If you have tried everything to loose weight, and you have a lot of weight to loose, you might want to consider bariatric surgery.
Whether you have surgery to make your stomach smaller and bypass some of your intestine (Roux-en-Y) or have an adjustable silicone band placed to decrease your stomach pouch (Lap Band/Gastric Banding/Gastric Sleeve), bariatric surgery may be your best chance to lose weight. For those who are severely overweight, weight-loss surgery and lifestyle changes can lead to a longer and healthier life.
It's not what you've got to lose, it's what you'll gain. How do you know if you're a good candidate for bariatric surgery?
Listen in as Michael Morris, MD explains bariatric surgery options at Doctors Hospital of Laredo and how our goal is to support you with valuable, accurate information about bariatric surgery.
Selected Podcast
Medical Treatment Of Obesity Through Bariatric Surgery
Featured Speaker:
He was born and raised in the foothills of the Appalachian Mountains of eastern Kentucky. The third son of tobacco farmers and elementary school teachers, in an impoverished region, he was very fortunate to learn from an early age not only the value of an education but also a hard day’s work.
Learn more about Michael Morris, MD
Michael Morris, MD
Dr. Michael Morris is a General Surgeon and the Medical Director of Doctors Hospital Weight Loss and Wellness Center.He was born and raised in the foothills of the Appalachian Mountains of eastern Kentucky. The third son of tobacco farmers and elementary school teachers, in an impoverished region, he was very fortunate to learn from an early age not only the value of an education but also a hard day’s work.
Learn more about Michael Morris, MD
Transcription:
Medical Treatment Of Obesity Through Bariatric Surgery
Melanie Cole (Host): If you've tried everything to lose weight and you have a lot of weight to lose, bariatric surgery may be your best tool in this endeavor. My guest today is Dr. Michael Morris. He's a general surgeon and Medical Director of Doctors Hospital Weight Loss and Wellness Center. Welcome to the show, Dr. Morris. Who should consider bariatric surgery? Are there certain parameters for people to note when they want to consider bariatric surgery?
Dr. Michael Morris (Guest): Thank you for that introduction. It is a pleasure to be with you today, Melanie. Who should consider bariatric surgery? Anyone that is suffering obesity with medical problems related to it, namely Diabetes Type II, hypertension, cholesterolemia, bad knees, people that snore very loud. Bariatric surgery can present a resolution to those medical problems. So, those are the people who should consider bariatric surgery.
Melanie: And, when they're considering, do they have to do certain things when you're discussing this with them and before they can be scheduled for surgery? Is there psychological counseling involved? Do you want them trying to lose weight? Speak about those parameters as well.
Dr. Morris: I start every conversation with patients and I give seminars on an every two week basis, I think the most important aspect of the preoperative evaluation is patient information and acquisition knowledge. Surgery alone can and will not work. It takes a dedicated patient behind those surgeries to be very effective. And, how effective, all depends on the patient. The most important aspect that I see in the improvement of the patient’s lifestyle and ultimately medical condition is the patient’s knowledge of these operations. So, yes, psychological counseling is a very important aspect about it. The primary care physician as a part of the team leader in guiding the patient through this path of a lifestyle change is also very important. It’s not just surgery. The surgery is a very important and critical standpoint that offers high volume, low risk of potential complications, but guided toward patient knowledge, acquisition and follow-up.
Melanie: Tell us about the types of bariatric surgery available.
Dr. Morris: There are many types of bariatric operations, many that have been phased out like the gastric band, or largely phased out, but if there was one procedure that was far better than all other procedures, there would only be one. The fact that there are two or three operations means there are the pros and cons of each of operation. So, a patient has to look at that, know the options and then choose the types of operation based on their lifestyle and the commitment they’re willing to have. For instance, the gastric bypass is a very sound resolution, 83% of Diabetes Type II, whereas sleeve would have 65% resolution of Diabetes Type II. So, therefore, if I get someone that requires insulin for their diabetes and has had 10 to 15 years of diabetes or medical conditions related diabetes, like blindness, and kidney insufficiency, I’ll be primarily considering a bypass.
