Have you ever had to plan a course through crowded areas, or struggle to find anything in your size while shopping? Individuals who are considered obese encounter situations on a daily basis that are taken for granted by two-thirds of the United States; even enjoying a movie in theaters or trip by plane is a challenge involving calculations about the size of the seats. “Common sense” dictates that a very dedicated individual with the right plan and lots of support could make slow and steady headway towards losing a few pounds per month; however, it is a sad realization for well-meaning friends and family that after a certain point, when the individual’s health is approaching morbidity, diet and exercise aren’t feasible options for the drastic change their loved one needs.
There is an option that can restore hope when every other course of action has been exhausted. Weight-loss surgery is a proven method for obese individuals to lose weight and improve their health. Considering that weight-loss surgery has improved in recent years to be a very safe and routine practice, what is stopping individuals from taking that second chance at an active lifestyle? Dr. Mario del Pino, director of the bariatric program at Rio Grande Regional Hospital, believes there is still some outdated information out there that could be keeping individuals from changing their lives.
Del Pino, who has been practicing three types of bariatric surgery in the Rio Grande Valley for 13 years, stresses that the surgery isn’t a magic solution. He says many prospective patients are often surprised to learn that the lifestyle of post-surgical care is as important as the surgery itself. “Lifestyle and dietary habit changes are key in order for the patient to be successful in the long term,” says Del Pino. “If you are not willing to make those changes, surgery is not for you because you may gain the weight back or not lose enough.” He finds that a multi-disciplinary program is a key component for the long term success of patients undergoing weight-loss surgery, that they must understand and follow completely.
Weight-loss surgery is not magic.
Bariatric surgery is like a jump start that allows you control your appetite, eat less, absorb less, and consequently lose a significant amount of weight. However, Del Pino wants to dissolve the idea that it means a person can eat whatever they want with no consequences. “If somebody keeps eating junk food or liquid calories after the surgery, they will not lose as much weight -or they may regain the weight after two to three years,” says Del Pino. While patients of Del Pino find support with nutritional, physical, and mental health at Rio Grande Regional Hospital’s monthly seminars and a multitude of other resources he discusses with them, the patient is ultimately responsible for those changes. “That it is why it is so important to educate patients before and after surgery to increase the chance of success,” says Del Pino.
One of the major factors in their success is keeping to a new diet that requires strict attention. Many patients find it better to limit or avoid bread and red meat the first year or two after the surgery as they may cause indigestion. Additionally, patients need to be careful if they are going to drink alcohol due to the new changes in the stomach’s natural absorption, which increases the alcohol’s potency.
In addition to maintaining healthy eating habits, Del Pino says all forms of bariatric surgery require that patients take multivitamins to prevent vitamin deficiency. “With reduced stomach size, a patient’s ability to absorb vitamins reduces and can result in vitamin deficiencies,” he explains. Vitamin supplementation and nutritional education are discussed with patients before and after surgery with their doctor and nutritionist. Yearly follow-ups with blood work are needed to monitor all levels of health and wellness.
Individuals who are obese can struggle with low self-esteem and their emotions, and unsuccessful attempts to manage their health with fad diets might lead to lost hope. While weight-loss surgery can change physical features and improve your overall health, patients who underwent this surgery will need emotional support from loved ones, which isn’t always what is found. “Sometimes relatives sabotage patients’ efforts to lifestyle and dietary changes,” says Del Pino. “They can get jealous and offer negative comments.”
Additionally, a person may already be suffering emotional problems or underlying conditions like depression or anxiety that may have contributed to overeating and severe obesity. Those conditions need to be addressed and stable before having surgery as they could undermine the fresh start offered by the surgery. A preoperative psychological evaluation is key to select patients for weight-loss surgery. “Having said that, depression or anxiety are not contraindications for surgery,” says Del Pino. “For these patients, postoperative support is key for success and weight loss helps stabilize their condition.”
To help ensure the best possible outcome, patients of Del Pino find support with nutritional, physical, and mental health at Rio Grande Regional hospital’s monthly seminars, where patients may converse with others who have undergone bariatric surgery, as well as dieticians, therapists, and bariatric doctors. Now, in the technologically advanced era, these groups are also found in the cyber world via Facebook pages, websites, blogs, and other platforms of social media. These social networking groups connect, inform, and persuade others to “go under the knife.”Del Pino shares information via his Facebook page, “mario del pino md.”
Calm those fears
Del Pino says there are some misconceptions about bariatric surgery, such as the idea that patients who’ve undergone surgery can lose too much weight at an unhealthy rate. Del Pino explained that in truth, weight loss stops when your body reaches an equilibrium that is finely tuned by your body. “People have lost perception of what a healthy weight is because unfortunately, most of us are unaware of us being overweight or obese,” he says.
Other patients fear waking up from anesthesia during their operation (or not waking up after); Del Pino can assure patients that that doesn’t happen. Bariatric surgery is quite safe. “This is an elective procedure and patients undergo a rigorous preoperative preparation to minimize complications and maximize outcome. Modern anesthesia has contributed significantly to the safety and success of weight-loss surgery,” he says.
Women considering getting pregnant have specific concerns if they are obese, and may face problems with conception. “Obesity is a known risk factor for infertility,” says Del Pino, explaining that fatty tissues create hormones that affect ovulation. Thus, Del Pino recommends women manage their weight first with the bariatric surgery and then wait a year before going for the pregnancy.
“Women are afraid that having weight -loss surgery will negatively affect future pregnancies or prevent them from getting pregnant,” says Del Pino. The message is exactly the opposite. “It is safer for the expecting mother once her weight and health are at stable conditions,” says Del Pino. Thus, he says it is better for women to get weight-loss surgery, lose the weight, and then get pregnant. The baby will be healthier and the pregnancy will be safer with less risks and complications for mom and baby. “The key is to wait one year after the surgery for weight and health to be stable,” he says.
Is it for you?
Bariatric surgery can give renewed life to those whose health has been negatively affected by their weight, allowing them the chance to regain an active and healthy lifestyle. The process is a journey that involves full engagement and many changes, but with support and pre and post-procedural information readily available, Del Pino believes there is no reason an individual can’t have a successful recovery and results they’re happy with.
Del Pino performs robotic gastric bypass, laparoscopic sleeve gastrectomy, and adjustable gastric bands. Read our previous July/August 2016 issue’s “options for obesity” for more information on Del Pino and the options for bariatric surgery.