A/Prof Michael Talbot hosted our latest webinar on the topic of weight regain after gastric sleeve or bariatric surgery. Here are some of the questions that he answered during the live Q&A that followed the short presentation.
What would be the revision surgery for a gastric bypass?
The type of revision surgery needed depends on several factors, including the type of bypass performed, the size of the stomach, and whether it has stretched over time.
If a patient’s stomach has stretched significantly after a bypass, it can often be trimmed and tightened. In these cases, a surgeon may also consider placing a ring around the stomach to prevent future stretching. However if the stomach has not stretched, a different procedure may be required. A bypass distalisation is also an option.
Before determining the best approach, a thorough assessment is needed. This typically includes a couple of scans and a dietary evaluation. If the patient has a small stomach but is engaging in frequent eating, surgery may not be the most effective solution.
Is there more risk in undergoing a different surgery after a sleeve?
Yes, any revision surgery after a sleeve gastrectomy is at least three times riskier than the initial sleeve procedure. This is primarily because the surgery may involve re-stapling along the existing staple line, which is technically more challenging and increases potential complications.
The risk of infection, for example, rises from approximately 1 in 500 for the first sleeve surgery, to around 1 in 50 – 1 in 100 for a revision procedure. The specific approach taken depends on the patient’s individual issues and needs.
If we notice weight gain coming on, what’s the first course of action?
The first step is to go back to basics. Focus on increasing your protein intake and incorporating more exercise into your routine. Consider using meal replacements like Optifast for around five meals a week.
It’s also important to book an appointment with the team for support and guidance. If you’ve already made these adjustments and they aren’t working, we often recommend a weight loss medication program. A structured 3 – 6 month course can help patients get back on track, and many can stop the medication once they regain control without the weight returning.
If the weight gain is significant and these simpler strategies aren’t effective, we may explore other therapies, including assessing the size of the stomach to determine if further intervention is needed.
Do you require health insurance for a revision (re-do) surgery?
Health insurance is required for nearly all weight loss surgeries, including revision procedures. While some bariatric surgeries are performed in the public system, access is extremely limited. At St George Hospital, we perform around 20 cases per year in the public system, compared to approx 1,200 in the private hospital.
In NSW, only about 2.5% of bariatric surgeries are done in public hospitals, meaning most patients will need either private health insurance or to self-fund their procedure. Health insurance is generally the more cost-effective option.
Is there a higher chance of ulcers and hernias with a gastric bypass?
Yes, ulcers are more common after a gastric bypass compared to other procedures like the sleeve or SADI. They are usually caused by factors such as aspirin, anti-inflammatory medications, smoking, or alcohol consumption. So if you’re a smoker, a bypass might not be the right option for you. However, ulcers can also develop due to bad luck, high stress, or following another operation.
As for hernias, anyone who loses a significant amount of weight is at a higher risk of developing symptomatic hernias. This is because hernias are often plugged with fatty tissue, and when that fat is lost, the hernia can loosen and become problematic. Additionally, in about 3% of cases the small bowel can twist around itself, which requires surgery to correct.
Is stomach stretching as big of an issue as once thought?
For most people, stomach stretching isn’t a major issue. However in a small number of cases it can be. When comparing stomach sizes between those who have lost weight and those who haven’t, the size is generally similar.
That said, if a patient reports feeling a lack of restriction, their stomach may have stretched slightly over time. In these cases, tightening the stomach can help restore that feeling of restriction, which can be beneficial.
Assessing stomach size is just one of many tools available when considering treatment options. Some stomachs naturally stretch more than others, though the reasons for this aren’t fully understood. This is why evaluating stomach size can be useful, especially if a patient is experiencing significant issues.
Why can individuals who have undergone bariatric surgery successfully discontinue weight loss medications without regaining weight, while those without surgery are more likely to experience weight relapse?
After bariatric surgery, the stomach can no longer produce the same range of appetite-stimulating hormones as it did before. This means that the surgical effect remains permanent, helping to regulate appetite long-term.
