El 16 de octubre se conmemora el Día del Anestesiólogo, una fecha dedicada a reconocer la labor de estos profesionales que desempeñan un papel crucial en el éxito de procedimientos quirúrgicos y en la seguridad de los pacientes.

Historia de la Anestesiología

La anestesiología comenzó a desarrollarse en el siglo XIX, marcando un hito en la medicina moderna. El 16 de octubre de 1846 se realizó la primera cirugía pública con anestesia en el Hospital General de Massachusetts, donde el Dr. William T.G. Morton utilizó éter para eliminar el dolor durante una operación quirúrgica. Este evento revolucionó la cirugía, permitiendo procedimientos más complejos y seguros para los pacientes.

Desde entonces, la especialidad ha avanzado significativamente, incorporando nuevas técnicas y fármacos, y hoy los anestesiólogos no solo controlan el dolor durante la cirugía, sino que también gestionan la recuperación y el estado clínico general del paciente.

El Rol del Anestesiólogo en la Medicina Actual

El trabajo del anestesiólogo no se limita solo a administrar medicamentos para dormir al paciente. Estos especialistas son responsables de monitorear y mantener estables las funciones vitales durante todo el procedimiento, asegurándose de que el paciente no sufra complicaciones.

Funciones principales de un anestesiólogo:

• Evaluación preoperatoria: Revisión del estado de salud del paciente antes de la cirugía, considerando antecedentes médicos y alergias.
• Control del dolor: Administración de anestesia general, regional o local según el tipo de intervención.
• Monitoreo intraoperatorio: Supervisión constante de la respiración, la presión arterial, el ritmo cardíaco y los niveles de oxígeno.
• Cuidado postoperatorio: Aseguran una recuperación adecuada del paciente, manejando posibles complicaciones o efectos secundarios.

Anestesia Moderna: Innovación y Seguridad

Gracias a los avances en la anestesiología, hoy es posible realizar cirugías más seguras y con menores riesgos. La introducción de técnicas mínimamente invasivas y procedimientos como la anestesia epidural o la sedación consciente han mejorado notablemente la experiencia del paciente.

Los anestesiólogos también desempeñan un papel fundamental en áreas como:

• Cuidados intensivos.
• Tratamiento del dolor crónico.
• Medicina de emergencia.

Conclusión: Reconociendo a los Anestesiólogos

El Día del Anestesiólogo es una oportunidad para reconocer la labor de estos profesionales que aseguran la seguridad y el bienestar de los pacientes durante procedimientos quirúrgicos y más allá. Su dedicación, conocimiento y capacidad para reaccionar rápidamente ante situaciones críticas los convierten en una parte fundamental del equipo médico.

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The answer is simple: during this procedure, we remove between 70% and 80% of the stomach’s total size. To ensure accuracy, we use a tool called a calibration tube, which serves as a guide. This instrument allows us to make sure we don’t leave the stomach too large, which could reduce the effectiveness of the surgery, nor too small, which could cause adverse effects, such as acid reflux or intolerance to certain foods.

During the procedure, we first show the stomach in its full size. We use a surgical stapler to make the first cut, following the guide provided by the calibration tube. The remaining part of the stomach, known as the gastric sleeve, is what will handle digestion after the surgery. We continue cutting the stomach until the desired portion is removed, ensuring the size is optimal for nutrient absorption and controlled weight loss.

If you have any questions or would like to learn more about the procedure, feel free to contact us. We’ll be happy to answer all your questions.

The post Gastric Sleeve Surgery: How Much of the Stomach is Removed and How is it Done? appeared first on My New Body Obesity Center.

Understanding Metabolic Syndrome

Before delving into the specifics of metabolic surgery, it’s important to understand metabolic syndrome. This condition is characterized by a cluster of risk factors that increase the likelihood of developing heart disease, stroke, and diabetes. These risk factors include:

1. Abdominal Obesity: Excess fat around the abdomen.
2. Insulin Resistance: The body’s inability to effectively use insulin.
3. High Blood Pressure: Hypertension.
4. High Blood Sugar: Hyperglycemia.
5. Abnormal Cholesterol Levels: Elevated levels of triglycerides and low levels of HDL (good) cholesterol.

Individuals with metabolic syndrome are at a significantly higher risk for developing serious health complications. Traditional approaches to managing these conditions include lifestyle changes (diet and exercise) and medication. However, for many, these measures are insufficient, and this is where metabolic surgery can play a crucial role.

Types of Metabolic Surgery

There are several types of metabolic surgery, each with its own mechanisms and benefits. The most common procedures include:

1. Roux-en-Y Gastric Bypass (RYGB):
   • Procedure: This involves creating a small pouch from the stomach and connecting it directly to the small intestine, bypassing a large part of the stomach and the first part of the small intestine (duodenum).
   • Benefits: Significant weight loss, improvement or remission of type 2 diabetes, reduction in hypertension, and improvement in cholesterol levels.
2. Sleeve Gastrectomy:
   • Procedure: About 75-80% of the stomach is removed, leaving a narrow, sleeve-shaped stomach.
   • Benefits: Significant weight loss, improvement in metabolic syndrome components, and a lower risk of complications compared to RYGB.
3. Adjustable Gastric Banding (AGB):
   • Procedure: An adjustable band is placed around the upper part of the stomach, creating a small pouch that limits food intake.
   • Benefits: Moderate weight loss, fewer complications, and the band can be adjusted or removed as needed.
4. Biliopancreatic Diversion with Duodenal Switch (BPD/DS):
   • Procedure: This involves removing a large part of the stomach and connecting the remaining portion to the lower part of the small intestine, bypassing most of the small intestine.
   • Benefits: Substantial weight loss, improvement in diabetes, and better long-term weight maintenance.

