Healthy Weight: Malabsorption makes vitamins necessary for gastric bypass

Billings, MT

Dear Dr. Baskett: Is it true that you have to take vitamins after weight loss surgery and that you have to do this for the rest of your life?

Actually, yes, that is true. After you have had bariatric surgery, regardless of the procedure - adjustable gastric banding (AGB) or Roux-en-Y gastric bypass - you are able to take in fewer calories. You are eating smaller amounts of food at any one time and you should not be snacking between meals. Therefore, you are at risk for nutritional deficiencies.

For example, after you have gastric bypass surgery, you often are able to eat only about a 1/2 cup of food at mealtime.

If you have had AGB, your capacity is also restricted to 1/2 cup to a cup of food at mealtime. Certainly, the decrease in calories leads to weight loss. This is your desired outcome. However, you are not able to get in all of the various nutrients that you need - such as calcium, iron, vitamin B12, and folate. Remember, that if you have had gastric bypass surgery, there is also a component of malabsorption. This can lead to further lack of essential nutrients.
Fortunately, this problem is readily resolved by taking a vitamin and mineral supplement on a daily basis. What is of most importance, though, is that you use a high-quality bariatric vitamin and mineral supplement.

There are several different brands that can be used and your bariatric team can make a recommendation for one that is suitable for you. These supplements have been designed specifically for the person who has had bariatric surgery and they provide the needed vitamins and minerals.

More common vitamins such as Flintstones or Centrum do NOT provide the essential nutrients that a bariatric surgical patient will need.

In addition, these products are not well absorbed. Although the bariatric supplements may cost a bit more, they are well worth the investment.

If your supplement is inadequate, long term nutritional and metabolic problems can occur.

Again, because you are eating less food, you are taking in less of the healthier fats called essential fatty acids - the omega 3's and 6's. Therefore, it is also important to supplement with fish oil capsules, flaxseed oil, or essential fatty acids (EFA).

Daily supplementation with bariatric vitamins/minerals and EFAs will help you to stay healthy after bariatric surgery. Don't shortchange yourself in this area.

Dr. Kathleen T. Baskett is medical director of the St. Vincent Healthcare Weight Management Clinic and author of "Moving Forward: The Weigh to a Healthier Weight."

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Weight loss more difficult for diabetics after gastric byass surgery, new study shows

Winter Park, FL

Diabetics and people with larger stomachs may have more difficulty losing weight after gastric bypass surgery, according to a new study.

The surgery involves doctors creating a smaller stomach pouch that restricts food intake and bypasses large sections of the digestive system. Although it’s an effective way for thousands of obese people to lose weight, approximately five to 15 percent of patients do not lose weight successfully.

In the study, 12 percent of patients did not lose the expected amount of weight a year after the surgery. Diabetes and having a larger size stomach pouch after surgery were independently associated with poor weight loss, researchers said.

The study’s authors said diabetics might take insulin or other drugs that stimulate the production of fat and cholesterol. They concluded that changes in the use of diabetes medications may reduce the risk of poor weight loss after gastric bypass surgery.

During gastric bypass, surgeons estimate the stomach pouch size using anatomical landmarks rather than using a sizing balloon.

“As the use of gastric bypass continues to grow, we believe it is critical to stress the importance of and to teach the creation of the small gastric pouch and to better standardize the technique used for pouch creation,” the authors wrote.

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Post-gastric byass body lift surgery, only way to lose excess skin

New York, NY

Tipping the scale at 330 pounds, 47-year-old Cindy Schreiner decided to get gastric bypass surgery in 2002.

“I was downtown on 9-11,” Schreiner recounted. “And I couldn’t run … I had a colleague pulling me down the street saying come on, you can run, you can run and I just thought, I can’t move anymore and I was so huge.”

It was turning point for Schreiner, who has lost 185 pounds to date.

But working out daily and changing her eating habits has not helped Schreiner obtain the body she has always wanted.

“I would grab the skin and go I want this gone,” she told FOXNews.com. “Because I had worked so hard to lose the weight and I didn’t see all the benefits because the skin was hanging.”

Click here to watch Schreiner tell her story.

Dr. Lyle Leipziger, chief of plastic surgery at Long Island Jewish Medical Center and North Shore University Hospital, said weight loss surgery is only half the battle for patients like Schreiner.

The majority of patients have excess skin, which could weigh five to 10 additional pounds. As a result, psychological and physical issues often plague patients after weight loss surgery.

“We've had patients that have excess abdominal skin almost hanging down to their knees,” said Leipziger, adding that the skin sometimes makes it difficult for patients to walk or move. “Patients can come in and sometimes they can get infections in the area underneath that abdominal extra skin.”

Body lift surgery was the answer to Schreiner’s problems. Sort of like a tummy tuck for your whole body, Leipziger said, a body life is the only way for these patients to get rid of the extra, baggy skin.

“You feel self-conscious about it,” she said. “You feel like you have, you’re flattening it, pushing it down … to hide it.”

But even with surgery, results do not happen overnight.

“The patient should have most importantly realistic expectations, understand that we can do a lot, we can’t turn people into supermodels, but we can certainly improve their appearance and quality of life.”

Schreiner has undergone five body lift procedures to contour her tummy, breasts, outer thighs, buttock and back. With one more surgery left to go, Schreiner is excited to finally have her "dream body". “I feel like I’ve been given a new life,” admitted Schreiner. “I’ve always dreamt of looking like this. I really did. And it’s like, I’m here.”

