Obesity Bariatric Surgery Our Program - Michigan Medicine
Lets learn about: Obesity Bariatric Surgery Our Program
Facts
Obesity is Common Approximately 1/3 of adults in Michigan are obese.
Obesity is Unhealthy Obesity is related to many illnesses such as: diabetes heart disease high cholesterol sleep apnea arthritis fatty liver disease infertility certain cancers
Losing weight helps: Weight loss can: Improve your health Reduce you need for prescription medication Extend your life
Bariatric Surgery Works National Institutes of Health (NIH) recognizes bariatric surgery as the only effective treatment to combat severe obesity and maintain weight loss in the long term.
Bariatric Surgery: Gastric Bypass Sleeve Gastrectomy
Laparoscopic Surgery Shorter hospitalizations Quicker return to activity Less complications
Procedures: Sleeve Gastrectomy
Sleeve Gastrectomy General anesthesia 1-2 hour procedure 2-3 days in the hospital 55% - 65% excess body weight loss 60-100 lbs weight loss Maximal weight loss occurs at 1 year.
Risks and Complications Overall complications 10% Major complications 2% Not reversible Heartburn Sleeve Gastrectomy
Procedures: Gastric Bypass
Gastric Bypass General anesthesia 2-3 hour procedure 2-3 days in the hospital 65% - 75% excess body weight loss 100-150 lbs weight loss Maximal weight loss occurs at 1 year.
Risks and Complications Gastric Bypass Overall complications 15% Major complications 3% Ulcers Highest risk with smokers and use of NSAIDs Dumping syndrome Internal hernia Longer operation higher risk of blood clots and wound complications
Risks and Complications Gastric Bypass Overall complications 15% Major complications 3% Ulcers Highest risk with smokers and use of NSAIDs Dumping syndrome Internal hernia Longer operation higher risk of blood clots and wound complications
Why does surgery work? Not clear but there are lots of theories: Limits portion size Decreases absorption of nutrients Changes body’s regulation system for gaining and losing weight
When does it fail? Eating habits and food choices Physical activity Genetics Gender Illness Age Medications
What happens after surgery? 2-3 days in the hospital 2 weeks - follow up in surgery clinic 2 months - follow up in surgery clinic 6 months and yearly - follow up in the Metabolic and Endocrine Clinic
What happens after surgery? 70 grams of protein/day 64 fluid ounces/day Small portions No concentrated sweets No carbonated drinks
Vitamin Supplementation Weight loss surgery reduces vitamin absorption. Taking supplemental vitamins is IMPORTANT!
What’s the best procedure for me? Gastric Bypass Sleeve Gastrectomy
Balancing the risks and benefits Weight Loss Complications
Outcomes Calculator
Outcomes Calculator
Outcomes Calculator
Weight Loss Change Weight loss is more than just a number It’s important to match your expectations with realistic goals: Reduction of comorbid conditions Reduction of prescription medications Life-long lifestyle changes Possible complications
Am I a candidate? Body mass index (BMI) BMI 40 or BMI 35 Weight related illnesses
Am I a candidate? Can tolerate general anesthesia. Able to make dietary and lifestyle changes Able to exercise Not smoking Psychological illnesses are well controlled No active cancer
The Road to Surgery
Informational Meeting Psychological Evaluation Medical Evaluation Dietary Evaluation Review Committee Meeting (RCM) 2 Support Group Meetings RCM Tasks Completed 3, 6 or 12 Months Medically Supervised Weight Loss Documented Insurance Authorization Pre-operative History and Exam Meet Surgeon Discuss Procedure Surgery Pre-Surgery Nutrition Class
Informational Meeting Psychological Evaluation Medical Evaluation Dietary Evaluation Review Committee Meeting (RCM) 2 Support Group Meetings RCM Tasks Completed 3, 6 or 12 Months Medically Supervised Weight Loss Documented Insurance Authorization Pre-operative History and Exam Meet Surgeon Discuss Procedure Surgery Pre-Surgery Nutrition Class
Informational Meeting Psychological Evaluation Medical Evaluation Dietary Evaluation Review Committee Meeting (RCM) 2 Support Group Meetings RCM Tasks Completed 3, 6 or 12 Months Medically Supervised Weight Loss Documented Insurance Authorization Pre-operative History and Exam Meet Surgeon Discuss Procedure Surgery Pre-Surgery Nutrition Class
Informational Meeting Psychological Evaluation Medical Evaluation Dietary Evaluation Review Committee Meeting (RCM) 2 Support Group Meetings RCM Tasks Completed 3, 6 or 12 Months Medically Supervised Weight Loss Documented Insurance Authorization Pre-operative History and Exam Meet Surgeon Discuss Procedure Surgery Pre-Surgery Nutrition Class