Mechanisms of Metabolic Surgery

Metabolic surgery works through several mechanisms:

1. Restriction: By reducing the size of the stomach, these procedures limit the amount of food that can be consumed, leading to reduced calorie intake.
2. Malabsorption: Some procedures, like the RYGB and BPD/DS, bypass parts of the small intestine, reducing the absorption of calories and nutrients.
3. Hormonal Changes: Metabolic surgeries alter gut hormones that play a role in hunger, satiety, and blood sugar control. For instance, the levels of ghrelin (a hunger hormone) decrease, while incretin hormones (which improve insulin secretion) increase.
4. Metabolic Changes: These surgeries can improve insulin sensitivity and increase energy expenditure, further aiding in weight loss and metabolic health.

Benefits of Metabolic Surgery

The benefits of metabolic surgery extend beyond weight loss. Key advantages include:

1. Type 2 Diabetes Remission: Many patients experience significant improvement or complete remission of type 2 diabetes. This is particularly evident in procedures like RYGB and sleeve gastrectomy.
2. Improvement in Cardiovascular Health: Reduction in risk factors such as hypertension, high cholesterol, and hyperlipidemia leads to improved cardiovascular health and reduced risk of heart disease and stroke.
3. Better Quality of Life: Weight loss and improvement in obesity-related conditions lead to enhanced mobility, reduced pain, and overall better quality of life.
4. Longevity: Studies have shown that metabolic surgery can lead to increased life expectancy by reducing the risk of obesity-related mortality.
5. Mental Health Benefits: Many patients report improvements in mental health, including reductions in depression and anxiety, after undergoing metabolic surgery.

Risks and Considerations

Like any surgical procedure, metabolic surgery carries risks. It’s important for patients to be well-informed and work closely with their healthcare providers to weigh the benefits and risks. Common risks include:

1. Surgical Complications: These can include infection, bleeding, and adverse reactions to anesthesia.
2. Nutritional Deficiencies: Due to reduced absorption of nutrients, patients may experience deficiencies in vitamins and minerals, necessitating lifelong supplementation.
3. Gastrointestinal Issues: Problems such as dumping syndrome, gallstones, and bowel obstructions can occur.
4. Weight Regain: Some patients may experience weight regain over time, particularly if they do not adhere to recommended lifestyle changes.

Patient Selection and Preoperative Assessment

Not everyone is a candidate for metabolic surgery. Ideal candidates typically:

1. Have a BMI of 40 or higher.
2. Have a BMI of 35 or higher with obesity-related health conditions.
3. Have tried and failed to lose weight through diet and exercise.
4. Are committed to making the necessary lifestyle changes post-surgery.

A comprehensive preoperative assessment is crucial. This includes medical evaluations, nutritional counseling, psychological assessment, and education about the surgery and its implications.

Postoperative Care and Long-term Management

Postoperative care is vital for the success of metabolic surgery. This includes:

1. Regular Follow-ups: Frequent visits to the healthcare provider to monitor progress and address any complications.
2. Nutritional Support: Guidance from dietitians to ensure adequate nutrient intake and manage deficiencies.
3. Physical Activity: Incorporating regular physical activity to maintain weight loss and improve overall health.
4. Support Groups: Engaging in support groups or counseling to address emotional and psychological challenges.

Conclusion

Metabolic surgery is a powerful tool in the fight against obesity and metabolic disorders. It offers significant benefits, including sustained weight loss, improvement or remission of type 2 diabetes, and better overall health. However, it is not a quick fix and requires a lifelong commitment to lifestyle changes and medical follow-up.

As a board-certified bariatric surgeon, I am committed to helping my patients navigate the complexities of metabolic surgery, providing them with the tools and support they need to achieve lasting health and wellness. If you are considering metabolic surgery, I encourage you to schedule a complimentary consultation to explore your options and embark on a journey towards a healthier, more fulfilling life.

The post Metabolic Surgery 101: An Essential Guide for Patients appeared first on My New Body Obesity Center.

Common Side Effects of Ozempic

Like any medication, Ozempic can cause side effects. The most commonly reported ones include:

1. Nausea: Many patients experience nausea, especially when they first start taking Ozempic or increase their dose. This side effect often decreases over time as the body adjusts to the medication.
2. Vomiting: Along with nausea, vomiting can occur, particularly at the beginning of treatment.
3. Diarrhea: Gastrointestinal issues such as diarrhea are also common, potentially leading to dehydration if not managed properly.
4. Constipation: On the opposite end of the spectrum, some patients may experience constipation while taking Ozempic.
5. Abdominal Pain: Discomfort or pain in the abdomen is another side effect that can occur.