Melanie: Are any of these reversible?
Dr. Morris: A gastric bypass is reversible. It’s very hard to do, but, yes, the gastric bypass can be reversed, including laparoscopically. A sleeve gastrectomy is a more permanent operation where we excise nearly 80% of the stomach, so I can't give that back. So, by definition, a sleeve cannot be reversed, yet a bypass can.
Melanie: Explain the difference between a sleeve and a bypass.
Dr. Morris: First, it’s very important to realize that a patient, when they wake up from anesthesia, does not feel like a sleeve or a bypass. It’s often preconceived notions to where patients will have what a bypass would or may feel like. The fact is patients don’t know the difference in that regard. So, it's very important to illustrate at the very beginning, a sleeve is a resection of 80% of the stomach. So, largely the GI tract is unchanged, it’s just the stomach is reduced; whereas, a bypass will effectively bypass the stomach. So, skipping the majority of the stomach in the first loop of the intestine called the duodenum, you get a very strong resolution rate for Diabetes Type II.
Melanie: What can patients expect after surgery, Dr. Morris, as far as their ability to eat? If you’ve created that pouch, are they able to eat solid foods? Is it a liquid diet for quite a while? Just give them a little bit of an overview of what to expect afterward.
Dr. Morris: I think with any surgery, esophageal gastric surgery, a diet change is absolutely necessary. I think over six weeks, the patients should be resuming a solid diet. And I keep saying to patients, “You eat for the size of person you will become.” I would rather be healthy, small and solid. So, their diet must be based on a solid food component. Healthy food only and in small portions. The surgery should help in that small portion but the election of what they eat is ultimately the patient.
Melanie: Dr. Morris, at the beginning I mention the word “tool” for weight loss. After the surgery, this is a tool. What do you want them to know about lifestyle modifications and preventing this from reoccurring, from getting heavy again, from changing their lifestyles, because it doesn't really work unless they do, does it?
Dr. Morris: That’s 100% correct. I tell the patients from the very, very beginning, and I illustrate cases of weight gain with all varieties of bariatric operations to illustrate the point that surgery can and will not and was never meant to work alone. It must take a dedicated patient, dedicated to their well-being and lifestyle changes that are not just implemented but maintained to be successful in the long-term. Surgery merely aids in that process as a tool. So, for the patients to look at it as a tool instead of an easy button is a more comfortable way to adapt to those lifestyle changes.
Melanie: And, if they follow all your recommendations, how much weight can they expect to lose?
Dr. Morris: The sky is the limit. There is median weight losses. With a bypass it will around 70, and with a sleeve will be very similar in that regard. So, to differentiate weight loss between a sleeve and a bypass, I don't think is an accurate estimation of the patient. I think both procedures lose the same amount. It is really based on the acquisition of healthy lifestyles. When you get a patient that is primarily sedentary because of knee pain and medical problems, then they get a surgery and they lose 150 pounds and, suddenly, their knees are much improved and they can walk more and they see the results, they’ll go for it more. They will be stimulated to lose more weight and to maintain that lifestyle. So, whether it’s a sleeve or bypass, they can lose up to 100% of their ideal body weight. But, I think illogical for them to look at that’s median 7% of their excess body weight. But, ultimately, my goals are resolution of their medical problems, namely diabetes and hypertension.
Melanie: In just the last few minutes, what should people that are severely overweight think about when seeking care?
Dr. Morris: I think they're looking at the quality program. I hear a lot of patients or otherwise comparing program to program. If you’ve got a high volume operator compared to another high volume operator, say, Dallas, Houston, Mexico City or Laredo, it doesn’t matter. I think what they should go for are local programs based on them. They give them knowledge before operations and is willing and dedicated to following them up post-operative to make sure they're there on the right track and they stay on that right track. And, that’s not just the surgeon. It takes a team approach; it takes a hospital setting to maintain that for now and for the rest of their life.
