Thursday, July 29, 2021
Weight loss isn’t easy, but it’s important to know you are not alone on your journey.
If you are considering weight-loss surgery, make sure to do your homework to find the right healthcare team and best surgical option to meet your needs.
Norman Regional Health System’s Journey Clinic is a comprehensive weight-loss program that offers medical and surgical options for patients wanting to lose weight and maintain a healthy lifestyle.
The Journey Clinic offers several surgical options, including band, bypass, sleeve and modified duodenal switch surgeries. These procedures are performed by a group of knowledgeable and compassionate surgeons who are all fellowship trained in weight-loss (bariatric) surgery. This means they spent an additional year after their general surgery training specifically focused on the surgical treatment of obesity.
Read on to learn more about the modified duodenal switch surgery from the Journey Clinic’s Dr. Lana Nelson, a board-certified obesity medicine physician and board-certified general surgeon specializing in weight-loss surgery.
What is the modified duodenal switch surgery?
The modified duodenal switch surgery is a laparoscopic procedure that combines a gastric sleeve and bypass. The procedure starts with the creation of a gastric sleeve to reduce the amount of food the patient can take in and decrease the amount of hunger hormone produced. This allows people to eat smaller amounts of food and not experience extreme hunger.
Next, the small intestines are rerouted, reducing the amount of calories the patient’s body absorbs by limiting the time food mixes with digestive juices. This means fewer calories and nutrients are absorbed by the body. This will require patients to take vitamins and supplements after surgery.
The procedure is highly effective not only for weight loss, but to help people with type 2 diabetes go into remission. This means their blood sugar levels are in the normal range and they can stop taking medicine to treat diabetes.
What is a laparoscopic procedure?
During this type of procedure, a surgeon uses a tiny camera (laparoscope) and thin surgical instruments to perform the surgery. This means less blood loss, smaller scars and a shorter recovery time.
Who would benefit from the modified duodenal switch surgery?
The modified duodenal switch surgery is most effective in people with a body mass index (BMI) of 50 or greater or people with uncontrolled type 2 diabetes.
It is also a great option for people with a high BMI who take non-steroidal, anti-inflammatory medicine to treat chronic joint issues. Gastric bypass surgery is not a good option for people who need to take non-steroidal, anti-inflammatory medicine because it increases their risk of developing ulcers.
Are there additional risks with the modified duodenal switch surgery compared to other types of weight-loss surgery?
Yes. Since we are doing more of a bypass, there’s a little bit higher risk of nutritional deficiencies. It is extremely important for patients to understand that they have to be very consistent about regularly taking their vitamins. They also need to commit to long-term follow-up care so we can do nutritional monitoring.
What steps do you need to take before you have surgery?
Our patients spend a minimum of three months preparing for surgery. During this time, they visit with a dietitian, psychologist and physical therapist on our team. We also get them into a support group system where they can interact with other patients.
We will do lab work prior to surgery to see if there are any nutritional deficiencies. Vitamin D deficiency is common in patients with obesity.
What does the dietitian help with?
Patients need to meet with a dietitian at least three times before surgery. A dietitian is a nutrition expert. They will typically set a goal for how much protein the patient should eat to ensure they are maintaining lean muscle mass while in the active phase of weight loss. Eating an adequate amount of protein can help people feel full so they don’t have to eat as often.
We also emphasize a diet featuring more whole foods and fewer processed foods. Processed foods tend to be more easily digested, meaning you can consume a higher volume of processed foods than whole foods.
What does the psychologist help with?
Patients will meet with a psychologist who will make sure the patient understands how the surgery will impact their life and find out if they have a support system in place to help. They will also screen for eating disorders.
If the psychologist identifies an eating disorder that has not been treated, patients will be referred to an eating disorder specialist. There will be certain steps they need to take before we would consider them a candidate for weight-loss surgery.
If traumatic events may have led to weight gain, the psychologist may also work with the patient to make sure there aren’t any unresolved issues that require additional counseling before they can proceed with surgery.
What happens after surgery?
After surgery, we will see patients a few times for follow-up visits. This includes meeting with the dietitian about three months after surgery.
Once a year, we will do lab work to check for things that wouldn’t normally be checked during a regular health screening with a primary care provider. This includes checking for nutritional deficiencies.
During that annual check-up, we also monitor weight. Since obesity is a chronic disease process, some people do experience a little bit of weight regain after surgery. If there are issues with that, we want to identify that early before it becomes a more difficult problem to address.
What does success look like?
Typically, most patients lose the majority of their weight within 12 to 18 months after the procedure. It’s pretty dramatic to see these results. For many people, it changes their lives. Some patients with type 2 diabetes may no longer have to take medicine to manage their condition. People may also see improvements in their ability to move. They can play with their kids or grandkids, or take a walk without getting out of breath. It’s also a really big deal for some of my patients who travel for work when they no longer have to ask for a seatbelt extender on the airplane.
It’s these success stories that remind me why I do what I do. It’s so gratifying.
If you would like an appointment with our team at Norman Regional Health System’s Journey Clinic, call us at 405-515-2049.