Serious Side Effects and Risks

While less common, Ozempic can also cause more serious side effects that require immediate medical attention:

1. Pancreatitis: There is a risk of developing pancreatitis, a potentially life-threatening inflammation of the pancreas. Symptoms include severe abdominal pain that may radiate to the back, nausea, and vomiting.
2. Kidney Problems: Ozempic can cause kidney issues, particularly in patients who experience severe vomiting or diarrhea, which can lead to dehydration and worsen kidney function.
3. Thyroid Tumors: Studies in rodents have shown an increased risk of thyroid C-cell tumors with semaglutide. While this has not been confirmed in humans, it remains a concern and patients should be monitored for symptoms such as a lump in the neck, hoarseness, or difficulty swallowing.
4. Allergic Reactions: Some individuals may have allergic reactions to Ozempic, ranging from mild skin rashes to severe reactions such as anaphylaxis, which requires emergency treatment.
5. Diabetic Retinopathy Complications: In patients with pre-existing diabetic retinopathy, Ozempic can worsen the condition, potentially leading to vision changes or loss.

Disadvantages and Considerations

In addition to the side effects, there are other disadvantages and considerations to keep in mind:

1. Cost: Ozempic can be expensive, and not all insurance plans may cover the full cost of the medication.
2. Injection Form: Ozempic is administered via injection once a week, which may be inconvenient or uncomfortable for some patients compared to oral medications.
3. Lifestyle Adjustments: Patients taking Ozempic need to adhere to lifestyle changes, including a healthy diet and regular exercise, to maximize the benefits of the medication.
4. Monitoring: Regular monitoring of blood sugar levels and periodic medical check-ups are essential to ensure the medication is working effectively and to catch any adverse effects early.
5. Interactions with Other Medications: Ozempic can interact with other medications, so it is important to inform healthcare providers of all drugs being taken to avoid potential interactions.

Conclusion

While Ozempic can be a valuable tool in managing type 2 diabetes, it is important for patients to be aware of the potential side effects and disadvantages. Discussing these risks with a healthcare provider can help ensure that the benefits of the medication outweigh the potential downsides. Regular monitoring and communication with your healthcare team are crucial to managing any adverse effects and achieving the best possible outcomes with Ozempic.

References

1. Khawagi WY, Alotabi J, Shamlan WB, Abdullah Sh, Bawazir M, Alqaysi L, et al. KSA Patients with Obesity: Their Knowledge and Awareness Level of the Side Effects of Ozempic. Arch Pharm Pract. 2023;14(S):A06231510
2. Bieganek, P., Sadłowski, B., Łukaszewicz, S., Pawłowski, P., Rybak, J.,  & Kordialik, J. et al. (2024). NEWLY-EMERGING SIDE EFFECTS OF SEMAGLUTIDE AND LIRAGLUTIDE USAGE ASSOCIATED WITH WEIGHT LOSS TREATMENT. Health Problems of Civilization. https://doi.org/10.5114/hpc.2024.140505
3. Ruder K. As Semaglutide’s Popularity Soars, Rare but Serious Adverse Effects Are Emerging. JAMA. 2023;330(22):2140–2142. doi:10.1001/jama.2023.16620

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Understanding Bariatric Surgery

Before delving into the cost comparison, it’s essential to understand the different types of bariatric surgery. The most common procedures include:

1. Bypass Gástrico: This involves creating a small pouch from the stomach and connecting it directly to the small intestine.
2. Sleeve Gastrectomy: This procedure involves removing a large portion of the stomach, leaving a tube-like structure.
3. Adjustable Gastric Band: This involves placing a band around the upper part of the stomach to create a small pouch that holds food.
4. Biliopancreatic Diversion with Duodenal Switch: This is a more complex procedure that involves a partial gastrectomy and re-routing the small intestine.

Each of these procedures varies in complexity, recovery time, and cost.

Cost of Bariatric Surgery in the United States

The cost of bariatric surgery in the United States can be prohibitive for many individuals. On average, the price for these procedures ranges from $15,000 to $25,000, depending on the type of surgery and the specific medical facility. Here is a breakdown of the average costs:

1. Bypass Gástrico: $18,000 – $25,000
2. Sleeve Gastrectomy: $15,000 – $20,000
3. Adjustable Gastric Band: $14,000 – $18,000
4. Biliopancreatic Diversion with Duodenal Switch: $20,000 – $30,000

Several factors contribute to these high costs, including:

• Surgeon’s Fees: Experienced and reputable surgeons command higher fees.
• Hospital Fees: This includes the cost of operating room time, hospital stay, nursing care, and post-operative care.
• Pre-Operative and Post-Operative Care: This includes consultations, nutritional counseling, psychological evaluations, and follow-up visits.
• Anesthesia Fees: Anesthesiologists’ fees can be substantial, depending on the length and complexity of the surgery.
• Insurance: While some insurance plans cover bariatric surgery, many patients face high deductibles and out-of-pocket costs.