Melanie: And, why should they come to Doctors Hospital of Laredo for their care? Tell us about your weight loss and wellness center team.
Dr. Morris: First, it takes a hospital dedicated, like Doctors Hospital Laredo has shown and illustrated in the past. They provide the resources for an effective program: a coordinator, a nutritionist, nurses, physicians, a hospital that has the outreach in the dedication to include the primary care physicians especially. Every member that team is as important as the other. So, I think Doctors Hospital really brings it all together at the setting that the patient is in in Laredo.
Melanie: Thank you so much for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information you can go to www.DoctorsHospLaredo.com. That’s www.DoctorsHospLaredo.com Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.
Medical Treatment Of Obesity Through Bariatric Surgery
Melanie Cole (Host): If you've tried everything to lose weight and you have a lot of weight to lose, bariatric surgery may be your best tool in this endeavor. My guest today is Dr. Michael Morris. He's a general surgeon and Medical Director of Doctors Hospital Weight Loss and Wellness Center. Welcome to the show, Dr. Morris. Who should consider bariatric surgery? Are there certain parameters for people to note when they want to consider bariatric surgery?
Dr. Michael Morris (Guest): Thank you for that introduction. It is a pleasure to be with you today, Melanie. Who should consider bariatric surgery? Anyone that is suffering obesity with medical problems related to it, namely Diabetes Type II, hypertension, cholesterolemia, bad knees, people that snore very loud. Bariatric surgery can present a resolution to those medical problems. So, those are the people who should consider bariatric surgery.
Melanie: And, when they're considering, do they have to do certain things when you're discussing this with them and before they can be scheduled for surgery? Is there psychological counseling involved? Do you want them trying to lose weight? Speak about those parameters as well.
Dr. Morris: I start every conversation with patients and I give seminars on an every two week basis, I think the most important aspect of the preoperative evaluation is patient information and acquisition knowledge. Surgery alone can and will not work. It takes a dedicated patient behind those surgeries to be very effective. And, how effective, all depends on the patient. The most important aspect that I see in the improvement of the patient’s lifestyle and ultimately medical condition is the patient’s knowledge of these operations. So, yes, psychological counseling is a very important aspect about it. The primary care physician as a part of the team leader in guiding the patient through this path of a lifestyle change is also very important. It’s not just surgery. The surgery is a very important and critical standpoint that offers high volume, low risk of potential complications, but guided toward patient knowledge, acquisition and follow-up.
Melanie: Tell us about the types of bariatric surgery available.
Dr. Morris: There are many types of bariatric operations, many that have been phased out like the gastric band, or largely phased out, but if there was one procedure that was far better than all other procedures, there would only be one. The fact that there are two or three operations means there are the pros and cons of each of operation. So, a patient has to look at that, know the options and then choose the types of operation based on their lifestyle and the commitment they’re willing to have. For instance, the gastric bypass is a very sound resolution, 83% of Diabetes Type II, whereas sleeve would have 65% resolution of Diabetes Type II. So, therefore, if I get someone that requires insulin for their diabetes and has had 10 to 15 years of diabetes or medical conditions related diabetes, like blindness, and kidney insufficiency, I’ll be primarily considering a bypass.
Melanie: Are any of these reversible?
Dr. Morris: A gastric bypass is reversible. It’s very hard to do, but, yes, the gastric bypass can be reversed, including laparoscopically. A sleeve gastrectomy is a more permanent operation where we excise nearly 80% of the stomach, so I can't give that back. So, by definition, a sleeve cannot be reversed, yet a bypass can.
Melanie: Explain the difference between a sleeve and a bypass.