Review Committee Letter Risk/Benefit Profile Estimated weight at 1 year Estimated complication rate Requirements Recommendations
Informational Meeting Psychological Evaluation Medical Evaluation Dietary Evaluation Review Committee Meeting (RCM) 2 Support Group Meetings RCM Tasks Completed 3, 6 or 12 Months Medically Supervised Weight Loss Documented Insurance Authorization Pre-operative History and Exam Meet Surgeon Discuss Procedure Surgery Pre-Surgery Nutrition Class
Insurance Coverage Varies: Private Insurance Veterans Medicare You need to contact your provider for specific details Use our insurance questionnaire as a guide
Important questions for your insurance carrier:
Medically Supervised Weight Loss Documentation
Multidisciplinary Team Surgeons Endocrinologists Physician Assistants Psychologists Dietitians Certified Bariatric Nurse Patient Service Associates
On-line Resources
C-Tools
Weight-Loss Conditioning Program
Hunger Within Nationally recognized treatment for weight management 12 week program Explores core reasons for overeating (triggers for emotional eating) https://www.uofmhealth.org/hunger-within-workshop
Clinic Domino’s Farms Lobby A, Suite 1200 4008 Ave Maria Dr. Ann Arbor, MI 48105
Surgery University of Michigan Health System 1500 E. Medical Center Dr Ann Arbor, MI 48109
Next Steps 1. Provide your name and contact information. 2. Contact your insurance carrier about details of your policy
Bariatric Surgery Our Program Lets learn about: Facts. Obesity is Common Approximately 1/3 of adults in Michigan are obese. Obesity is Unhealthy Obesity is related to many illnesses such as: diabetes heart disease high cholesterol sleep apnea arthritis fatty liver disease infertility
Improvement in mortality after bariatric surgery 72 1.21 Resolution of co - morbidities after bariatric surgery 73 1.22 Bariatric surgery leads to an improv ement in glucose homeostasis 74 1.23 The economic costs of obesity can be counteracted by obesity surgery 75 1.24 Our hypoth
rates after bariatric surgery have fallen by 80% in the past decade. Data involving nearly 60,000 bariatric pa-tients from American Society for Metabolic and Bariatric Surgery (ASMBS) Bariatric Centers of Excellence data-base show that the risk of death within the 30 days fol-lowing bariatric surgery av-erages 0.13%, or approxi-
1. Bariatric Clear Liquids: starts the day after surgery. 2. Bariatric Full Liquids: starts the day you go home from the hospital. 3. Bariatric Pureed Food: starts at your 2-week post-op clinic visit. 4. Bariatric Soft Foods: lasts about 2 weeks for Bypass and 4 weeks for the Sleeve. 5. Bariatric Regular diet: Begins at your 2-month post-op .
Post-bariatric surgery health behaviour changes. Post-bariatric surgery diet. Centres that perform bariatric surgery will typically provide pa-tients with a dietary protocol to follow. Initially, over several weeks, patients transition from liquid, to soft and then to a sol-id diet. Over the long term, patients are encouraged to follow
Bariatric Surgery Patient Binder Weight Loss Surgery Bariatric surgery, or weight loss surgery, is a tool to help people lose weight. When accompanied by permanent lifestyle changes, it can help individuals achieve lasting health benefits. Baptist Health Bariatric Center offers the lat-est and safest weight loss surgery options:
This Coverage Policy addresses bariatric surgery and procedures for the treatment of morbid obesity. Coverage Policy . Coverage for bariatric surgery or revision of a bariatric surgery procedure varies across plans and may be governed by state mandates. Refer to t
4 Fifth report of the Bariatric Surgery Registry June 2017 List of Figures Figure 1 » Rate of Obesity in Australia (1995 to 2015) 10 Figure 2 » MBS Data on Number of Bariatric Procedures in Australia 11 Figure 3 » Hospitals and Surgeons Performing Bariatric Surgery in Australia as at 30 June 2017 13 Figure 4 » Accumulation Rate of Patients Participating in the BSR by Patient Type 15
argue that classical social theory is primarily a theory of modernity and that the classical tradition of modern social theory raised fundamental questions concerning the nature, structure, and historical trajectories of modern societies. By putting modern societies in broad historical perspective, by emphasizing the linkages between their differentiated social institutions, and by expressing .