Cost of Bariatric Surgery in Tijuana, Mexico

In contrast, the cost of bariatric surgery in Tijuana is significantly lower, making it an attractive option for many patients. The average costs are as follows:

1. Bypass Gástrico: $5,500 – $8,500
2. Sleeve Gastrectomy: $4,000 – $6,500
3. Adjustable Gastric Band: $4,000 – $6,000
4. Biliopancreatic Diversion with Duodenal Switch: $7,000 – $10,000

Several factors contribute to the lower costs in Tijuana:

• Lower Overhead Costs: Medical facilities in Tijuana generally have lower overhead costs compared to those in the United States.
• Competitive Market: The medical tourism market in Tijuana is highly competitive, driving prices down.
• Lower Labor Costs: Medical professionals in Mexico typically have lower salaries compared to their counterparts in the United States.
• Currency Exchange Rates: Favorable exchange rates can make medical procedures in Mexico more affordable for U.S. patients.

Additional Considerations

While cost is a significant factor, it’s not the only consideration when choosing where to have bariatric surgery. Other factors include:

1. Quality of Care: It’s crucial to research the quality of care provided by medical facilities and surgeons in Tijuana. Look for internationally accredited hospitals and surgeons with extensive experience in bariatric surgery.
2. Travel Expenses: Factor in the cost of travel, including airfare, accommodations, and transportation. These expenses can add up but are often still lower than the cost of surgery in the United States.
3. Post-Operative Care: Consider the logistics of follow-up care. Will you be able to stay in Tijuana for an extended period, or will you need to return for follow-up visits? Ensure you have a plan for managing post-operative care once you return home.
4. Legal and Safety Concerns: Be aware of the legal and safety concerns associated with undergoing surgery abroad. Ensure that the medical facility adheres to strict safety and hygiene standards.

Risks and Benefits

Benefits of Choosing Tijuana:

• Cost Savings: The most significant benefit is the substantial cost savings. Patients can save thousands of dollars by opting for surgery in Tijuana.
• Shorter Wait Times: Patients may experience shorter wait times for surgery compared to the United States.
• Personalized Care: Some patients report receiving more personalized care and attention in Tijuana.

Risks and Challenges:

• Quality Control: There is a risk of varying standards of care. Not all facilities may meet the high standards expected in the United States.
• Communication Barriers: Language barriers can pose challenges in communication, although many facilities cater to English-speaking patients.
• Legal Recourse: In the event of complications or malpractice, legal recourse may be more complicated and less effective than in the United States.
• Travel Risks: Traveling shortly after surgery carries its own risks, including complications related to changes in air pressure and the physical strain of travel.

Conclusion

Choosing where to undergo bariatric surgery is a significant decision that involves weighing the cost against other critical factors such as quality of care, safety, and post-operative support. While the cost savings of having bariatric surgery in Tijuana can be substantial, it’s essential to thoroughly research and consider all aspects of the decision.

For many, the affordability of bariatric surgery in Tijuana offers a viable solution to the high costs in the United States. However, patients should approach this option with careful planning and consideration of all potential risks and benefits. Consulting with healthcare professionals, reviewing the credentials of the medical facilities and surgeons, and ensuring comprehensive post-operative care are crucial steps in making an informed decision that prioritizes both cost and safety.

Ultimately, the goal of bariatric surgery is to achieve significant weight loss and improve overall health. Whether in the United States or Tijuana, patients should prioritize their health and well-being in their decision-making process, ensuring that they receive the highest standard of care possible within their financial means.

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The Gastric Bypass (RNY): A Proven Track Record

The RNY gastric bypass is the gold standard of bariatric surgery, boasting a long history of success.¹ Developed in the 1960s, it has undergone refinement over decades, resulting in a well-established and highly effective procedure. Here’s how it works:

• Stomach Reduction:A small pouch is created from the upper portion of the stomach, significantly limiting food intake and promoting early satiety.
• Intestinal Rerouting: The small intestine is divided, and the lower portion is bypassed, connecting directly to the new stomach pouch. This bypasses a section of the small intestine, where nutrients are typically absorbed.
• Dual Mechanisms: The RNY works through two primary mechanisms: restriction (reduced stomach size) and malabsorption (bypassed intestine). This combination leads to significant calorie restriction and weight loss.
  

  The Mini Gastric Bypass (MGB): A Streamlined Approach

  The MGB is a more recent innovation, emerging as a less complex alternative to the RNY. Here’s a breakdown of the MGB procedure:

• Stomach Reduction: Similar to the RNY, a small stomach pouch is created.
• Single Intestinal Connection: Unlike the RNY, the small intestine is not divided. Instead, a single connection is fashioned between the new stomach pouch and a specific point lower in the small intestine. This bypasses a shorter segment of the intestine compared to the RNY.
• Simpler Technique: The MGB involves fewer steps and intestinal resections, making it a potentially faster procedure.
  

  Key Differences Between MGB and RNY

  1. Surgical Complexity:  The RNY is a more intricate procedure due to the creation of two connections (anastomoses) and the division of the small intestine. The MGB, with its single anastomosis and no intestinal division, is considered less complex.

  2. Potential Risks: The RNY carries a slightly higher risk of complications due to the additional anastomosis and potential for leaks or stenosis (narrowing) at these connection points. The MGB, with its single connection, may have a lower risk of these specific complications.²

  3. Recovery Time: The MGB, being a faster procedure, may translate to a shorter hospital stay and potentially quicker recovery.
  