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Virginia woman dies, contracted human variant of mad cow after gastric bypass surgery

Portsmouth, VA

A 22-year-old Virginia woman suspected of having the human variant of mad cow disease died at 5:30 p.m. Wednesday, The Virginian-Pilot reports.

Doctors suspect Aretha Vinson contracted Creutzfeldt-Jakob Disease shortly after she had gastric bypass surgery three months ago. The disease, which affects roughly one-in-a-million people, is a degenerative and fatal brain disorder linked to tainted medical instruments and certain medical procedures, as well as to contaminated beef.

Vinson’s health began to deteriorate just after she had the surgery. The Portsmouth, Va., resident's motor skills and memory had faded and she became unconscious and died at the Bon Secours Maryview Medical Center.

There is no treatment or cure for the disease.

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Despite risks, gastric-bypass surgeries soar

Orlando, FL

Gastric-bypass procedures can be effective -- but require a lifelong commitment.

Monica Ramos lost about 200 pounds the hard way.

In 2004, a doctor stapled her stomach and rerouted her intestines.

A year later, Ramos collapsed in her Orlando home and was rushed to the hospital, where she needed another operation to stop internal bleeding.

Her weight-loss surgery represents the gamble that legions of morbidly obese Americans are taking every year. For many, it is worth the risk.

When Ramos had her initial operation, she was on 17 medications for diabetes and other ailments. Today, she needs no prescriptions. Her diabetes is gone; she feels great.

But the soft-spoken nursing student warns that surgery is not a cure for obesity.

"This is a lifelong commitment, and there are going to be days when you're sorry you've made this commitment," said Ramos, 26, who runs a support group in Orlando for weight-loss-surgery pa- tients.

If current trends continue, she will be busy. More >>

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Woman on death bed warns of gastric bypass surgery dangers

December 2, 2007

As she lay dying, Jan Malcolm made her husband promise.

"Tommy, we've got to tell people," she said. "If I live through this, we need to warn everyone so that no one else has to suffer like this. If I die, you must warn everyone so they will be aware of what to do to avoid this."

The last words T.F. "Tom" Malcolm heard from his wife of 47 years were, "You were right." more >>

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Some Obese Gastric Bypass Patients Too Big for Imaging Devices

November 28, 2007

Morbidly obese patients who undergo bariatric surgery and then experience complications are often too big to undergo routine diagnostic tests.

For example, if a person weighs more than 350 lbs -- and is obviously at risk of heart disease -- that individual cannot receive a diagnostic angiography because the standard angiography table cannot support that much weight. And if a computer tomography scan is required and the patient weighs in excess of 450 lbs, that person, likewise will have to undergo risky open surgery because the scanning devices cannot handle that much weight.

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Carnie Wilson re-gains most of weight lost after gastric bypass surgery

November 29, 2007

Singer CARNIE WILSON is struggling with her weight again after piling on the pounds following the birth of her baby daughter. The Wilson Phillips star underwent gastric bypass surgery in 1999 when she weighed an estimated 300 pounds (136 kilograms) - but insists that wasn't the end of her weight worries. Wilson admits she's still fighting to get fit after weighing in at 240 pounds (108.8 kilograms) following the birth of baby Lola in April, 2005. She says, "I was back to 240 pounds after I had my baby. It's (weight) never going to be what I want it to be, always when I want it to be. I'm struggling with 30 (pounds) now."

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Controlling Postoperative Nausea and Vomiting for Gastric Bypass Patients

Controlling Postoperative Nausea and Vomiting for Gastric Bypass Patients

By Arushi Sinha, PhD

SAN FRANCISCO, CA -- October 16, 2007 -- With the growing incidence of gastric bypass surgery, there is an accompanying need to better control the postoperative adverse effects of this procedure. As body mass index (BMI) increases, there can also be an associated increase in adverse events, including nausea and vomiting.

Research presented here on October 15th at the Annual Meeting of the American Society of Anesthesiologists (ASA) suggests that better control of nausea and vomiting may also reduce the incidence of postoperative pain. More >>

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Death Rate Higher after Gastric Bypass Surgery

Death Rate Higher after Gastric Bypass Surgery

PITTSBURGH, Oct. 16 (UPI) -- A Univershttp://www.blogger.com/img/gl.link.gifity of Pittsburgh study found 6 percent of those undergoing bariatric surgery -- a treatment for severe obesity -- died within five years.

The study, published in the Archives of Surgery, also found the death rate for those with the surgery higher than that of the general population in the cases of heart disease and suicide.

Dr. Bennet I. Omalu, of the University of Pittsburgh, and colleagues analyzed data on all bariatric operations performed on Pennsylvania residents between 1995 and 2004. Following 16,683 operations, 440 patients -- less than 3 percent -- died. Almost 20 percent of those deaths were from heart disease.

The study authors suggest mortality after bariatric surgery could be reduced by better coordination of follow-up after the surgery, especially control of high risk factors such as hypertension, diabetes, high cholesterol and smoking.

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Gastric bypass diet: What to eat after weight-loss surgery

MayoClinic.com

The gastric bypass diet outlines what you can eat and how much after gastric bypass surgery. Find out ways to establish new eating habits for successful weight loss.

What you eat, how you eat and how much you eat changes after gastric bypass surgery — surgery that alters the anatomy of your digestive system to promote weight loss.

With your stomach pouch reduced to the size of a walnut or small egg and portions of your small intestine bypassed, you'll need to follow a specific diet after gastric bypass surgery. A registered dietitian can assist you in creating this gastric bypass diet, which includes what type and how much food to eat with each meal and the required consistency and texture of the food. Closely following your gastric bypass diet promotes healthier weight loss and better nutrition. More >>

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