your guide to weight loss surgery

MU HEALTH CARE | YOUR GUIDE TO WEIGHT LOSS SURGERY 1

YOUR GUIDE TO

WEIGHT LOSS SURGERY

– Wende, seven months post-surgery


It’s about gaining life.At MU Health Care, bariatric surgery isn’t about

dropping pounds or pant sizes. It’s about finding

a long-term solution to help you regain your health

and live a life unhindered by weight.

With multiple weight loss options, we work with

you to find what best meets your goals and give

you an entire team of support before, during and

long after your care.

Our collaborative approach to care means no

matter where you’re at in your weight loss journey,

our team is committed to making sure you have

everything you need to be successful. It means

we don’t just get you in and out for surgery or

short-term results; rather, we work together to

foster a lasting, healthy lifestyle through nutrition

counseling, health evaluations, educational classes,

support groups, treatment of weight-related issues

and regularly scheduled check-ins.

To us, bariatric surgery isn’t about losing weight;

it’s about gaining life, and we’re here to help

make it happen. In this guide, you’ll find all of the

bariatric procedures we offer, as well as some

information about our non-surgical medical weight

loss program.

“I saw people older than me getting the surgery so they could qualify for a hip or knee replacement. I thought, ‘this is the clue — if I get it now, maybe I won’t need a joint replacement.”

– Bill, 13 months post-surgery


Our ProcessFirst appointment: Meet with our team, go over medical conditions, talk through options and answer any questions.

Evaluation: Complete a behavioral evaluation to help determine which lifestyle changes are needed and appropriate for long-term success.

Dietary visit: Learn about dietary and lifestyle changes that come with each procedure.

Additional clearances, if necessary: For instance, if you have other significant medical conditions, consultations with doctors who specialize in those conditions may be necessary.

Insurance authorization: This can take 2-6 weeks to obtain, depending on your insurance plan.

Pre-surgery class: Receive your surgery date and go over important pre- and post-surgery details such as diet, preparation for surgery and post-surgery care.

Surgery: Most of our procedures, on average, require one or two nights in the hospital. Our team will be checking in with you during your stay to ensure your safety at all times.

Follow up: To track changes and ensure everything is running smoothly, follow-up appointments will occur at one week, one month, three months, 6 months and then yearly for the next five years.

Ongoing support: In-person and online support groups, additional

classes and a dietitian always available via phone or email.

EACH PROGRAM INCLUDES:

• Expert support for the insurance approval process

• Dietary consultations

• Supplemental education before and after surgery

• A long-term support system to help you maintain weight loss


Body Mass Index (BMI) EligibilityTo qualify for weight loss surgery, candidates typically

need a BMI of 40 or more, which translates to about

100 pounds over ideal body weight for men and 80

pounds for women.

Those with a BMI of 35 or greater may also qualify for

surgery if they have other conditions related to their

weight, including:

Body Mass Index (BMI) Chartshttps://www.vertex42.com/ExcelTemplates/bmi-chart.html © 2009 Vertex42 LLC

[42]Obese (>30) Overweight (25-30) Normal (18.5-25) Underweight (<18.5)

4'8" 4'9" 4'10" 4'11" 5'0" 5'1" 5'2" 5'3" 5'4" 5'5" 5'6" 5'7" 5'8" 5'9" 5'10" 5'11" 6'0" 6'1" 6'2" 6'3" 6'4" 6'5"lbs (kg) 142cm 147 150 152 155 157 160 163 165 168 170 173 175 178 180 183 185 188 191 193 196