However, some patients go through difficult periods where they experience sudden weight regain over six months or so. This isn’t usually due to changes in their stomach but rather life events that impact their behaviour and eating habits. In these cases, using WLM (Weight Loss Medication) can help patients lose the regained weight and return to their previous habits, allowing them to maintain their results.
For people without surgery, weight loss often leads to increasing hunger over time. Once they stop WLM, their hunger returns, making it much harder to maintain weight loss. This is where bariatric surgery provides an advantage – it helps regulate hunger, making long-term weight management more achievable.
What if you’ve lost 20% with surgery but can’t lose any more weight, even with exercise?
In this case, it might be related to your metabolism. A metabolic rate analysis can help determine how much energy your body uses at rest. This information can give insights into how your metabolism is functioning and whether it’s impacting your ability to lose more weight.
If you’ve lost a significant amount of weight and still need to lose more, considering Weight Loss Medication (WLM) could be a good option. It can help speed up the process and might help you lose an additional 10-12%. Typically, people tend to lose 8-10% of their body weight within 6-9 months, and that’s often all they need to get back on track.
Start with WLM to see if it works for you. If it doesn’t, or if it’s not the right fit, we can then look into further tests to understand what’s going on.
How long can you use Weight Loss Medications (WLM)?
Weight loss medications can be used long-term, with many studies showing that they are safe and effective for use over extended periods, including 2 years or more. However, the challenge with long-term use is the cost, as they can become relatively expensive.
It’s worth testing de-escalation strategies, such as reducing the dose or using intermittent dosing to lower the cost. Increasing exercise can also help boost your metabolic rate and complement the medication. Medically, it’s safe to use these medications long-term, but it’s helpful to explore ways to manage the financial burden while still achieving effective results.
If a GP says the drugs won’t work if you don’t have any appetite, is that true?
This is often the case. If you don’t have much of an appetite and are still struggling to lose weight, it could indicate other factors at play, such as unacknowledged snacking or a metabolic rate issue. However even in these situations, it’s still worth trying the medications because they do more than just suppress appetite.
They can help reduce your overall interest in food, which allows you to unconsciously eat less. Additionally, they alter the way your body uses glucose, which can further support weight loss.
How soon post-surgery would you recommend weight loss medications?
The timing of introducing weight loss medications (WLM) post-surgery depends on several factors including the type of surgery, the amount of weight lost, and individual progress. A key concept in weight loss surgery and in weight loss treatment in general, is that you can predict how much weight someone will lose based on their initial progress in the first 3 to 4 months.
For example, with sleeve gastrectomy, the goal is usually for patients to lose about 30% of their total body weight. A target of 15% weight loss should occur in the first 3 to 4 months. If the patient has not reached 15% by that point, it may suggest they may not achieve their full weight loss goal, and WLM could be considered at that time.
For most patients, the first 12 to 18 months post-surgery is the key window for weight loss. If progress slows down significantly or a plateau persists, introducing medications may be appropriate to support further weight loss.
In cases of revision surgery such as switching from sleeve to bypass, weight loss may take longer to achieve so it might be reasonable to consider starting WLM earlier, once the patient is on normal food.
Should I go to my GP for weight loss medication (WLM) or UGIS?
It depends on your GP. Dr Jenny Matthei is a General Practitioner (GP) with a specialist interest who has retrained as a weight loss physician and focuses solely on weight loss management. She is happy to supervise patients through the process.
However, many GP’s are generalists and may feel less confident managing patients who are using weight loss medications. It’s often a good idea to start by consulting your GP, but if they are not comfortable with or interested in this approach, you can always make an appointment with Jenny.
A common pitfall when using WLM with your GP is that without the proper diet and lifestyle plan, you may not reach your weight loss goals for several reasons. First, if you use WLM without a high-quality diet, you may lose protein and muscle mass along with fat. This can contribute to increased fatigue, which can be even worse if you’re not eating the right vitamins and nutrients. Losing muscle mass also lowers your metabolic rate.
