Bariatric surgery is an option to facilitate weight loss for the morbidly obese.
Dr. Angel M. Caban, Bariatric Surgeon at Ocala Health Surgical Group, discusses bariatric surgery.
When is it Time to Consider Bariatric Surgery?
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Learn more about Angel M. Caban, MD
Angel M. Caban, MD
Angel M. Caban, MD completed his medical degree at the Universidad Autonoma de Guadalajara in Mexico. His surgical training as an intern began in New York City at St. Vincents Hospital. From there he transferred to the University of Florida in Gainesville were he completed his surgical training and became a Board Certified General Surgeon by the American Board of Surgery.Learn more about Angel M. Caban, MD
Transcription:
Adam Ragusea (Host): If you struggle with your weight, it’s a pretty tantalizing prospect that you could fix it with a simple surgery. But is bariatric surgery right for you? Let’s talk to Dr. Angel Caban, a surgeon at Ocala Health. This is Helmet of Health, the podcast from HCA-Ocala. I’m Adam Ragusea and Dr. Caban, before we talk about who should be getting bariatric surgery, just remind us what exactly it consists of.
Angel M Caban, MD (Guest): Well bariatric surgery or better known as weightloss surgery, it’s where we make the stomach smaller or divert a portion of the gastrointestinal tract in order for people to lose weight.
Host: I’ve heard it referred to as stomach stapling? Do you actually use staples?
Dr. Caban: Yes, we do. So, a big portion of the operation is making the stomach smaller and we do use a device called a stapler which uses very, very small staples.
Host: All right cool, well so let’s say that I get my stomach stapled; would that mean that I would simply be able to eat less food, or would I actually want less food?
Dr. Caban: It’s both. So, especially at the beginning. So, the stomach always wants to be a stomach, so it’s always after a certain amount of time; you are going to notice that you’ll be able to eat a little bit more after surgery or your body actually starts to ask you for food. But especially in the beginning from like the first three to six months after the surgery; a lot of people eat because they have to eat, not really because they are hungry. But they will regain some of the hunger mechanisms and yes, they are going to notice a significant amount of difference in the amount of food that they can eat after the surgery.
Host: Okay. And how quickly do people lose weight when they get this done?
Dr. Caban: So, it really depends. It’s always patient dependent, right? Even after weightloss surgery, you are going to get out of it what you put into it. So, the more effort you put into it, the more weight you are going to lose. But if I was just going to give you a ballpark average for the average person let’s say, if you had a sleeve, you should expect to lose probably somewhere between 40 and 50 pounds in the first three months. That’s pretty average. And for a bypass it’s a little bit higher than that, so it’s probably somewhere between 50 to 70 pounds.
Host: Wow. Now the sleeve that you are talking about; that’s getting the stomach stapled. What’s a bypass?
Dr. Caban: A gastric bypass we make a smaller stomach which we call the stomach pouch. It’s pretty much about the size of an egg and then we divide the small intestines. We bring it back to meet the small stomach and we are bypassing a large portion of the GI tract to make them lose more weight. So, not only do they eat less because their stomach is smaller; but we are also bypassing a portion of the intestines, so they don’t absorb everything they eat right away.
Host: So, are people able to live a normal life after they get this done?
Dr. Caban: Absolutely for the most part. The biggest difference in my opinion is the first three months and I always tell that to the patients when they come to the office. Because they pretty much need to learn how to eat again especially at the beginning. Because there is going to be things that they like to eat now that they won’t be able to eat it later or that they don’t like anymore because somehow the surgery changes their eating patterns or taste buds.
But it’s also true for other things. I have patients that didn’t like certain things and now they like it. And also, they need to learn how to eat slower because they cannot eat as fast as they used to and they are going to get full quicker, so they are going to have to adjust how much to eat, how fast they eat it and what they eat. So, it’s a little bit of a learning curve at the beginning, but once they get used to that; they should be able to lead pretty much a normal life.
Host: Do people have problems with malnutrition and nutrient absorption problems after they get this surgery done?
Dr. Caban: So, it depends on the surgery. That’s less likely with like a gastric band, for example or a sleeve gastrectomy. It can be a little bit more pronounced on a bypass or what’s called a duodenal switch which is a bigger, more aggressive weightloss surgery. So, it really depends on what type of surgery you have but yes, you could but it’s not as significant as some people think.
Host: All right Dr. Caban. Here’s the big question, for whom is bariatric surgery, right? It is right for somebody like me who really only needs to lose about 15 pounds?
Dr. Caban: So, most of the time, it’s not. It’s more suitable for people who are significantly overweight. Now it’s also a good surgery for somebody that is slightly overweight and doesn’t want to keep gaining weight. Because it is statistically proven that as you get older, your metabolism changes and the likelihood that you are going to continue to gain weight is very significant. So, if you want to break that cycle; having weightloss surgery can prevent you to get there.
The problem is, who is going to pay for the surgery, right? So, insurance companies have a requirement that if you don’t meet it; you don’t qualify for the surgery and they won’t pay for it. Now you can break that by if you pay cash for the operation, right? It’s like when you go to a plastic surgeon and you want breast augmentation, you pay cash for the surgery, they will do it even if you need it or not.
So, weightloss surgery is the same. If you can afford to pay cash for it and you want to lose 20 pounds and you don’t want to gain any more weight; I’ll be happy to do a sleeve gastrectomy. And even if you pay for it, it’s not going to hurt you but if you were going to pay with insurance; the insurance is not going to cover it because you don’t meet the criteria for them to pay for the surgery.
