BayChoice Bariatrics & Digestive Center

   The key factor to any healthy pregnancy is nutrition and this is especially true for bariatric surgery patients. Please make sure your Obstetrician is aware of the type of bariatric surgery that you have undergone and also maintains close contact working with your Bariatric Surgeon throughout your pregnancy to ensure that both you and your baby are getting proper nutrition.

   Although it would be easier if there were, there are no set recommendations about how much of specific nutrients a pregnant woman should consume daily. Everyone is different. Talk with your surgeon about your needs and work with your dietician to make sure you are receiving the proper nutrition. Post bariatric surgery, women should be sure that they are receiving enough of the following:

• Folate
• Calcium
• Iron
• Vitamin B12
• Vitamin D

   Prenatal vitamins are extremely important to pregnancy and contain many, if not all, of these essential nutrients. Remember, gastric banding is adjustable. The band can be deflated during pregnancy due to severe nausea and vomiting or if the mother is unable to fully swallow prenatal vitamins. Keep your bariatric surgeon in the loop, because if you are experiencing morning sickness, loosening the band can help to make you feel better. Talk to your obstetrician about chewable or liquid prenatal vitamin options. It is recommended that women start taking prenatal vitamins before they even become pregnant.

Congratulations, you’ve completed your successful bariatric surgery and reached your weight loss goals. You’ve decided to start a family, but wonder “Is it safe or even possible to become pregnant after my bariatric surgery? How long should I wait?”

These are but a few of the questions you may be asking yourself. Well, we’re here to tell you that if you are a woman able to get pregnant, yes you can! In fact, it is often safer for both mother and child to have a baby after bariatric surgery rather than while still being morbidly obese. Morbidly obese women are often infertile and more apt to experience pregnancy-related complication such as gestational diabetes, hypertension, pre-eclampsia, and fetal distress. Also, morbidly obese women are prone to require a cesarean or C-section delivery.

How Long Should I Wait? …


Any woman of childbearing age who wishes to become pregnant after gastric banding surgery with Lap-Band is suggested to wait approximately 6 months post-surgery. This 6 month span consists of a period of weight loss which will create challenges in meeting nutritional needs without the added stress of pregnancy. Often times during weight loss, a growing fetus may be deprived nutrients needed to develop.

We recommend all of our female patients of child-bearing age use a reliable contraception during the 6 month waiting period.


How is Pregnancy After Bariatric Surgery Safer? …

The latest review of 75 studies found that becoming pregnant after bariatric surgery is actually less risky than becoming pregnant while still obese and decreased the rates of adverse outcomes for mothers and their newborns. The study, appearing in the November 2008 issue of the Journal of the American Medical Association, found specifically that none of the women who had weight loss surgery developed gestational diabetes, however this condition was discovered in 22.1 percent of obese women. Also, none of the women who had bariatric surgery were found to have pre-eclampsia but this condition was discovered in 3.1 percent of their obese counterparts.

Weight loss surgery may actually help protect obese women and their babies from the following common complications:



Many mothers who have previously undergone weight loss surgery prior to pregnancy experience less gained weight during their pregnancy. This is beneficial to both mother and child because too much weight gain is risky. All in all, pregnancy after Lap-Band surgery has been found to be both safer and more beneficial to the health and well-being of both mother and child.

Obese individuals who undergo bariatric surgery substantially slash their risk of certain obesity-related cancers, according to a new study presented at the 25th annual meeting of the American Society for Metabolic and Bariatric Surgery in Washington, D.C.

Calling this a "very exciting finding," lead researcher Nicolas Christou, MD, PhD, Director of Bariatric Surgery and Professor of Surgery at McGill University in Montreal, said that "hopefully subsequent studies will shed more light on this subject."

Being overweight or obese raises the risk of several types of cancer including breast, colon, esophageal and kidney, accoeding to the American Cancer Society. Every year 500,000 Americans dieof cancer, and one-third of these deaths are linked to diet, lack of physical activity and being overweight, the group states. Soem cancers, such as lung cancer and mesothelioma, are unrelated to these factors.

Exactly how weight loss surgery reduces cancer risks is not fully understood, Christou says. "A lot of cancer risk is genetic, and we don't alter a person's genetics," he says. "Is it hormonal? We don't know."

Perhaps, he speculates, "it is the inability to eat a 16-ounce perterhouse steak that is barbecued with carcinogens," he says. Many cancer-causing chemicals or carcinogens are created during cooking. Consuming large amounts of red meat has also been linked to certain cancers. Weight loss surgery patients are unable to eat large volumes of food, due to the decreased size of their stomach following surgery.

In the studay, bariatric surgery patients were 78 percent less likely to develop any cancer, when compared with their equally overweight counterparts who did not undergo weight loss surgery. Bariatric surgery patients had an 83 percent reduction in their risk for developing breast cancer and a 68 percent reduction in risk of developing colorectal cancer, when compared with their counterparts who did not have surgery.

Reductions were also seen in risk for other, more rare cancers such as pancreatic cancer, endometrial cancer, kidney cancer, myeloma, melanoma and non-Hodgkin's lymphoma among thse particpants who underwent weight loss surgery; however, these reductions were not statistically significant, Christou said.

The Canadian Bariatric Cohurt Study compared 1,035 bariatric surgery patients with 5,746 controls who were matched for body mass index and did not undergo surgery to lose weight. They were tracked for a maximum of five years. None of the study participants had a history of cancer. During the study period, two percent of people in the surgery group were diagnosed with cancer, compared with 8.5 percent of participants who did not have bariatric surgery.