For the best results, it’s crucial to combine WLM with the right diet and exercise plan to maximise your success. GP’s often don’t have the resources to provide all of these components, but at UGIS we offer everything in one place, with Jenny providing the necessary prescriptions as well as guidance on diet and exercise.
Can the stomach “bounce back”?
The size of your stomach doesn’t change if you don’t eat. Resetting your stomach size, going on a diet, or taking weight loss medications (WLM) won’t change how much your stomach can hold. However, what you eat can change how much you eat.
When patients experience weight regain after bariatric surgery, they often report being able to eat large portions of certain foods, like macaroni and cheese, but feeling full quickly with healthier options like salad or vegetables. The key is changing what you eat, rather than focusing on the stomach size itself.
By introducing meal replacements or using WLM, you can modify your food choices. High-protein, low-sugar foods can help suppress appetite, while sugary, high-energy foods can stimulate hunger. GLP-1 agonists, a type of WLM, help reduce cravings for sugar and carbs, which are often the foods that trigger hunger. This approach can help re-establish healthier eating habits and better appetite control.
When will the price of weight loss medication (WLM) come down?
The price of WLM is unlikely to decrease significantly for at least five years. Currently there seems to be a bit of a double standard, as diabetics can access GLP 1 agonists for free and the “wholesale price” is low, while those seeking it for weight loss must pay more.
It will likely take around five years before GLP-1 agonists come off patent and become available for generic production, which could help reduce prices. Additionally, with only two options currently available on the market and the demand being so high, the companies have little incentive to lower prices. However as we’ve seen with other expensive medications in the past, once more companies enter the market, the prices will eventually come down in order to capture a share of the market. Still, it will likely take a minimum of five years for prices to drop.
How do you increase metabolism in someone who physically can’t exercise?
Increasing metabolism without exercise is quite challenging, but it can be done by making dietary adjustments. The key is to switch from foods that drive insulin production to those that don’t. Foods that require more effort to metabolise can help increase energy burn.
It’s also worthwhile to assess the individual’s metabolic rate, which can be measured to understand how many calories they burn while at rest. Once you know the baseline, you can tailor their diet to suit their metabolism, ensuring that they are consuming foods that support their more efficient metabolism.
In this blog, we answer your top questions about weight loss medication.
Are weight loss medications safe?
All medications have side effects and risks but most people tolerate weight loss medications well. Side effects become more of an issue if the dose of weight loss medication is increased too quickly. Common side effects such as nausea and constipation will mostly settle in the first month or two of treatment when managed under the care of our doctors.
If you experience nausea, we advise that you eat smaller meals, avoid fatty foods and take your time to eat more slowly. There are medications our doctors can also prescribe to help with nausea. If you experience constipation, increase your fluid intake, eat more vegetables, consider using a fibre supplement such as Metamucil and if you still have constipation you can use a laxative such as lactulose or movicol.
You shouldn’t increase your dose of weight loss medications until your side effects are under control. More serious and troublesome side effects and complications occur in about 1 in 200 patients which is a similar rate to a wide range of commonly prescribed medications for other health conditions. You can visit the website of your prescribed weight loss medication, to learn about the risks in more detail.
How long do I need to take weight loss medication?
Weight loss medications are effective in helping patients to lose weight and keep the weight off in the long-term, when used alongside lifestyle changes including healthy eating patterns and regular exercise. If these medications are stopped and patients go back to their previous unhealthy eating habits and stop exercising, their weight will increase again.
Some patients are able to stop weight loss medication and keep weight off if they continue to work on lifestyle management strategies. Other people do better with continuing on medication, often at a lower dose or with intermittent dosing, alongside lifestyle management in the longer term. It is important to monitor your weight regularly as you may need to restart your medication if your weight increases more than 3kg after stopping.
What are the long-term effects of weight loss medication?
Obesity is a chronic disease that affects every system in the body. Losing 10-20% of your starting weight will result in improvements in a wide range of other conditions including joint pain, high blood pressure, high cholesterol, heart disease, kidney disease, diabetes, sleep apnoea and mental health conditions. Losing weight can also prevent you from developing some of these diseases especially if you receive treatment before these diseases are established.
