Weight-Loss Surgery's Vital Link to Diet, Nutrition

Obesity remains at epidemic levels among U.S. adults and it’s a growing concern with children as well. Since the early 1990s, weight-loss surgery — or bariatric surgery — has been a vital treatment option for obese adults.

While dieting and regular exercise for those who are moderately overweight may prove successful, such commitments to lifestyle changes are mostly ineffective for those who are severely obese.

Who is a prime candidate for weight-loss surgery?

“A good candidate for bariatric surgery includes somebody who has tried and failed medically supervised weight-loss programs for their obesity,” says Anthony Gonzalez, M.D., director of bariatric surgery at South Miami Hospital, which offers three types of weight-loss surgeries. “Somebody who is stable, psychologically and socially. Someone who does not have an addiction to drugs or alcohol. And someone who has the correct social support to be successful in the long run.”

(Watch as the Baptist Health News Team hears from Anthony Gonzalez, M.D., director of bariatric surgery at South Miami Hospital, about the importance of dieting and nutrition before and after weight-loss surgery. Video by Dylan Kyle.)

Over the past two decades, there have been significant advances in bariatric surgeries, especially with the use of robotic technology to facilitate minimally invasive procedures. But one aspect that has not changed much is the need for patients to reduce calorie intake and consume healthier, smaller meals.

Bariatric surgery can reduce the size of the stomach by up to 70 percent. The sacrifice can be considerable, but the result can be very rewarding. Significant weight can be reduced to improve symptoms of many chronic illnesses, such as coronary heart disease and diabetes.

South Miami Hospital offer these three weight-loss surgery procedures:

• Gastric Bypass – reduces the size of your stomach and reroutes the digestive system (the gold standard for bariatric surgery).
• Adjustable Gastric Band – shrinks stomach capacity and restricts food intake after a silicone band is placed around the top end of the stomach.
• Gastric Sleeve – removes a section of your stomach, causing a reduction in food intake, reducing hunger sensation.

“We’re doing quite complex operations on patients who are obese,” says Dr. Gonzalez. “Using the robots, with the benefits of three-dimensional vision and wrist articulation of these instruments, allows us to have better outcomes for the patients.”

Even with the most advanced technology and skilled surgeons, bariatric procedures cannot be successful without the patient making substantial lifestyle changes when it comes to dieting and nutritional choices, says Dr. Gonzalez.

“Nutrition is very important before and after bariatric surgery and patients need to have nutritional counseling prior to surgery, and this counseling continues after surgery,” he says.

Weight loss varies depending on the type of surgery and the health of the patient. With adjustable gastric band, a patient could lose 40 to 50 percent of excess weight. After a gastric sleeve, a weight loss of about 60 to 65 percent of excess weight is quite possible, says Dr. Gonzalez, while a gastric bypass could result in a 75 to 80 percent reduction of excess weight.

“It really has to be a long-term commitment with regard to nutrition because we understand that eating behavior has to be changed,” says Dr. Gonzalez. “A typical patient will start after surgery with a liquid diet, move on to a puree diet and eventually eat regular food. We try to teach the patients to eat small meals frequently that are mainly based on proteins, while staying away from carbs and starches.”