WASHINGTON, D.C., June 2008 - by Denise Mann

NEW YORK (Reuters Health) – Having weight-loss surgery? Shedding a few pounds before the surgery might reduce your risk of having surgical complications, a new study hints.

A look back at the medical records of 881 patients who had weight-loss surgery found that the more weight patients lost before surgery, the less likely they were to suffer post-op complications, such as infections, blood clots, and kidney problems.

Preoperative weight changes varied among the 881 patients, ranging from modest weight gain to weight loss of more than 10 percent of excess body weight.

The post-surgery complication rate was nearly twofold higher in patients who gained weight before surgery relative to those who lost weight before surgery, Dr. Peter N. Benotti of the Saint Francis Medical Center in Trenton, New Jersey and colleagues report in the Archives of Surgery.

All of the patients had undergone open or "keyhole" Roux-en-Y gastric bypass surgery. With this procedure, staples are used to create a pouch in the stomach that can hold only a small amount of food at a time; then, a portion of the small intestine is attached to the pouch so that food bypasses the rest of the stomach and part of the small intestine.

Patients who had the more-invasive open surgery were at increased risk of post-op complications, regardless of whether they gained or lost weight before the surgery, the researchers found.

The popularity of weight-loss surgery has increased in recent years and so too have the numbers of patients seeking surgery who are older and sicker, the researchers note.

As more of these high-risk patients seek out surgical weight-loss options, doctors are facing a need to identify risk factors and help prepare patients for successful surgery. The current study, the researchers say, suggests that pre-surgery weight loss may be one step that will help those having weight-loss surgery to achieve a more favorable outcome.

Some surgeons who perform weight-loss surgery mandate that certain high-risk patients lose some weight before having the surgery, Benotti and colleagues note. However, others believe that mandated pre-surgery weight loss "may be a deterrent to surgery." In addition, the long term effect of shedding a few pounds before weight-loss surgery is also unclear.

In a telephone interview with Reuters Health, Benotti said patients need to know that weight-loss surgery "is not a definitive treatment." A healthy diet, lifestyle change, and behavior modification are essential for maintaining weight loss after surgery, the researcher said.

"Surgery is a carrot; it provides motivation for people knowing they will have help," Benotti said.

SOURCE: Archives of Surgery, December 2009.

Research has proven that patients that lose weight (even a little) prior to any weight-loss surgical procedure will have a higher probability of attaining their weight management goals. We urge our patients to be conscience of their pre-operative weight to ensure greater success through this life-changing journey. Losing weight prior to surgery is great and encouraged.

Our practice recommends OPTIFAST to patients interested in Bariatric Surgery for a few reasons:

1. Weight loss is a process and not something that just happens overnight because you had a procedure. That said, choosing OPTIFAST and implementing this meal replacement program helps patients to change their mental "mindset" about food and nourishment. The program mentally re-programs how a patient thinks about food and assists them in transforming how they relate to food.  
   
2. OPTIFAST promotes weight loss. Did you know? When you lose weight, your liver will actually decrease in size depending on the amount of pounds shed. A smaller liver makes the whole procedure less risky for the patient.  
3. OPTIFAST has a proven track record for success ranging back to the 1970's. Many people seeking weight management have reached their goals by implementing a structured program directly recommended by our professional healthcare team led by Dr. Ken Hollis.  
4. Our patients understand that losing weight prior to surgery is important, but they also do not want to have to carry around tubs of powder to make shakes, etc. We understand... that's a hassle! OPTIFAST is very portable and you can carry your entire day's supply with you.

OPTIFAST comes in the following flavors (and yes, we eat and drink them, too!):

Shakes/Powder:

• Chocolate
• Vanilla
• Strawberry

Soups:

• Chicken Soup
• Tomato Soup 

Snack Bars:

• Chocolate
• Peanut Butter Chocolate
• Berry Yogurt

OPTIFAST is available for purchase in our office and coming soon... via our online e-Store!

Call Us - BayChoice Bariatrics at 281-482-5300 and Order Today!

NEW YORK (United Press International, 2010) 

Obesity has become an equal, if not greater, contributor to illness and a shortened life as smoking, U.S. researchers found.

Haomiao Jia and Dr. Erica I. Lubetkin of Columbia University and The City College of New York calculated that the quality adjusted life years lost due to obesity is now equal to, if not greater than, those lost due to smoking.

The researchers used data from the 1993-2008 Behavioral Risk Factor Surveillance System, which conducted interviews of more than 3.5 million individuals with annual interviews starting with 102,263 in 1993 and ending with 406,749 in 2008.

From 1993-2008, the proportion of smokers among U.S. adults declined 18.5 percent and smoking-related, quality adjusted life years lost were relatively stable at 0.0438 quality adjusted life years lost per population.

During this same period, the proportion of obese people increased 85 percent and this resulted in 0.0464 quality adjusted life years lost. Smoking had a bigger impact on deaths while obesity had a bigger impact on illness, the study found.

The study is to be published in the February issue of the American Journal of Preventative Medicine.

Dr. Hollis has practiced laparoscopic surgery for nearly 20 years, beginning in 1989 as one of the early surgeons in the U.S. performing minimally invasive procedures. He is the Medical Director for Memorial Hermann Southeast specializing in LapBand and Bariatric surgeries.

Obesity is rapidly becoming the nation’s No. 1 health concern. Of the 97 million Americans who suffer from obesity, 5 million to 10 million of them are considered morbidly obese.

We invite you to browse our website, and look forward to working with you to build a healthy lifestyle and meet your weight loss goals!

To Your Success!
Dr. Ken Hollis & the BayChoice Staff