Bari­atric surgery is a dras­tic weight-loss move. Spe­cial­ist bari­atric di­eti­tian Zoe Wil­son weighs op­tions and out­comes.

Healthy Food Guide (Australia) - - NEWS -

Bari­atric surgery is a dras­tic way to lose weight. Our spe­cial­ist di­eti­tian weighs the op­tions and out­comes

For those who have tried al­most ev­ery­thing and still strug­gle to lose weight and keep it off, bari­atric surgery can seem the so­lu­tion. Is it re­ally?

When is surgery ap­pro­pri­ate?

Be­ing obese doesn’t in it­self au­to­mat­i­cally qual­ify you for surgery. How­ever, you may be a suit­able can­di­date if:

You have a Body Mass In­dex (BMI) of 40 or more (this can typ­i­cally trans­late to be­ing over­weight by 45kg or more).

You have a BMI of over 35 and are suf­fer­ing from other health is­sues that may im­prove with weight loss (eg, di­a­betes or heart dis­ease).

You’ve tried all ap­pro­pri­ate non-sur­gi­cal mea­sures, but still have not achieved or main­tained ad­e­quate weight loss.

You are gen­er­ally fit for anaes­the­sia and surgery.

You’re com­mit­ted to the need for long-term fol­low-up.

What are the ben­e­fits?

You can ex­pect to lose be­tween 60 to 70 per cent of your ex­cess body weight (the weight you carry

above your ideal BMI). The amount that you lose de­pends on a num­ber of fac­tors, such as your age, prior health con­di­tions, the type of surgery be­ing per­formed, your diet fol­low­ing surgery, your level of mo­ti­va­tion, and so­cial sup­port pro­vided af­ter­wards.

Af­ter surgery you may also re­duce the amounts of med­i­ca­tion you take for type 2 di­a­betes, high choles­terol, high blood pres­sure or re­flux, or even come off meds al­to­gether. Of­ten peo­ple feel more con­fi­dent, have more en­ergy, en­joy mov­ing again and im­prove their re­la­tion­ship with food.

Any side ef­fects?

It’s com­mon to ex­pe­ri­ence re­ac­tions like nau­sea, vom­it­ing, stom­ach cramps and dizzi­ness if you overeat, par­tic­u­larly sweet foods. Re­tain­ing large amounts of ex­cess skin is a com­mon com­plaint.

How does it change your eat­ing habits?

Af­ter a liq­uids phase, most peo­ple can slowly be­gin eat­ing nor­mal, healthy foods 8–12 weeks fol­low­ing surgery, but in much smaller quan­ti­ties.

You’ll need to spend 20–30 min­utes eat­ing a meal — tak­ing small bites to avoid dis­com­fort or re­flux. And you’ll need daily vi­ta­min and min­eral sup­ple­ments.

‘I feel 10 years younger with the en­ergy to match!’

When I fin­ished school, my weight be­gan to in­crease, due to changes in life­style, emo­tional eat­ing and

de­pres­sion. This be­gan a long 10–year cy­cle of los­ing and gain­ing weight. Each time I’d find my­self gain­ing back more weight than I’d lost.

We took the kids on a hol­i­day to Hong Kong in June, 2014. It was hot, hu­mid and I spent the en­tire trip sweaty and un­com­fort­able. What should have been an en­joy­able va­ca­tion just made me re­alise how much my weight had af­fected my life. I had gas­tric sleeve surgery in Septem­ber 2014. I wasn’t at my big­gest then (120-plus kg), but on the day of the surgery I was 104kg. I lost over 40kg due to the surgery, the ma­jor­ity within the first nine months. Now I try to keep my weight be­tween 62–65kg.

I don’t weigh my­self all that of­ten, but tend to go by my clothes and how tightly they fit. I have so much more en­ergy now to keep

up with the fam­ily! I have a fam­ily his­tory of di­a­betes, and had high blood pres­sure be­fore the surgery, which is now back within a nor­mal range. I was al­ways fairly ac­tive (I be­lieved I was fat-fit), but now I feel 10 years younger — with the en­ergy to match! I go to the gym, do yoga and have no prob­lem keep­ing up with the kids at the park. I still en­joy eat­ing out with friends and

fam­ily. I gen­er­ally or­der an en­trée-sized meal. I’m a bit of a ‘cheap date’ now — be­cause my stom­ach is a lot smaller, I’m quickly af­fected by al­co­hol, so af­ter two glasses of wine I’m ready to go home! Bari­atric surgery is not the easy op­tion. I had tried so many di­ets, ex­er­cise pro­grams and weight-loss shakes to get to that point. Part of my suc­cess in los­ing weight and keep­ing it off is be­cause I al­ways con­sid­ered the surgery to be a tool, not a com­plete so­lu­tion to weight loss. I still need to eat nu­tri­tious food, ex­er­cise and con­tinue a healthy life­style to pre­vent fu­ture weight gain. I would rec­om­mend the surgery to others,

but it isn’t a ‘quick fix’ for weight loss. The only thing that’s dif­fer­ent af­ter you wake up from surgery is that you have a smaller stom­ach. You still have to com­mit to life­style changes and care­fully se­lect the sorts of foods that your body needs, as your stom­ach can’t fit very much! The ben­e­fits to my health, self-es­teem and hap­pi­ness have made this jour­ney well worth it — and I would do the surgery again in a heart­beat.

What’s the cost?

Each sur­geon will have a dif­fer­ent cost.. You’ll gen­er­ally need to ei­ther use your pri­vate health in­sur­ance or pay upfront, but in some cases you can ac­cess your su­per.

Is it for you?

Only if you’re pre­pared to change your life­style and eat­ing habits dra­mat­i­cally, and com­mit to long-term fol­low-up with your sur­gi­cal team. Bari­atric surgery in­volves huge phys­i­cal and psy­cho­log­i­cal changes, and it can be a shock to re­alise you’ll never eat the same way again. If you’re con­sid­er­ing it, dis­cuss it with your GP.

AF­TER Weight: 62kg Height: 169cm Dress size: 8–10 BMI: 21.7

BE­FORE Weight: 104kg Height: 169cm Dress size: 20 BMI: 36

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