Dr. Morris: First, it’s very important to realize that a patient, when they wake up from anesthesia, does not feel like a sleeve or a bypass. It’s often preconceived notions to where patients will have what a bypass would or may feel like. The fact is patients don’t know the difference in that regard. So, it's very important to illustrate at the very beginning, a sleeve is a resection of 80% of the stomach. So, largely the GI tract is unchanged, it’s just the stomach is reduced; whereas, a bypass will effectively bypass the stomach. So, skipping the majority of the stomach in the first loop of the intestine called the duodenum, you get a very strong resolution rate for Diabetes Type II.
Melanie: What can patients expect after surgery, Dr. Morris, as far as their ability to eat? If you’ve created that pouch, are they able to eat solid foods? Is it a liquid diet for quite a while? Just give them a little bit of an overview of what to expect afterward.
Dr. Morris: I think with any surgery, esophageal gastric surgery, a diet change is absolutely necessary. I think over six weeks, the patients should be resuming a solid diet. And I keep saying to patients, “You eat for the size of person you will become.” I would rather be healthy, small and solid. So, their diet must be based on a solid food component. Healthy food only and in small portions. The surgery should help in that small portion but the election of what they eat is ultimately the patient.
Melanie: Dr. Morris, at the beginning I mention the word “tool” for weight loss. After the surgery, this is a tool. What do you want them to know about lifestyle modifications and preventing this from reoccurring, from getting heavy again, from changing their lifestyles, because it doesn't really work unless they do, does it?
Dr. Morris: That’s 100% correct. I tell the patients from the very, very beginning, and I illustrate cases of weight gain with all varieties of bariatric operations to illustrate the point that surgery can and will not and was never meant to work alone. It must take a dedicated patient, dedicated to their well-being and lifestyle changes that are not just implemented but maintained to be successful in the long-term. Surgery merely aids in that process as a tool. So, for the patients to look at it as a tool instead of an easy button is a more comfortable way to adapt to those lifestyle changes.
Melanie: And, if they follow all your recommendations, how much weight can they expect to lose?
Dr. Morris: The sky is the limit. There is median weight losses. With a bypass it will around 70, and with a sleeve will be very similar in that regard. So, to differentiate weight loss between a sleeve and a bypass, I don't think is an accurate estimation of the patient. I think both procedures lose the same amount. It is really based on the acquisition of healthy lifestyles. When you get a patient that is primarily sedentary because of knee pain and medical problems, then they get a surgery and they lose 150 pounds and, suddenly, their knees are much improved and they can walk more and they see the results, they’ll go for it more. They will be stimulated to lose more weight and to maintain that lifestyle. So, whether it’s a sleeve or bypass, they can lose up to 100% of their ideal body weight. But, I think illogical for them to look at that’s median 7% of their excess body weight. But, ultimately, my goals are resolution of their medical problems, namely diabetes and hypertension.
Melanie: In just the last few minutes, what should people that are severely overweight think about when seeking care?
Dr. Morris: I think they're looking at the quality program. I hear a lot of patients or otherwise comparing program to program. If you’ve got a high volume operator compared to another high volume operator, say, Dallas, Houston, Mexico City or Laredo, it doesn’t matter. I think what they should go for are local programs based on them. They give them knowledge before operations and is willing and dedicated to following them up post-operative to make sure they're there on the right track and they stay on that right track. And, that’s not just the surgeon. It takes a team approach; it takes a hospital setting to maintain that for now and for the rest of their life.
Melanie: And, why should they come to Doctors Hospital of Laredo for their care? Tell us about your weight loss and wellness center team.
Dr. Morris: First, it takes a hospital dedicated, like Doctors Hospital Laredo has shown and illustrated in the past. They provide the resources for an effective program: a coordinator, a nutritionist, nurses, physicians, a hospital that has the outreach in the dedication to include the primary care physicians especially. Every member that team is as important as the other. So, I think Doctors Hospital really brings it all together at the setting that the patient is in in Laredo.
Melanie: Thank you so much for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information you can go to www.DoctorsHospLaredo.com. That’s www.DoctorsHospLaredo.com Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.