If you use weight loss medications and don’t eat a proper diet (including eating adequate amounts of protein and a wide range of fruit and vegetables), don’t drink adequate fluids or exercise (including resistance exercises), you will be at risk of muscle and bone loss or vitamin and mineral deficiencies.
How much weight can I expect to lose with medication?
There are a range of weight loss medications and the expected weight loss varies between 8-20% off the starting weight.
Is weight loss medication covered by insurance?
Some funds do pay a benefit for weight loss medications under ‘extras’ cover. We recommend you check with your insurer.
Can I take weight loss medication if I have diabetes?
Some of the weight loss medications available in Australia are also used for diabetes management and so can help with both weight loss and blood sugar control. Some of the agents are available to patients with diabetes on the PBS when certain criteria are met.
Are weight loss medications suitable for older adults?
Weight loss medications can be suitable and effective for older adults, however there is limited research data for patients over 75 years of age. Weight loss can be associated with a loss of muscle mass and so older patients who need to lose weight to improve their health will need to take these medications under good medical supervision.
Exercise is one of the major pillars of health maintenance for successful, lifelong weight loss. By including regular exercise into your weekly routine you will see:
✓ Physical Health improvements
✓ Mental health improvements
Exercise is an excellent way to:
✓ Prevent weight regain
✓ Prevent and/or treat joint/back pain or mobility issues
When can you start exercising after Bariatric Surgery
In the first few weeks after surgery, it’s important to commit to walking a minimum of 20 minutes or around 2,000 steps per day. After 2 weeks, treadmill exercise is okay for most people.
After 6 Weeks
After surgery, wait 6 weeks (unless advised by your specialist) before beginning light, simple exercise. This would include activities like:
● Walking – it’s low-impact, effective for weight loss and easy to fit into daily life for long-term success.
● Cycling – gentle on the joints, improves cardiovascular fitness and can be easily adjusted to match your fitness level.
● Swimming – is a full-body workout that supports weight loss, while being low-impact and easy on the joints.
● Simple resistance exercises – a high protein diet and resistance exercise will help prevent muscle loss during weight loss. This could include exercises like seated leg lifts, squats and workouts with resistance bands or light weights.
Try to incorporate a minimum of 2-3 hours of exercise each week to support your weight loss, build strength and improve overall health.
Sustainable Exercise for Long-term Success
New Activities
Improving mobility makes it easier to get back into exercise. Use this opportunity to engage in new activities, planning for weekdays and weekends. If you find something you enjoy actively taking part in, like cycling club or a fitness class, you are more likely to commit to it long-term for sustainable weight maintenance.
Increase Resistance Training
As you gain strength, it’s important to incorporate resistance training into your weekly routine to support skeletal health and protect from injury. Long-term resistance training could look like attending Pilates/Yoga classes, joining a local gym or engaging a personal trainer. For people with any musculoskeletal disorder, an Exercise Physiologist is the preferred exercise provider.
There are many online fitness programs available and plenty of useful apps to support including exercise into your everyday life. What’s important is finding what is going to work best for you, long-term.
Undergoing bariatric surgery is a significant step towards improving your health and achieving long-term weight loss. As part of our Ongoing Care Program at UGIS we provide all our patients with a Bariatric Surgery Tool Kit – a set of resources designed to help you build healthy habits for life. In this blog, we’ll guide you through effectively using each item in your tool kit.
Your Complete Guide to Nutrition for Weight Loss Surgery
This book by Sally Johnston is tailored specifically for bariatric patients. It covers everything from meal planning to understanding your nutritional needs after surgery. Here’s how to make the most of it:
- Use it as your go-to reference for post-surgery nutrition, meal ideas, and guidance on portion sizes.
- Plan your meals in advance using the practical tips and recipes included.
- Keep it accessible – having it on your kitchen counter or bedside table ensures you can refer to it when needed while reminding you to continue your healthy eating habits.