  4. Weight Loss: Studies suggest both procedures can achieve similar weight loss results in the long term. However, some data indicates the RNY might lead to slightly greater initial weight loss.³

  5. Malabsorption: The RNY bypasses a longer segment of the intestine, potentially leading to a higher degree of malabsorption of certain nutrients. The MGB, with its shorter bypass, may result in less malabsorption.

Who is a Good Candidate for Each Procedure?

The ideal candidate for each procedure depends on several factors:

• Body Mass Index (BMI): Both procedures are typically recommended for patients with a BMI of 40 or higher or those with a BMI of 35 or higher with significant weight-related health problems.
• Anatomy: Certain anatomical variations might favor one procedure over the other.
• Surgical History: Prior abdominal surgeries can influence the choice of procedure.
• Patient Preferences: Some patients may prioritize a less complex surgery with a potentially faster recovery (MGB), while others may be comfortable with the established track record of the RNY.⁴
  

  Important Considerations Before Surgery

  Regardless of the chosen procedure, a successful weight loss journey requires a long-term commitment to healthy lifestyle changes.

Here are some crucial aspects to consider:

• Pre-operative Evaluation: This involves a comprehensive assessment of your medical history, nutritional habits, and psychological readiness.
• Dietary Changes: Both procedures necessitate significant dietary modifications post-surgery to ensure proper nutrient absorption and prevent complications.
• Nutritional Support: Supplementation with vitamins and minerals is often necessary after both procedures.
• Long-Term Follow-Up: Regular follow-up with your bariatric surgeon and a registered dietitian is essential for monitoring progress and addressing any potential issues.

The Bottom Line: Partnering for Optimal Results

The decision between MGB and RNY is not a one-size-fits-all solution. During your consultation, I will discuss your individual needs, medical history

• 1. Maclellan, W. C., & Johnson, J. M. (2021). Laparoscopic Gastric Bypass: Still the Gold Standard?. The Surgical clinics of North America, 101(2), 161–175. https://doi.org/10.1016/j.suc.2020.12.013
  2. Sumer, A., Mahawar, K., Aktokmakyan, T. V., Savas, O. A., Peksen, C., Barbaros, U., & Mercan, S. (2021). Bridged one-anastomosis gastric bypass: technique and preliminary results. Surgery today, 51(8), 1371–1378. https://doi.org/10.1007/s00595-021-02264-y
  3. Barros, F., Negrão, M. G., & Negrão, G. G. (2019). WEIGHT LOSS COMPARISON AFTER SLEEVE AND ROUX-EN-Y GASTRIC BYPASS: SYSTEMATIC REVIEW. Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 32(4), e1474. https://doi.org/10.1590/0102-672020190001e1474
  4. Kermansaravi, M., Parmar, C., Chiappetta, S., Shahabi, S., Abbass, A., Abbas, S. I., Abouzeid, M., Antozzi, L., Asghar, S. T., Bashir, A., Bhandari, M., Billy, H., Caina, D., Campos, F. J., Carbajo, M. A., Chevallier, J. M., Jazi, A. H. D., de Gordejuela, A. G. R., Haddad, A., ElFawal, M. H., … De Luca, M. (2022). Patient Selection in One Anastomosis/Mini Gastric Bypass-an Expert Modified Delphi Consensus. Obesity surgery, 32(8), 2512–2524. https://doi.org/10.1007/s11695-022-06124-7

The post What is the difference between Mini Gastric Bypass and Gastric Bypass? appeared first on My New Body Obesity Center.

Comparing Weight Regain Across Bariatric Surgeries:

• Gastric Bypass: Gastric bypass surgery involves creating a small stomach pouch and rerouting the digestive tract. Initially effective, studies indicate that approximately 10% to 20% of patients may experience significant weight regain within five years post-surgery.¹
• Sleeve Gastrectomy: Sleeve gastrectomy involves removing a portion of the stomach to create a smaller pouch. While effective initially, research suggests that around 15% to 30% of patients may encounter weight regain within five years after the procedure.
• Adjustable Gastric Banding: Adjustable gastric banding, once popular, has declined due to complications and inadequate weight loss maintenance. Weight regain rates can be high, with up to 50% of patients experiencing significant weight regain within five years.
• Switch Duodenal: Duodenal switch surgery combines gastric sleeve surgery and intestinal rerouting, offering significant and sustained weight loss. However, around 5% to 15% of patients may experience weight regain over time.
• Revisional Surgery: For those experiencing weight regain after initial bariatric surgery, revisional surgery may be an option. Success varies depending on the type of original surgery and individual patient factors.

Understanding the Causes of Weight Regain

Several factors contribute to weight regain after bariatric surgery, including changes in eating habits, psychological factors, medical conditions, surgical factors, and inadequate follow-up care and support.

