In a study of 608 patients who underwent a gastric bypass, 553 maintained contact for 14 years; the study reported that significant weight loss was maintained at 14 years.
It’s recommend not to drive for the first two weeks following surgery and then only if you are able to perform an emergency stop safely. You should also talk to your insurance company to ensure you are covered.
After your surgery, making a habit of regular intentional exercise can be one of the most important changes you can make to lose and maintain weight.
Heavy activity straight after surgery is not allowed, but light activity, such as walking is recommended from the day after surgery. The aim is to walk more each day, and within the few weeks you should be able to walk for up to an hour each day.
Some patients who have severe knee problems are unable walk due to pain, but they may be able to swim or ride a stationary bicycle. Swimming or water exercise such as aqua jogging are allowed after two weeks.
After six weeks, it’s time to start more intense regular exercises, which include muscle strengthening and flexibility and endurance training.
After weight loss surgery, you lose weight because the amount of food energy (calories) you are able to eat is much less than your body needs. Therefore, your body has to use its reserves. Your body will tend to burn any unused muscle before it begins to burn the fat. If you do not exercise daily, your body will break down your unused muscle and you will lose muscle mass and strength. Daily aerobic exercise for 20 minutes is necessary to burn the fat instead of muscle mass.
Regular physical activity after surgery helps to increase and maintain your weight loss Studies have shown that patients who exercise at least 120 minutes per week, lose an average of 4 kg more weight than those who do not.
In addition to weight loss, physical activity has many other positive health effects. It also helps you sleep and rest more peacefully, improves circulation, heart and lung function and can provide an outlet from the stresses often experienced in everyday life. It increases the ability to concentrate and learn and can make you happy and feel good.
Obesity and infertility are very closely linked.
Insulin resistance is prevalent in the obese population. This is thought to be a significant factor for a lack of an egg production (anovulation) by the ovaries, and therefore infertility. The elevated levels of intra-abdominal fat are known to produce the male hormones, known as androgens. These in turn prevent maturation of eggs in the ovaries and contributes to anovulation.
Studies have shown that with BMIs above 31, women have a 170% higher chance of having infertility issues secondary to anovulation, when compared to women of normal weight.
Once pregnancy occurs, obese women are at higher risk for gestational diabetes, high blood pressure and miscarriage.
In another study evaluating women who are obese but had normal ovulation, it was shown that women with a BMI over 40, were 43% less likely to get spontaneously pregnant . It also demonstrated that obese women required higher doses of infertility drugs in order to achieve pregnancy.
On the basis of studies at least 60 – 70 % of obese women, who have struggled to get pregnant prior surgery, become pregnant after weight loss surgery because the obesity is a significant underlying cause their infertility.
After weight loss surgery, risks associated with pregnancy are reduced. This is because obesity increases the risk of foetal macrosomia, caesarean section, maternal gestational diabetes and eclampsia. So, when the mothers weight falls, the risks of these occurring also reduces.
Pregnancy is not recommended with in 18 months of weight loss surgery, because during that time your calorific intake is very low and you are at the greatest risk of micronutrient deficiencies, which could affect your baby’s development. The best time to get pregnant is when your weight loss plateaued. Before you consider trying to conceive, we recommend to that you make contact with a dietitian and have blood tests to assess your nutritional status.
Absorption of oral contraceptives might not be effective after surgery. It is therefore recommended to use alternative options, e.g. transdermal patches or intrauterine devices.
Evidence suggests that bariatric and metabolic surgery changes the chemical signals between the stomach, intestine, brain, and liver – changing the underlying mechanisms of diabetes. Research from the Cleveland Clinic has shown that intensive medical treatment in conjunction with either gastric bypass or sleeve gastrectomy were more effective than intensive medical treatment alone on patients in regard to managing uncontrolled type 2 diabetes in obese patients.
The study authors concluded that “bariatric surgery represents a potentially useful strategy for management of uncontrolled type 2 diabetes, capable of completely eliminating the need for diabetes medication in some patients and a marked reduction in need for drug treatment in others.
Findings indicated that:
- At least 3 times more surgery patients achieved normal blood sugar levels than intensive medical therapy patients.
- T2DM was resolved in 42% of gastric bypass and 27% of sleeve gastrectomy patients compared to 0% for patients who only received medical therapy.
- Bariatric surgery significantly reduced the need for diabetes medications and eliminated the need in more than 50% of patients.
Who is eligible?
• BMI over 40
• BMI of over 35 where hyperglycemia is inadequately controlled (without insulin)
• BMI of over 30 where hyperglycemia is inadequately controlled (despite insulin)
This guidance is based on the opinion of 48 experts in the field of diabetes and metabolic surgery, including 12 surgeons, 28 diabetologists, cardiologists, dieticians, gastro-enterologists and general physicians. These experts came together to form an expert committee, which evaluated all the medical evidence published.
As mentioned earlier, the evidence shows that the gastric bypass is the most effective operation for metabolic illnesses, but the gastric sleeve isn’t far behind.