Beginning Your Journey

The journey to becoming a patient of New York Bariatric Group generally starts when someone becomes frustrated with repeated, failed attempts to lose weight. We treat adults and adolescents who have struggled with obesity, and often also have health conditions associated with extra weight.

Despite the myth that obesity can be treated by simply “eating less and exercising more,” weight loss, especially in the obese population, is more complicated than that. The weight loss experts at New York Bariatric Group are well aware of the biological, metabolic, psychological, and social barriers to losing weight and keeping it off.

Gastric Bypass Journey

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What is Gastric Bypass?

The Roux-en-Y gastric bypass procedure is usually performed laparoscopically (i.e. keyhole surgery with a telescope). In this gastric bypass operation, the stomach is completely divided with a stapler to leave a pouch that initially measures only 25 mls. The small bowel is divided and the divided end is brought up and joined to the small stomach pouch. The other small bowel end is joined back onto the small bowel about a meter down from the stomach. Thus the whole stomach is bypassed apart from a tiny pouch. This operation works in two ways:

Restriction: the small pouch restricts the volume of food you can eat at one meal.
Malabsorption: the reconfiguration of the small intestine, results in some of the food you eat passing through the intestine without being absorbed.

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What Are The Advantages Of Gastric Bypass?

Gastric bypass is an effective weight-loss operation in most patients (the operation is the tool, in the end, success is dependent on how well the tool is used). Advantages of gastric bypass:

More rapid weight loss than banding
The discomfort of dumping offers a useful deterrent to eating high calorie food and drinks
Long track record- the gastric bypass operation has been around in various forms for 30 years
No foreign object to break or erode
Most patients lose 60-70% EWL over 2 years

Gastric Bypass and Diabetes

Diabetes is a leading cause of death in the United States, so it is important to recognize that the gastric bypass can be a particularly good choice for patients who have type 2 diabetes. In studies, patients with diabetes who undergo gastric bypass surgery experience a remission of their diabetes, often within a day, after their operation. This is particularly interesting because there is no way that the weight loss over a few days could lead to remission of diabetes. There appears to be a physiological change that happens from gastric bypass surgery that may treat diabetes. Although this is not the case for all patients, those with diabetes should be considered for gastric bypass surgery. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), approximately 80% of patients who have gastric bypass surgery go into remission of their type 2 diabetes.

gastrectomy

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Disadvantages of gastric bypass:

This procedure has a slightly higher serious complication rate than some of the other operations because of multiple staple lines and bowel connections that can potentially leak.
There is a need to take oral supplements of iron, vitamins, and calcium for life, and some patients will also need Vitamin B12 injections.
Recovery time is slightly longer than after other procedures.

How to Get Started?

The Insurance experts at the New York Bariatric Group will verify your insurance benefits for you free of charge.
The first step is to call or contact us to make an appointment with one of the experienced surgeons at the New York Bariatric Group.
As a candidate for bariatric surgery, you can expect to undergo a series of consultations and evaluations. A detailed comprehensive program has been developed to ensure your long-term health and safety pre-and post-surgery.
Dr. Garber explains how you can initiate the process to become a new healthier you.
You will receive extensive patient education from our psychologist who will perform a psychological evaluation that is required by the hospital and most insurance providers.
Meet with our registered dietitian to discuss healthy lifestyle changes pre- and post-weight loss surgery.
Participate in studies to determine your pulmonary, gastrointestinal, and cardiovascular health. You can usually complete this entire work-up in one day in our office.
After the workup is completed you will meet with your surgeon for a second visit to be scheduled for surgery. Our insurance experts will then obtain approval from your insurance company.
You will be scheduled for preadmission testing at the hospital. During this testing, you will meet our bariatric coordinator who will give you a complete educational class on how to prepare for surgery, what will happen when you arrive at the hospital on your surgery day, as well as what to expect when you go home from the hospital.

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Day of Surgery and Recovery

Based on this designation, we have proven that your hospital stay will provide all that is necessary for a fast and pleasant recovery. From our full time bariatric nurse coordinator to specialized equipment that is needed to fulfill the needs of patients post-bariatric surgery, including bariatric chairs, beds, gowns, and other specialized equipment, our program is designed solely for the purpose of the bariatric patient.

The surgery usually takes only 75-90 minutes and is performed under general anesthesia. You will usually spend two nights in the hospital. On the first morning after the surgery you will undergo a GI series to make sure everything looks good. You will then be started on a liquid diet. On postoperative day two, you will start on a pureed diet. Once you are tolerating pureed food you will be discharged home.

Recovery Period

The recovery period after Gastric Bypass surgery is usually about 2 weeks until you can return to work.