1. Changes in Eating Habits: While bariatric surgery initially restricts the amount of food that can be consumed, some patients may gradually revert to old eating habits over time. This could include consuming calorie-dense, nutrient-poor foods or snacking between meals, leading to an increase in calorie intake and weight regain.
2. Psychological Factors: Emotional eating, stress, depression, and anxiety can all play a significant role in weight regain after bariatric surgery. Some individuals may turn to food as a coping mechanism for dealing with life’s challenges, which can sabotage weight loss efforts and contribute to regain.
3. Medical Conditions and Medications: Certain medical conditions, such as hypothyroidism or hormonal imbalances, can affect metabolism and lead to weight regain. Additionally, medications used to manage these conditions may have side effects that promote weight gain.
4. Surgical Factors: While bariatric surgeries are designed to promote weight loss, anatomical changes to the gastrointestinal tract can sometimes be altered over time. This may include pouch dilation in gastric bypass or sleeve gastrectomy patients, or stoma enlargement in adjustable gastric banding patients, which can result in decreased restriction and subsequent weight regain.
5. Inadequate Follow-Up Care and Support: Successful weight management after bariatric surgery requires ongoing monitoring, education, and support. Patients who do not receive regular follow-up care from their healthcare team may be more prone to weight regain due to a lack of accountability, guidance, and reinforcement of healthy behaviors.
6. Metabolic Adaptations: The body’s metabolism may adapt to weight loss over time, leading to a decrease in energy expenditure and potential weight regain. This phenomenon, known as metabolic adaptation, can make it challenging to maintain weight loss long-term, especially without ongoing lifestyle modifications.
7. Social and Environmental Factors: Social influences, such as family dynamics, workplace culture, and community norms, can impact eating behaviors and contribute to weight regain. Environmental factors, such as easy access to high-calorie foods or sedentary lifestyles, can also influence weight management outcomes.

If you’re experiencing weight regain after bariatric surgery, seek support from healthcare professionals who specialize in bariatric care. Take these steps:

• Consult with your bariatric surgeon or a bariatric medicine specialist to discuss concerns about weight regain after bariatric surgery.
• Reevaluate diet and lifestyle habits with the guidance of a registered dietitian or nutritionist who understands the unique needs of bariatric patients.
• Address underlying psychological factors contributing to weight regain by seeking support from a therapist or support group.
• Explore the possibility of revisional surgery with your healthcare team if deemed appropriate.

Remember, weight regain after bariatric surgery is a complex issue, but with the right support and strategies, it’s possible to overcome challenges and achieve long-term success in managing weight regain after bariatric surgery.

References

1. Maleckas, A., Gudaitytė, R., Petereit, R., Venclauskas, L., & Veličkienė, D. (2016). Weight regain after gastric bypass: etiology and treatment options. Gland surgery, 5(6), 617.

The post Understanding Weight Regain After Bariatric Surgery: A Comparative Analysis appeared first on My New Body Obesity Center.

	Pros: Orbera boasts a strong reputation in the gastric balloon market, offering a straightforward placement procedure and a track record of successful weight loss outcomes. Its balloon placement procedure involves endoscopic insertion under sedation, which is minimally invasive and typically well-tolerated by patients. The six-month treatment duration allows for significant weight loss during the initial phase of the program.	Cons: Despite its advantages, the fixed volume of Orbera balloons may lead to discomfort for some patients, especially during the initial adjustment period. Additionally, the limited treatment duration may pose challenges for sustaining long-term weight loss, as patients may regain weight once the balloon is removed.
	Pros: The Spatz3 distinguishes itself with its adjustable volume feature, providing personalized treatment options tailored to individual patient needs. Unlike other gastric balloons, the Spatz3 allows for volume adjustment post-insertion, enabling healthcare providers to optimize balloon size based on patient tolerance and anatomical factors. Moreover, the Spatz3 offers a prolonged placement duration of up to 12 months, providing extended support for weight loss and potentially improving long-term outcomes.	Cons: While the Spatz3 offers enhanced adjustability and duration compared to other balloons, its availability may be limited to certain centers, potentially impacting accessibility for some patients. Additionally, the procedure for Spatz3 insertion and removal requires endoscopic intervention, which may involve some discomfort and risks associated with the procedure.
	Pros: ReShape Duo features a dual-balloon system, potentially enhancing satiety and weight loss compared to single-balloon alternatives. The two connected balloons work synergistically to occupy more space in the stomach, leading to increased feelings of fullness and reduced food intake. Additionally, the ReShape Duo program includes a comprehensive support system, including dietary counseling and behavioral therapy, to help patients achieve long-term success.	Cons: Despite its potential benefits, the dual-balloon system of ReShape Duo may increase the risk of side effects such as nausea, vomiting, and discomfort. Moreover, the endoscopic insertion and removal procedure may be more invasive compared to other gastric balloon options, requiring careful consideration of individual patient tolerance and preferences.
	Pros: Allurion (formerly known as Elipse) stands out as a swallowable gastric balloon, offering a non-invasive insertion method without the need for endoscopy. The Allurion balloon is swallowed in capsule form and inflated with a catheter attached to a small tube, which is then removed, leaving the balloon in the stomach. This innovative approach eliminates the need for sedation or anesthesia and may appeal to patients seeking a less invasive weight loss solution.	Cons: Despite its non-invasive nature, the self-deflating nature of Allurion balloons limits treatment duration to approximately four months. Furthermore, the lack of endoscopic placement and removal may limit healthcare provider oversight and monitoring, potentially increasing the risk of complications such as balloon migration or early deflation.
	Pros: Heliosphere offers a gas-filled balloon system with a non-invasive insertion method, similar to Elipse. The balloon is inserted orally and inflated with a gas-filled capsule, eliminating the need for endoscopy. This approach may appeal to patients seeking a less invasive alternative to traditional gastric balloons.	Cons: Despite its non-invasive insertion method, Heliosphere balloons have a shorter treatment duration due to self-deflation within four months. Additionally, concerns regarding migration and premature deflation may arise, as with other gas-filled balloon systems.
	Pros: Obalon presents a unique swallowable balloon system, eliminating the need for endoscopic procedures. The Obalon balloon is swallowed in capsule form and inflated with a catheter, similar to Elipse. This approach offers a non-invasive insertion method without sedation or anesthesia.	Cons: Despite its innovative design, the requirement for multiple balloons increases procedural complexity and costs. Each Obalon balloon is designed to remain in the stomach for approximately six months, and patients may require multiple treatment cycles to achieve their desired weight loss goals.

