomfort and pain. The length of time to return to normal activities can vary from patient to patient, but your healthcare team will advise you on when to return to work and resume prior activities.

One patient's story

For Cindy Tucker, one of Dr. Gary's first vertical sleeve gastrectomy patients, the weight-loss surgery has been a resounding success.

In the summer of 2014, Tucker weighed 372 pounds and decided it was time to make a life change. With a BMI of 54, she had vertical sleeve gastrectomy surgery in September 2014. After four months, she has lost 70 pounds, and the weight continues to come off.

"I am so happy," she said. "I have tried to lose weight in the past, but the plans did not work for me. I believe, partially, that was due to the fact that my mind was not quite ready yet, to be honest. As I approached 40 years old, I realized that I needed to change my ways fast. This surgery is a permanent tool.

"I have changed my lifestyle completely," Tucker added. "I now go to the gym, which I was afraid to do before. But now, it makes me feel better every time I go! Even my family is involved in my weight-loss journey. I would absolutely recommend this to anyone who is ready for a lifestyle change."

Weighing in: The benefits of weight loss

Vertical sleeve gastrectomy has a mean excess weight loss at 3 years of 66 percent. In addition to weight loss, the surgery also helps to resolve obesity-related health conditions. These include:

  • Obstructive sleep apnea: 45 percent to 76 percent resolved
  • Asthma: 39 percent improved
  • Urinary stress incontinence: 50 percent resolved
  • Osteoarthritis and other degenerative joint disease: 41 percent resolved
  • Depression: 47 percent reduced
  • Migraines: 46 percent improved
  • Type 2 diabetes: 45 percent to 68 percent resolved
  • High blood pressure: 42 percent to 66 percent resolved
  • Nonalcoholic fatty liver disease: 37 percent resolution of steatosis

Is gastric sleeve surgery for you?

Gastric sleeve surgery isn't an option for all people with obesity. Ideal candidates meet the following criteria:

  • Have a BMI greater than 35 and an obesity-related disease, or greater than 40 without
  • Are healthy enough to undergo a major operation
  • Have not succeeded with previous attempts at medical weight loss
  • Are free of drug and alcohol problems
  • Have no uncontrolled psychological conditions
  • Understand the surgery and its risks
  • Get approval by consensus from a multidisciplinary team

The most important factor is that candidates for surgery must be dedicated to a permanent lifestyle change, along with a lifetime of follow-ups.

Vertical sleeve gastrectomy is a laparoscopic procedure in which twothirds to three-fourths of the stomach is removed, leaving the remaining portion of the muscle. The stomach can typically hold 1.5 to 2 liters of fluid or food, but after the surgery, the stomach is roughly the size of a banana and can only hold about 150 milliliters.

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