260 (117.9) 58 56 54 53 51 49 48 46 45 43 42 41 40 38 37 36 35 34 33 32 32 31255 (115.7) 57 55 53 51 50 48 47 45 44 42 41 40 39 38 37 36 35 34 33 32 31 30250 (113.4) 56 54 52 50 49 47 46 44 43 42 40 39 38 37 36 35 34 33 32 31 30 30245 (111.1) 55 53 51 49 48 46 45 43 42 41 40 38 37 36 35 34 33 32 31 31 30 29240 (108.9) 54 52 50 48 47 45 44 43 41 40 39 38 36 35 34 33 33 32 31 30 29 28235 (106.6) 53 51 49 47 46 44 43 42 40 39 38 37 36 35 34 33 32 31 30 29 29 28230 (104.3) 52 50 48 46 45 43 42 41 39 38 37 36 35 34 33 32 31 30 30 29 28 27225 (102.1) 50 49 47 45 44 43 41 40 39 37 36 35 34 33 32 31 31 30 29 28 27 27220 (99.8) 49 48 46 44 43 42 40 39 38 37 36 34 33 32 32 31 30 29 28 27 27 26215 (97.5) 48 47 45 43 42 41 39 38 37 36 35 34 33 32 31 30 29 28 28 27 26 25210 (95.3) 47 45 44 42 41 40 38 37 36 35 34 33 32 31 30 29 28 28 27 26 26 25205 (93.0) 46 44 43 41 40 39 37 36 35 34 33 32 31 30 29 29 28 27 26 26 25 24200 (90.7) 45 43 42 40 39 38 37 35 34 33 32 31 30 30 29 28 27 26 26 25 24 24195 (88.5) 44 42 41 39 38 37 36 35 33 32 31 31 30 29 28 27 26 26 25 24 24 23190 (86.2) 43 41 40 38 37 36 35 34 33 32 31 30 29 28 27 26 26 25 24 24 23 23185 (83.9) 41 40 39 37 36 35 34 33 32 31 30 29 28 27 27 26 25 24 24 23 23 22180 (81.6) 40 39 38 36 35 34 33 32 31 30 29 28 27 27 26 25 24 24 23 22 22 21175 (79.4) 39 38 37 35 34 33 32 31 30 29 28 27 27 26 25 24 24 23 22 22 21 21170 (77.1) 38 37 36 34 33 32 31 30 29 28 27 27 26 25 24 24 23 22 22 21 21 20165 (74.8) 37 36 34 33 32 31 30 29 28 27 27 26 25 24 24 23 22 22 21 21 20 20160 (72.6) 36 35 33 32 31 30 29 28 27 27 26 25 24 24 23 22 22 21 21 20 19 19155 (70.3) 35 34 32 31 30 29 28 27 27 26 25 24 24 23 22 22 21 20 20 19 19 18150 (68.0) 34 32 31 30 29 28 27 27 26 25 24 23 23 22 22 21 20 20 19 19 18 18145 (65.8) 33 31 30 29 28 27 27 26 25 24 23 23 22 21 21 20 20 19 19 18 18 17140 (63.5) 31 30 29 28 27 26 26 25 24 23 23 22 21 21 20 20 19 18 18 17 17 17135 (61.2) 30 29 28 27 26 26 25 24 23 22 22 21 21 20 19 19 18 18 17 17 16 16130 (59.0) 29 28 27 26 25 25 24 23 22 22 21 20 20 19 19 18 18 17 17 16 16 15125 (56.7) 28 27 26 25 24 24 23 22 21 21 20 20 19 18 18 17 17 16 16 16 15 15120 (54.4) 27 26 25 24 23 23 22 21 21 20 19 19 18 18 17 17 16 16 15 15 15 14115 (52.2) 26 25 24 23 22 22 21 20 20 19 19 18 17 17 16 16 16 15 15 14 14 14110 (49.9) 25 24 23 22 21 21 20 19 19 18 18 17 17 16 16 15 15 15 14 14 13 13105 (47.6) 24 23 22 21 21 20 19 19 18 17 17 16 16 16 15 15 14 14 13 13 13 12100 (45.4) 22 22 21 20 20 19 18 18 17 17 16 16 15 15 14 14 14 13 13 12 12 1295 (43.1) 21 21 20 19 19 18 17 17 16 16 15 15 14 14 14 13 13 13 12 12 12 1190 (40.8) 20 19 19 18 18 17 16 16 15 15 15 14 14 13 13 13 12 12 12 11 11 1185 (38.6) 19 18 18 17 17 16 16 15 15 14 14 13 13 13 12 12 12 11 11 11 10 1080 (36.3) 18 17 17 16 16 15 15 14 14 13 13 13 12 12 11 11 11 11 10 10 10 9

Note: BMI values rounded to the nearest whole number. BMI categories based on CDC (Centers for Disease Control and Prevention) criteria.https://www.vertex42.com BMI = Weight[kg] / ( Height[m] x Height[m] ) = 703 x Weight[lb] / ( Height[in] x Height[in] ) © 2009 Vertex42 LLC

HEIGHT in feet/inches and centimeters WEIGHT

Body Mass Index (BMI) Table for Adults

DIABETES

SLEEP APNEA

HEART DISEASE

HIGH BLOOD PRESSURE

JOINT PROBLEMS


Improving Weight-Related ConditionsThere are many studies being done to

determine the effects bariatric surgery

has on weight-related health conditions.

Here are some of the results:

Sources: Cleveland Clinic, 2018; JAMA, 2012

“I’m no longer diabetic, have a normal blood pressure, normal cholesterol… The only pills I take now are vitamins.”

– Megan, nine months post-surgery

Of patients six-years post-surgery achieve and maintain a normal blood pressure

Of patients six-years post-surgery achieve and maintain remission for type 2 diabetes

Reduced risk of heart attack and stroke for people with type 2 diabetes.


