Bariatric (Weight Loss) Surgery

What is Bariatric Surgery?

Here at Precision Integrated Medical Specialists we offer Bariatric (also known as Metabolic or Obesity) Surgery as part of our integrated approach to your health.

As well as the weight reduction surgery, we also offer band adjustment, removal or replacement and sleeve gastrectomy-related hiatus hernia repairs, and revisions procedures where previous operations have lost some effectiveness.

Obesity surgery is more accurately known as bariatric or metabolic surgery. Why? Because as well as the weight loss, major improvements are often seen in many other aspects of your health including:

• Diabetes control and reduced severity
• Sleep apnoea
• Chronic fatigue and osteo-arthritis
• Back pain
• Poly-cystic ovarian syndrome (PCOS)
• Fertility

When considering operations such as hernia repairs, joint replacement, or spinal surgery, a weight loss operation beforehand will often result in better outcomes and reduced anaesthetic risk.

Why Have Surgery?

It’s not just about losing weight. It’s about breaking the weight loss “yo-yo”, keeping the weight off, and staying healthy.

Nearly all our patients have successfully lost some weight at least once and often several times before coming to see us. But almost invariably some weight goes back on, driven by permanent changes in hormone and brain mechanisms, combined with environmental effects.

Metabolic/Bariatric surgery helps break the weight loss “yo-yo” by altering hunger-related hormone levels and altering the way we absorb and process food, whilst allowing a normal diet (in smaller portions), good satiety and an active high quality lifestyle.

The benefits of this surgery aren’t just weight-related. Type II diabetics will typically show a dramatic improvement in insulin resistance and diabetic control within weeks of the operation.

What Type of Surgery?

There are many operations available, however over 80% of Australian patients undergo the “sleeve” gastrectomy. This “set and forget” procedure offers the benefit of no foreign or obstructing band, is highly effective and allows for revision procedures, such as bypass, in the future if required.

A Comprehensive and Holistic Approach

Surgery is the key part of the journey, but only the second of three stages on your road to sustained better health.

Here at PIMS, we take an integrated, holistic approach both to helping you lose the weight and ensuring it stays off.

Our efforts focus on the type and sustainability of the weight loss. Our goals are to maximise loss of fat, minimise muscle mass/protein loss and maintain nutrition.

Step 1 – Initial Assessment and Preparation
Following an initial meeting with our surgeon to discuss the procedure and assess eligibility, you will be reviewed by the rest of our multidisciplinary team of dieticians, fitness trainers, bariatric physicians and surgeon. This may include a 4 week preoperative dietician-directed weight loss program, optimisation of nutritional status and general health in order to ensure best outcomes.

Step 2 – Weight Loss Surgery
The operation typically takes around an hour and is performed using keyhole surgery. Typical hospital stay is 2 nights. Our surgeon will typically see you again 10 days after the procedure and again at 6 weeks and 3 months.

Step 3 – Adaptation to New Stomach Size and Optimisation of Fitness and Diet
The aim of stage three is to ensure maximisation of loss of fat with maintained muscle mass and nutrition. Following discharge from hospital, your diet will gradually be increased and brought back towards normal under the guidance of our dieticians over several weeks.

Once you are back to a normal diet, our fitness team and dieticians will begin a program to optimise muscle mass and prevent protein loss whilst you continue to lose weight. Your surgeon will continue to review you throughout this period.

One of the most important determinants of success, both in how much weight you lose and how well it stays off, is regular follow-up with our team over the year after surgery, but especially in the first 6 months.

What do the different people you see do?

Dietician
One of the most important people on this journey – they will help you prepare for surgery and optimise your nutrition, and will help you adjust to your new stomach size and ensure that you maintain optimal nutrition long term. They also will help with those patients who are regaining some weight, to identify and resolve any issues that are causing this.

Fitness Trainer
Our fitness trainers are there to help you both general fitness-wise, but also to ensure you maintain your muscle mass during the weight loss period. They will optimise you pre-operatively and at the same time asses your overall physiological status including body fat composition, functional activity/walking test, strength/power, mobility and lung function.

Bariatric Assessor/Physician
Our Bariatric assessor is a GP/Physician who will assess your overall health and provide advice to the surgeon regarding readiness for surgery including any previous undiagnosed conditions. They sometimes will refer you for additional tests (such as sleep studies) as part of this. They will also assess you over the few months after the operation to ensure that any changes to medication required due to your weight loss (such as reducing blood pressure medication) occur smoothly, in consort with your regular GP.