Portion Perfection Bariatric Plate and Bowl
After surgery, you will only be able to eat small amounts, but long-term portion control is critical for maintaining a balanced diet and preventing discomfort. The Portion Perfection bariatric plate and bowl help you visualise appropriate portion sizes and ensure you’re eating the right amount.
- Use the plate as a guide for serving your meals. Each section indicates the correct proportions of protein, vegetables, and carbohydrates.
- Measure your food – over time you will intuitively know how much of each food type you should be including on your plate while becoming familiar with how much food you need to feel satisfied without overeating.
Bariatric Multivitamins: A Lifelong Habit
Bariatric surgery alters your body’s ability to absorb certain nutrients, making lifelong vitamin supplementation essential. Your tool kit includes a one-month supply of bariatric multivitamins to get you started.
- Take your vitamin daily as prescribed by your healthcare team to prevent deficiencies.
- Set reminders on your phone or keep your vitamins in a visible place to ensure consistency.
- Continue your supplements long-term – even if you feel well, nutrient deficiencies can develop over time if vitamins are not taken regularly.
Embracing Your New Lifestyle
Your Bariatric Surgery Tool Kit is designed to set you up for success. By making these resources a part of your daily routine, you’ll be better equipped to maintain healthy habits, optimise your nutrition, and achieve long-term weight loss. If you have any questions about your tool kit or need further guidance, don’t hesitate to reach out to our team, we’re here to support you every step of the way.
Consumption of Alcohol by the Body
Alcohol whenever consumed is the first fuel for the body to burn; while your body is processing the alcohol it will not burn fat. It will not stop your weight loss, but it will postpone it. After consuming your first alcoholic drink, 25% is absorbed straight from the stomach into the bloodstream and the remainder is taken in through the small bowel.
The speed at which alcohol is absorbed depends on different factors such as the amount of food in your stomach (a fuller stomach slows the rate of absorption), the concentration of alcohol in the drink (the higher the level of alcohol the quicker it is absorbed) and whether the drink is carbonated (there is a reason people say “champagne goes straight to my head”!). On average a standard drink will take around 10 hours for a person to process.
Calorie Content of Alcohol
We’ve all heard the rumours, and yes we’re afraid that it is true – alcoholic drinks are high in calories and calories from alcohol alone have no nutritious value whatsoever. Some examples of calories contained in popular alcoholic drinks:
Beer (375ml) – 150 to 250 calories
Wine (150ml) – around 120 – 130 calories
Daiquiri (120ml) – around 250 – 300 calories
Champagne (150ml) – around 90 – 105 calories
Rum and Coke (150ml) – around 150 – 180 calories
Vodka and club soda (150ml) – around 65 calories
The variety and quantity of alcohol will also determine the calories, so overall it is important to cut down on your alcohol intake whilst trying to lose weight and maintain a healthy eating plan. If you do decide to have alcohol, it is best to try to avoid mixers that are high in sugar content such as Coke, or beer which is also high in calories. Opt for a lower calorie drink such as vodka, lime and soda, or a small glass of wine.
Increased Hunger
As soon as you have an alcoholic drink your body uses the stored glycogen (stored glucose) in your liver which in turn makes you hungry. This increased hunger due to alcohol will put unnecessary pressure on you to be able to stick to your healthy eating plan.
Making Poor Choices
Although we are aware alcohol can lead us to make poor choices, in this scenario we mean that alcohol leads you to make poor food choices. We know alcohol increases your hunger and because you feel the effects of the alcohol taking hold you are more likely to make poor food choices such as opting to have pizza or chips as they are quick and convenient rather than choosing a healthy snack or meal.
We understand that alcohol consumption plays a large part in society and that avoiding it completely would be very difficult for a lot of people. Consider the following next time you are having a drink:
- Choose wisely; opt for a low calorie alcoholic drink.
- Quantity; ask for small servings such as a small glass of wine rather than the large glass. Also recognise when you have consumed too much and attempt to prohibit excessive consumption.