Host: All right Doc. Appreciate it. That’s Dr. Angel Caban, a surgeon at Ocala Health. Thanks for checking out this episode of Helmet of Health. Head to www.ocalahealthsystem.com to get connected with Dr. Caban or another provider. If you found this podcast helpful, please share it on your social channels. That would be good for our body image. And be sure to check back soon for the next podcast.
Adam Ragusea (Host): If you struggle with your weight, it’s a pretty tantalizing prospect that you could fix it with a simple surgery. But is bariatric surgery right for you? Let’s talk to Dr. Angel Caban, a surgeon at Ocala Health. This is Helmet of Health, the podcast from HCA-Ocala. I’m Adam Ragusea and Dr. Caban, before we talk about who should be getting bariatric surgery, just remind us what exactly it consists of.
Angel M Caban, MD (Guest): Well bariatric surgery or better known as weightloss surgery, it’s where we make the stomach smaller or divert a portion of the gastrointestinal tract in order for people to lose weight.
Host: I’ve heard it referred to as stomach stapling? Do you actually use staples?
Dr. Caban: Yes, we do. So, a big portion of the operation is making the stomach smaller and we do use a device called a stapler which uses very, very small staples.
Host: All right cool, well so let’s say that I get my stomach stapled; would that mean that I would simply be able to eat less food, or would I actually want less food?
Dr. Caban: It’s both. So, especially at the beginning. So, the stomach always wants to be a stomach, so it’s always after a certain amount of time; you are going to notice that you’ll be able to eat a little bit more after surgery or your body actually starts to ask you for food. But especially in the beginning from like the first three to six months after the surgery; a lot of people eat because they have to eat, not really because they are hungry. But they will regain some of the hunger mechanisms and yes, they are going to notice a significant amount of difference in the amount of food that they can eat after the surgery.
Host: Okay. And how quickly do people lose weight when they get this done?
Dr. Caban: So, it really depends. It’s always patient dependent, right? Even after weightloss surgery, you are going to get out of it what you put into it. So, the more effort you put into it, the more weight you are going to lose. But if I was just going to give you a ballpark average for the average person let’s say, if you had a sleeve, you should expect to lose probably somewhere between 40 and 50 pounds in the first three months. That’s pretty average. And for a bypass it’s a little bit higher than that, so it’s probably somewhere between 50 to 70 pounds.
Host: Wow. Now the sleeve that you are talking about; that’s getting the stomach stapled. What’s a bypass?
Dr. Caban: A gastric bypass we make a smaller stomach which we call the stomach pouch. It’s pretty much about the size of an egg and then we divide the small intestines. We bring it back to meet the small stomach and we are bypassing a large portion of the GI tract to make them lose more weight. So, not only do they eat less because their stomach is smaller; but we are also bypassing a portion of the intestines, so they don’t absorb everything they eat right away.
Host: So, are people able to live a normal life after they get this done?
Dr. Caban: Absolutely for the most part. The biggest difference in my opinion is the first three months and I always tell that to the patients when they come to the office. Because they pretty much need to learn how to eat again especially at the beginning. Because there is going to be things that they like to eat now that they won’t be able to eat it later or that they don’t like anymore because somehow the surgery changes their eating patterns or taste buds.
But it’s also true for other things. I have patients that didn’t like certain things and now they like it. And also, they need to learn how to eat slower because they cannot eat as fast as they used to and they are going to get full quicker, so they are going to have to adjust how much to eat, how fast they eat it and what they eat. So, it’s a little bit of a learning curve at the beginning, but once they get used to that; they should be able to lead pretty much a normal life.
Host: Do people have problems with malnutrition and nutrient absorption problems after they get this surgery done?
Dr. Caban: So, it depends on the surgery. That’s less likely with like a gastric band, for example or a sleeve gastrectomy. It can be a little bit more pronounced on a bypass or what’s called a duodenal switch which is a bigger, more aggressive weightloss surgery. So, it really depends on what type of surgery you have but yes, you could but it’s not as significant as some people think.
Host: All right Dr. Caban. Here’s the big question, for whom is bariatric surgery, right? It is right for somebody like me who really only needs to lose about 15 pounds?
Dr. Caban: So, most of the time, it’s not. It’s more suitable for people who are significantly overweight. Now it’s also a good surgery for somebody that is slightly overweight and doesn’t want to keep gaining weight. Because it is statistically proven that as you get older, your metabolism changes and the likelihood that you are going to continue to gain weight is very significant. So, if you want to break that cycle; having weightloss surgery can prevent you to get there.
The problem is, who is going to pay for the surgery, right? So, insurance companies have a requirement that if you don’t meet it; you don’t qualify for the surgery and they won’t pay for it. Now you can break that by if you pay cash for the operation, right? It’s like when you go to a plastic surgeon and you want breast augmentation, you pay cash for the surgery, they will do it even if you need it or not.
So, weightloss surgery is the same. If you can afford to pay cash for it and you want to lose 20 pounds and you don’t want to gain any more weight; I’ll be happy to do a sleeve gastrectomy. And even if you pay for it, it’s not going to hurt you but if you were going to pay with insurance; the insurance is not going to cover it because you don’t meet the criteria for them to pay for the surgery.
Host: All right Doc. Appreciate it. That’s Dr. Angel Caban, a surgeon at Ocala Health. Thanks for checking out this episode of Helmet of Health. Head to www.ocalahealthsystem.com to get connected with Dr. Caban or another provider. If you found this podcast helpful, please share it on your social channels. That would be good for our body image. And be sure to check back soon for the next podcast.