ProceduresNationally accredited by the Metabolic and Bariatric Surgery Acceditation and Quality Improvement Program (MBSAQIP),

our board-certified doctors offer a range of surgical and nonsurgical options to meet the needs of those struggling with

weight loss. All of our procedures improve obesity-related medical conditions and are almost always performed laparoscopically

to improve recovery, reduce time off work and decrease the rates of complications.

ROUX-EN-Y GASTRIC BYPASS During roux-en-y gastric bypass, the surgeon creates a small stomach pouch and attaches it directly to the small intestine, bypassing the rest of the stomach and upper part of the intestine. The smaller stomach reduces food intake by helping you feel fuller faster, while bypassing the intestine helps control hunger between meals.

• Limits food intake and reduces caloric absorption

• Patients typically lose 30 pounds in the first month, and one to two pounds per week afterward

• Helps control hunger through hormonal changes

This procedure is not well-suited for someone with severe medical illnesses or extensive abdominal surgery.

SURGICAL OPTIONS


GASTRIC SLEEVE For the gastric sleeve procedure, the surgeon creates a small stomach sleeve in the shape of a banana that is about half an inch wide and removes the rest of the stomach. The limited stomach space restricts the amount of food that can be eaten, while hunger hormones decrease to help control hunger between meals.

• Limits food intake and controls hunger

• Stomach size is reduced by 80 percent

• The majority of weight loss comes in the first 18 months

• Fewer long-term side effects compared to procedures with intestinal modifications

• Not reversible, but can be transformed into other weight loss options if necessary

Unique to bariatric options, the sleeve can be performed in patients with severe medical illnesses, as well as in someone with extensive abdominal surgery.

BILIOPANCREATIC DIVERSION WITH DUODENAL SWITCH Our biliopancreatic diversion with duodenal switch procedure creates a stomach sleeve similar to the gastric sleeve procedure, however, with this procedure, the surgeon also bypasses a significant portion of the intestine, thereby limiting absorption and improving weight loss.

• Limits food intake, reduces caloric absorption and controls hunger

• Leads to the most significant weight loss

• Patients generally lose 70 to 80 percent of excess weight within two years

Like the gastric bypass, this procedure isn’t recommended for someone with severe medical illnesses or extensive abdominal surgery.

Procedures (cont.)


LAP BAND During lap band surgery, the surgeon places an adjustable silicon band around the upper portion of your stomach to create a small pouch. The pouch helps limit food intake by creating a sense of fullness. Based on your nutritional needs and goals, the band can be adjusted to allow more or less food after the initial surgery.

• Limits food intake

• Adjustable depending on nutritional needs

• Designed for those who don’t have much weight to lose

Procedures (cont.)

WEIGHT LOSS REVISIONAL SURGERYIf you are struggling with weight loss after bariatric surgery or are dealing with long-term side effects, it might be possible to try another method or modify your current procedure. While it poses a higher risk as a second stomach operation, it may be a good option if you’re facing weight regain or negative side effects.


NON-SURGICAL OPTIONS

GASTRIC BALLOON Our gastric balloon procedure offers modest weight loss results in a non-invasive way. During the procedure, an inflatable balloon is placed in the stomach via the esophagus with the ability to adjust the amount of space available for food.

With coaching from our staff, patients work on healthier meals and exercise options to lose weight. Most patients who choose this method lose the most weight within the first six months and then have to rely on a healthy lifestyle to keep the pounds off.

• Limits food intake

• No surgical incision

• Balloon is removed after six months

• Adjustable depending on nutritional needs

MEDICAL WEIGHT LOSS PROGRAMMU Health Care also offers a comprehensive non-surgical weight loss program using medications to help control hunger. This program can also be paired with a surgical procedure to maximize your weight loss and keep it off.

Procedures (cont.)

“I’m doing yoga poses I couldn’t do before, getting faster in my running, learning to rock climb… I’m finding the person I always wanted to be.”

– Wende, seven months post-surgery


Insurance

When it comes to insurance, every policy is

different, though most tend to cover bariatric

services. Our team can assist in determining if

your insurance covers weight loss surgery and

will be glad to help you meet any pre-surgery

diet and weight loss requirements.

Ready to start losing weight and gaining life?

Call (573) 882-LOSE or request an appointment at muhealth.org/weightlosssurgery.

I’m looking forward to one day riding roller coasters with our kids as they get older. Not having the anxiety prior to a flight of okay, I need to find a good seat… without other people sitting next to me.”

– John, 13 months post-surgery

your guide to weight loss surgery

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