- Mindfulness; when you’ve had a drink and you are feeling the pang of hunger, make sure you pick up a healthy snack or have a healthy meal. Preparing for this in advance and having these readily available will help.
Undergoing bariatric surgery is a life-changing decision that requires careful planning; not just for the procedure itself but for the financial investment involved. In Australia, the cost of bariatric surgery can vary widely depending on whether you have private health insurance or are paying out of pocket for hospital costs.
We’ve outlined the key factors to consider when budgeting for bariatric surgery, from understanding insurance coverage to managing additional expenses. With the right preparation, you can make informed decisions and focus on achieving your health goals.
Costs Before Bariatric Surgery
Your first consultation with a bariatric specialist will incur a fee, which varies depending on the doctor you choose. This fee has a Medicare rebate for eligible patients, which offsets the cost. Before surgery, you may also require pre-operative assessments such as blood tests or imaging, which may not be fully covered by Medicare.
Bariatric Surgery – With Private Health Insurance
If you have private health insurance it can significantly reduce your hospital charges, but there are other considerations:
Waiting Periods: Private health insurers require a 12-month waiting period for bariatric surgery coverage. Before booking your surgery, make sure you are eligible (see below). If you are still waiting for your cover to become available for bariatric surgery, you can download our free eBook ‘12 Month Pre-Surgery Guide’.
Coverage for Procedure: Not all procedures, such as gastric sleeve or gastric bypass, may be covered under your policy. Confirm your coverage details with your provider using the correct procedure number (below).
Sleeve Gastrectomy – 31575
Gastric Bypass – 31572
Gastric Band – 31569
Excess Payments: Check your policy for any hospital excess fees or co-payments you may need to pay upfront.
Gaps in Coverage: Out-of-pocket expenses such as anaesthetist or assistant fees that are not covered by your insurer.
Although post-operative care such as follow-up appointments and Dietitian consults are included in the clinic fee at our practice, there are other things to consider when budgeting for bariatric surgery. All bariatric surgery requires a short hospital day of approx. 2 – 3 days with a subsequent recovery period of around 2 weeks (for most people). It is important to budget for time off work during this period. If you live in a remote or regional area, it’s also important to factor in travel expenses when you are budgeting for bariatric surgery.
Multivitamins After Bariatric Surgery
Bariatric surgery changes your digestion and limits the amount of food consumed at a mealtime therefore limiting the nutrients your body can absorb. Studies undertaken on patients who have had Bariatric surgery indicate that as many as 15% will end up with neurological (nervous system) disorders if they don’t take supplementary vitamins. As a result, it is important to take multivitamins daily for the rest of your life to protect you from long-term deficiencies. Therefore budgeting for lifelong multivitamins is an important factor to consider.
Long-term Value of Bariatric Surgery
Although bariatric surgery can seem expensive, consider the long-term savings on medical costs associated with obesity-related conditions, such as diabetes, heart disease or joint issues. The improvements in quality of life and overall health of a person following weight loss after bariatric surgery are invaluable.
If you’re considering bariatric surgery and want to learn more about what to expect, reach out to our clinic to make an appointment.
When people think about bariatric surgery they often focus on the benefits, like significant weight loss, improved overall health and enhanced mobility. However, a lesser-known side effect is how a person’s sense of taste can change after surgery. Let’s explore the science behind taste changes and how they can positively impact your post-surgery journey.
Why Does Bariatric Surgery Change Your Taste?
Recent research has shown that bariatric surgery doesn’t just alter the way your body processes food, it can also influence how you perceive flavours. The primary drivers of this change are hormonal shifts and changes in the gut-brain axis.
- Hormonal Changes: Bariatric surgery alters the production of hormones like ghrelin (popularly called the hunger hormone) and peptide YY (which regulates satiety, the feeling of being satisfied with what you have eaten). These hormones don’t just affect hunger but can also influence taste perception.
- Neurological Factors: The gut-brain axis, a complex communication network between your digestive system and brain, undergoes significant changes post-surgery. This can lead to altered responses to food, including taste and smell.