In conclusion, each gastric balloon brand offers distinct advantages and considerations. While Orbera, ReShape Duo, Elipse, Heliosphere, and Obalon provide viable options for weight loss, the Spatz3 stands out for its adjustable volume and extended placement duration. If you’re considering gastric balloon therapy, it’s essential to consult with a healthcare provider to determine the best option for your individual needs. At My New Body Obesity Center, Dr. Carlos specializes in weight loss interventions and offers free consultations to discuss your options and develop a personalized treatment plan. Take the first step towards a healthier you and schedule your consultation today.

References

1. Stavrou, G., Shrewsbury, A., & Kotzampassi, K. (2021). Six intragastric balloons: Which to choose?. World journal of gastrointestinal endoscopy, 13(8), 238–259. https://doi.org/10.4253/wjge.v13.i8.238

The post What is the Best Brand of Gastric Balloon? A Comprehensive Comparison of Major Brands appeared first on My New Body Obesity Center.

The IGB is a non-surgical weight loss device placed in the stomach to promote feelings of fullness and reduce food intake. However, its effectiveness relies heavily on dietary modifications.¹ Let’s delve into the world of post-balloon nutrition and explore how to optimize your weight loss journey.

The First Few Days: A Time for Adjustment

Immediately following IGB placement, your stomach will be quite sensitive. Your doctor will likely recommend a clear liquid diet for the first 24-48 hours. This allows the balloon to settle comfortably and minimizes the risk of nausea or vomiting. Clear liquids include water, clear broths, unsweetened black tea or coffee, and diluted fruit juices.

Transitioning to Soft Foods: Introduce Variety with Caution

After a few days, you can gradually introduce soft, easily digestible foods. Think mashed potatoes, yogurt, scrambled eggs, and well-cooked, flaked fish. Remember, portion control is crucial. Start with small bites and chew thoroughly, listening to your body’s fullness cues.

Here are some key principles to remember during this soft food phase:

• Prioritize Protein: Protein keeps you feeling full for longer. Aim for lean protein sources like chicken breast, fish, tofu, or low-fat cottage cheese.
• Hydration is Key: Water is essential for digestion and helps prevent constipation, a common side effect of the IGB. Aim for 1.5-2 liters of water daily.
• Limit Sugary Drinks: Avoid sugary sodas, juices, and sports drinks. They contribute to empty calories and can cause bloating.
• Minimize Fatty and Greasy Foods: Fatty and greasy foods can irritate your stomach and delay digestion. Opt for lean protein sources and healthy fats like avocado or olive oil.
• Say No to Straws: Straws can increase air intake, leading to discomfort and bloating. Sip directly from your cup or glass.

The Art of Portion Control: Your New Best Friend

Following the IGB placement, your stomach capacity will be significantly reduced. This presents a unique opportunity to adopt healthy portion control habits. Here are some tips:

• Use Smaller Plates: Smaller plates visually trick your brain into feeling satisfied with a smaller amount of food.
• Focus on Nutrient-Dense Foods: Fill your plate with fruits, vegetables, and whole grains packed with vitamins, minerals, and fiber to keep you feeling nourished.
• Mindful Eating: Slow down and savor your food. Put down your fork between bites, and pay attention to your body’s fullness cues. Stop eating before you feel completely stuffed.
• Snack Strategically: Choose healthy snacks like fruits, vegetables, or low-fat yogurt to curb hunger pangs between meals. Avoid sugary, processed snacks.

Building a Sustainable Eating Pattern for Long-Term Success

The post-balloon diet isn’t just about short-term weight loss; it’s about establishing healthy eating habits for the long haul. Here are some additional tips to consider:

• Plan Your Meals: Planning your meals helps avoid impulsive choices. Consider prepping some healthy snacks and meals in advance for busy days.
• Don’t Skip Meals: Skipping meals can lead to overeating later. Aim for 3 balanced meals and 2-3 healthy snacks throughout the day.
• Find a Support System: Surround yourself with positive influences who support your weight loss goals. Consider joining a weight loss support group or finding an accountability buddy.

Conclusion and Call to Action

The intragastric balloon is a powerful tool for weight loss, but it’s only one part of the equation. By following a well-structured nutritional plan, you can maximize your results and create a healthier, happier you.

Ready to Take Control of Your Weight Loss Journey?

Schedule a consultation with me, Dr. Monica Valencia, to discuss whether the IGB is right for you. We can develop a personalized plan to optimize your weight loss journey.

Additionally, consider joining the My New Body Obesity Center Facebook Support Group! Connect with a supportive community of individuals on a similar path. Share experiences, ask questions, and find encouragement as you work towards a healthier you.

