Fertility Center of Las Vegas

What Do You Know About Bariatric Surgery and its Success?

Q. Dear Lory, RD
I am trying to get pregnant, and my Dr. says I should lose some weight first. I have tried every diet imaginable, but have not been successful. I lose 10-15 lbs, but then I end up gaining back 20 lbs. I am always back where I started, or worse. I am really desperate and considering weight loss surgery before I get too old to have children. What do you know about bariatric surgery and its success?

Regina,
Las Vegas, NV

A. Dear Regina,
I have done extensive counseling of patients before, as well as after weight loss surgery. The two most popular procedures are outlined below:

Gastric Band is a silicone band that can be tightened or loosened over time to change the size of the passage to the lower stomach. This band creates a small pouch and a more narrow passage to the lower stomach. This small passage delays the emptying of food from the pouch and causes a feeling of fullness.

Gastric Bypass a small stomach pouch is created to curb food intake, by stapling a portion of the stomach. Then, a Y-shaped part of the small intestine is attached to the stomach pouch so that food can bypass the duodenum, as the bypass extends to the initial portion of the jejunum. When the small intestine is bypassed, there is a decrease of absorption of food nutrients.

In theory, both procedures should promote weight loss. The standard diet regimen post surgery is to consume 3 meals per day, no greater than 4 ounces food per meal, and 3 ounces of each meal should be a protein. No snacking between meals and beverages should not contain calories or sugar. The foods to avoid include high fat, high sugar foods, which may cause the unpleasant side effect dumping syndrome, alcohol, nuts (they may cause blockage) and a long list of foods that may produce gas. The overall plan when analyzed would provide approximately 1000-1200 calories per day.

From a dietitian standpoint though, if a patient does not have the willpower or is not equipped with the necessary nutrition knowledge to lose weight by changing their lifestyle habits to begin with, they will have minimal success with weight loss surgery.

Many clients experience initial weight loss, but soon begin to feel deprived, and learn how to re-incorporate all of the foods that caused their weight gain in the first place. They learn to stay within their 4 ounce portions per meal, but they consume 10 to 12 meals per day, that provide greater than 2500- 3000 calories per day when analyzed. Now the patient has become a yo-yo eater with a bypass or lap band.

Finally, one thing you should consider before deciding upon weight loss surgery, would be the possible complications when you do become pregnant. Remember that with the bypass, you are limiting the amounts of nutrients being absorbed. This means less nutrition for yourself and your baby.

There have been some preliminary reports of women who became pregnant after weight-loss surgery. Some of these women experienced such complications as bleeding in the woman's stomach or intestines, anemia and limited growth of the baby in the uterus.

My recommendation would be for you to meet with a registered dietitian and create an action plan complete with a healthy weight for you to achieve pre-pregnancy. You would also benefit from adjusting your meal plan once you are pregnant, and again when you are lactating, or post pregnancy.

Hope you find this helpful,

Sincerely,
Lory, RD

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Lory Hayon, B.S., R.D.
Registered Dietitian & Nutritionist.
Lory@FertilityCenterLV.com