How Taste Changes After Bariatric Surgery
The way food tastes after surgery varies from person to person, but here are some common changes:
- Reduced Cravings for Sweets and Fats: Many patients report a lessened desire for high-sugar or high-fat foods, which were often problematic before surgery.
- Enhanced Sensitivity to Flavours: After surgery, even small amounts of sugar or salt can feel overwhelmingly strong, subtly encouraging patients to avoid overly processed foods.
- Aversion to Certain Foods: Once loved foods such as greasy takeaways or sugary treats, might suddenly become unappealing.
These changes aren’t just in your mind; they stem from physiological shifts that rewire how your brain interprets taste.
How Taste Changes Help Prevent Bad Eating Habits
One of the biggest challenges in weight loss – overcoming bad eating habits, long-term. Post-bariatric surgery patients often experience a natural aversion to high-calorie, low-nutrition foods. This physical transformation complements the psychological tools and guidance you receive before and after surgery.
Imagine biting into a sugary doughnut only to find it too sweet to enjoy. Or discovering that greasy hot chips leave an unpleasant aftertaste. These experiences can make it easier to replace unhealthy choices with healthy options, reinforcing new eating habits crucial to long-term success.
For many, the shift in taste preferences is a welcome change. It can:
- Encourage Healthier Eating: Foods that once contributed to weight gain may no longer be appealing, making it easier to stick to post-surgery dietary guidelines.
- Break Emotional Eating Cycles: As cravings for certain comfort foods fade, patients often find it easier to manage emotional eating.
- Promote Long-Term Weight Loss: These taste changes can reinforce positive behaviours, making weight management more sustainable.
The changes in taste after bariatric surgery are more than just a side effect, they’re an important part of the process. By making unhealthy foods less appealing, your body naturally guides you toward better choices. At Upper GI Surgery, we’re here to support every part of your journey, from the physical to the behavioural.
If you’re considering bariatric surgery and want to learn more about what to expect, reach out to our clinic to make an appointment.
For those planning to conceive or start a family after bariatric surgery, it’s essential to understand how it affects pregnancy and fertility. Here’s a comprehensive look at the implications of bariatric surgery on pregnancy and fertility
Understanding Bariatric Surgery
Bariatric surgery is designed to help people achieve substantial weight loss by altering the digestive system. Common procedure types include gastric bypass and gastric sleeve surgery. These surgeries can improve conditions like diabetes, hypertension, and sleep apnea, all linked to obesity.
Bariatric Surgery: Impact on Fertility
Research shows that individuals who undergo bariatric surgery can experience improved fertility. A study published in the American Journal of Obstetrics and Gynecology found that weight loss after surgery is associated with improved ovulatory function, particularly in women with conditions such as polycystic ovary syndrome. Many patients report increased menstrual regularity and a higher likelihood of conception following bariatric surgery.
Timing of Pregnancy
While the prospect of pregnancy may be exciting, timing is crucial. We typically recommend waiting at least 12 to 18 months after bariatric surgery before trying to conceive. This recommendation allows the body to stabilise after significant weight loss and ensures that nutrient levels are adequate to support a healthy pregnancy. Rapid weight loss can lead to nutritional deficiencies, which may negatively affect both maternal and fetal health.
Nutritional Considerations
Nutritional health is vital during pregnancy, especially after bariatric surgery. The altered digestive system can affect how the body absorbs nutrients, making it essential for individuals to prioritise their dietary intake.
If you would like to know more, you can download our patient handout – Nutrition Guidelines for Pregnancy After Bariatric Surgery.
Potential Risks and Considerations
While many individuals have healthy pregnancies after bariatric surgery, there are potential risks to be aware of:
Nutritional Deficiencies – the body may struggle to absorb certain nutrients post-surgery, leading to deficiencies that can impact both mother and baby.
Gestational Diabetes – this condition can occur during pregnancy and may be more prevalent in individuals who have undergone bariatric surgery. Regular monitoring is essential.
Weight Gain – gaining too much weight during pregnancy can pose risks, including complications during delivery. Maintaining a healthy weight gain throughout pregnancy is important.