References

1. Swei, E., Almuhaidb, A., Sullivan, S., Al-Shahrani, A., D’Souza, F. R., Altayar, O., … & Kushnir, V. (2023). Comparison of the Efficacy and Safety of the FDA-approved Intragastric Balloon Systems in a Clinical Setting. Journal of clinical gastroenterology, 57(6), 578-585.
2. Silva, C. M., & Zotarelli Filho, I. J. (2023). Major considerations in the use of bariatric endoscopic therapy (intragastric balloon) and nutrological therapy in successful weight loss in patients with obesity: a systematic review. International Journal of Nutrology, 16(3).
3. Nunes, G. C., & Silva, L. B. (2020). Nutritional Follow-Up during Intragastric Balloon Treatment. Intragastric Balloon for Weight Management: A Practical Guide, 229-237.

The post Nutrition After Intragastric Balloon: A Guide by Dr. Monica Valencia appeared first on My New Body Obesity Center.

Understanding the Role of Nutrition After Bariatric Surgery: After bariatric surgery, the anatomy of the digestive system is altered, leading to changes in the way the body absorbs and processes nutrients. As a result, it’s crucial to adopt a carefully planned and balanced diet to ensure adequate nutrition while promoting weight loss and preventing complications.

Phase 1: Clear Liquid Diet: In the immediate post-operative period, patients are typically instructed to follow a clear liquid diet for a certain period, usually the first few days after surgery. This phase helps to rest the digestive system, prevent dehydration, and minimize discomfort. Clear liquids include water, broth, sugar-free gelatin, and clear fruit juices without pulp. It’s essential to sip liquids slowly and avoid carbonated beverages and straws, as they can cause gas and discomfort.

Phase 2: Full Liquid Diet: Once the clear liquid phase is tolerated, patients progress to a full liquid diet, which includes thicker liquids such as protein shakes, low-fat yogurt, and cream-based soups. The full liquid diet provides more nutrients and protein to support healing and recovery while still being easy to digest. It’s essential to choose liquids high in protein and low in sugar to support muscle preservation and promote satiety.

Phase 3: Soft/Pureed Diet: As the surgical site heals, patients can transition to a soft or pureed diet, which includes foods that are soft in texture or blended to a smooth consistency. Examples include scrambled eggs, cottage cheese, mashed potatoes, and pureed vegetables. It’s crucial to chew food thoroughly and eat slowly to prevent discomfort and ensure proper digestion. Patients should also focus on consuming adequate protein to support muscle maintenance and promote healing.¹

Phase 4: Transition to Solid Foods: After several weeks on a soft/pureed diet and with approval from their healthcare provider, patients can gradually reintroduce solid foods into their diet. However, it’s essential to start with small portions and focus on low-fat, high-protein foods such as lean meats, fish, poultry, tofu, and legumes. Patients should avoid foods high in sugar, fat, and calories, as they can contribute to weight regain and digestive issues.

Key Nutritional Guidelines After Bariatric Surgery:

1. Prioritize Protein: Protein is essential for preserving lean muscle mass, promoting satiety, and supporting the body’s healing process after surgery. Aim to consume at least 60-80 grams of protein per day, focusing on lean sources such as poultry, fish, eggs, and plant-based proteins.
2. Stay Hydrated: Adequate hydration is crucial for overall health and proper digestion. Drink at least 64 ounces of water or other calorie-free fluids daily, sipping fluids between meals to avoid overfilling the stomach.
3. Limit Sugary and High-Fat Foods: Avoid foods and beverages high in sugar, fat, and empty calories, as they can contribute to weight regain and gastrointestinal discomfort. Opt for nutrient-dense foods that provide essential vitamins, minerals, and protein without excess calories.
4. Chew Thoroughly and Eat Mindfully: Take small bites and chew food thoroughly to prevent discomfort and aid digestion. Practice mindful eating by focusing on the taste, texture, and satisfaction of each meal, eating slowly and stopping when you feel comfortably full.
5. Supplement Wisely: Bariatric surgery can affect the body’s ability to absorb certain nutrients, leading to deficiencies if not addressed. Work closely with your healthcare provider to determine the appropriate supplements to support your nutritional needs, including multivitamins, calcium, vitamin D, and vitamin B12.

Nutrition plays a crucial role in the success of bariatric surgery, helping patients achieve and maintain weight loss while supporting overall health and well-being. By following the recommended nutritional guidelines after bariatric surgery, individuals can optimize their outcomes, minimize complications, and enjoy a healthier and more fulfilling life. Remember to consult with your healthcare provider or a registered dietitian for personalized guidance and support on your post-operative journey.

Join our Facebook support group to connect with others who have undergone bariatric surgery, share experiences, ask questions, and receive support and encouragement on your journey to a healthier lifestyle. Together, we can empower each other to achieve our weight loss goals and live our best lives. Click here to join now: https://www.facebook.com/groups/1586019738129126

References:

1. Pinnock, G. L., & O’Kane, M. P. (2023). Nutritional management after bariatric surgery. In Obesity, Bariatric and Metabolic Surgery: A Comprehensive Guide (pp. 1177-1191). Cham: Springer International Publishing.

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