Pregnancy After Bariatric Surgery
Pregnancy after bariatric surgery can be a rewarding experience, but it requires careful planning and management. Understanding the implications of bariatric surgery on fertility, nutrition, and overall health can help individuals navigate their pregnancy journey successfully.
If you’re considering pregnancy after bariatric surgery, it’s important to work closely with your healthcare team to develop a comprehensive plan that prioritises both your health and that of your future child. With the right support and knowledge, many individuals go on to have healthy pregnancies and families after bariatric surgery.
Gastric sleeve surgery is among the most popular procedures for obesity treatment globally. Gastric sleeve surgery reduces the stomach’s volume to 15-20% of its original size, making it highly effective for weight loss. On average, individuals can lose 20-35% of their total body weight. We have been performing this operation since 2004.
Why might a Gastric Sleeve require revision?
Despite the success of gastric sleeve surgery, some patients may experience challenges over time, such as weight regain or developing complications. The stomach and oesophagus can stretch and sag, and patients can develop new conditions such as ulcers or reflux.
In general, these operations are like anything mechanical: the better you maintain it, the longer it lasts. If patients lose their initial enthusiasm and gradually stop looking after themselves and their sleeve it can lead to weight regain, problems with how the operation works, and complications that require surgical intervention.
Unfortunately, being compliant and sensible does not guarantee a hassle-free gastric sleeve, although it will reduce the risk of problems by about 75%. In general, between about 10 – 30% of patients having any type of bariatric surgery will require later surgery to treat complications or weight regain. One of the main reasons patients should return to their surgeon for follow-up is to reduce the risk of repeat surgery and to notice and treat any problems early.
Gastric Sleeve Revision Options
Depending on the individual needs and the nature of their issue, several options are available for gastric sleeve revision:
Resleeving: This involves reducing the stomach size again, recommended when the stomach has stretched and led to weight regain.
Conversion to Gastric Bypass: If the patient experiences severe reflux or needs further weight loss, converting the gastric sleeve to a gastric bypass may be an option. This can help address reflux and provide additional weight loss benefits.
Eating habits, weight regain patterns, and symptoms like reflux or hernias will also be considered when deciding the best revision option.
While gastric sleeve surgery is intended to provide long-term weight loss, some patients may face challenges over time. Gastric sleeve revision surgery provides options for patients who have experienced weight regain or complications. If you’d like to speak to one of the UGIS bariatric surgeons to determine the most appropriate course of action based on your specific circumstances please contact our team today – you can book an appointment online or call the practice on (02) 9553 1120.
Are you suffering weight regain after a previous sleeve gastrectomy or Type 2 Diabetes? We’re running a clinical trial where we’ll be offering patients bypass surgery to help them with this problem. Watch the video below to find out more.
We are running a trial using a surgical device that is currently under investigation so is not available for human use outside a clinical trial. The device has been used in over 85 patients worldwide and appears as safe as other currently used surgical methods. Eligible patients, who have undergone medical screening will be offered the procedure as part of a clinical trial. While we cannot foresee what results or outcomes may occur for people in the trial, these types of surgeries can allow patients to lose around 15% of their starting weight by a year after surgery, and an improvement in weight, or Obesity related conditions such as Type II diabetes.
Who is eligible for the study?
Patients with weight regain after previous sleeve gastrectomy surgery, and or patients with Type II
diabetes.
What does the surgery involve?
It’s a combined endoscopy and laparoscopy procedure which involves creation of a bypass between the duodenum and the distal small bowel, otherwise known as a duodeno-ileostomy. This leads to a change in hormones associated with eating as well as absorption of calories from food. Both of these together helps cause weight loss however they can also lead to diarrhoea and nutrient deficiencies if not combined with dietary change and vitamin/mineral supplements.
Would you like to be considered for this surgery?
All patients wishing to be considered for surgery will need to fill in the eligibility questionnaire. Click below to complete online:
If you have any questions and would like more information please email info@uppergisurgery.com.au