Lifestyle Changes After Gastric Bypass Surgery

After Bariatric Surgery Lifestyle Changes

Adjusting to your post bariatric surgery diet and lifestyle is one of the most important keys to your long-term success. Develop healthy daily nutrition and exercise habits. Connect with your fullness cues. Avoid reverting to old habits that led to poor health, fatigue, depression, and attempts at binge eating. Making a commitment to lifestyle change will bring fast & substantial weight loss. Let us show you how.

Is permanent weight loss after bariatric surgery possible? Absolutely! But you aren’t going to find weight loss success by merely having restrictive weight loss surgery. Get thin quick schemes are a dime a dozen. They are usually costly plans that promise fast weight loss. They work too – temporarily. The problem with fast weight loss plans alone is they are not long-term solutions to losing weight and keeping it off.

Tips To Avoid Feeling Deprived While Dieting (Even Before Entering Our Program)

Learn and adhere to a sensible diet plan
Focus on making a lifestyle change, rather than looking for a quick fix
Find a new and exciting way to stay motivated
Indulge in your bariatric treats once in a while
Find enjoyment in activities other than eating
Reward yourself for reaching weight loss goals, but not with food.
Connect with friends and ask for support
Be accountable for your eating, even on your down days.
Eat small meals at specific schedules to avoid feeling hungry
Don’t skip meals
Create lighter versions of your favorite meals that you can enjoy eating

Post-Surgery Diet

Post-bariatric surgery diet guidelines are fully discussed with patients during their comprehensive nutritional evaluation prior to surgery. Patients follow a Stage I diet for the first 4-6 weeks after surgery. This includes all foods that are soft, mushy, and/or pureed consistencies. Examples of pureed foods are anything blended and smooth such as baby foods, fruitless yogurt, cottage cheese, and hummus. Soft/mushy foods include chopped up ground meats such as turkey, veal, chicken or pork, soft, white, flaky fish that is baked, broiled or grilled, scrambled eggs, and egg whites. Solid foods of all kinds should be completely avoided until weeks 4-6 or when the surgeon allows it.

This practice stresses the importance of good hydration, using non-carbonated, decaffeinated, sugar-free beverages. We always promote good quality proteins to be consumed from day one after bariatric surgery. High sugar and high-fat foods are limited and very specific guidelines are provided to help equip patients with a clear-cut way to determine which foods are healthy for them to eat. Fruits, vegetables, and high fiber foods are reintroduced after the first 3 months. All patients get full details on dietary progression from our experienced nutritionists at their follow-up visits.

The New York Bariatric Group is fully dedicated to promoting high standards for nutritional health. That doesn’t mean that patients should not enjoy eating. The New York Bariatric Group weight loss program has been designed to help patients lose weight rapidly, but provides you with resources to help enjoy your new lifestyle by keeping the flavor and fun in eating. Each patient is given the option to enroll in our Store. We brought together great tasting meals and supplements for breakfast, lunch, dinner, and even snacks which can be ordered on our website.

before

Before

after

After

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Lap-Band Surgery

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What is the Lap Band?

Popularly known as the LAP-BAND®, a gastric band is a hollow band made of special material that is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. Following the initial surgery, the band itself can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.

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In certain patients, we can do this with a single incision in your belly button, so a scar is barely noticeable.

How Does The Lap-Band Surgery Work?

In the surgical procedure, the band is placed around the upper part of the stomach, creating a small pouch that can hold only a small amount of food. The narrowed opening between the stomach pouch and the rest of the stomach controls how quickly food passes from the pouch to the lower part of the stomach. The system helps the patient eat less by limiting the amount of food that can be eaten at one time and increasing the time it takes for food to be digested.

Depending on the patient’s needs, after the device is implanted via the initial surgery the narrowed opening between the pouch and the lower part of the stomach can be adjusted in size by inflating or deflating the hollow band. Inflating the band makes the opening smaller, causing food to pass more slowly. Deflating the band makes it wider, and causes food to pass more quickly. This adjustment is made by adding or removing fluid inside the hollow band. The doctor does this by injecting or removing the fluid through a small button-like part called the access port. This access port is placed under the skin in a muscle in the chest wall. The port is connected to the band by the tubing. Learn about the adjustments of the band post-op below.

Advantages Of Lap-Band Surgery?

Gastric banding is the most simple of the bariatric surgery options, and leads to the smallest number of serious complications. LAP-BAND patients often return to work in just a week or two. Another advantage of this weight loss treatment is that the band is adjustable. This means that the surgeon can change the level of fluid in your band at a quick office visit. Adding fluid makes the band tighter, and removing fluid makes the band looser. Each patient is different, so as time goes on you will work with our team and can call the office any time your band feels too loose or too full.

Another advantage of the band is that it is reversible. Although the band is meant to stay in place permanently, if there are side effects or other reasons to remove it, this is an option. No cutting or stapling is done, and the anatomy of the body is not changed at all when the gastric band is put in place. The LAP-BAND also does not have a malabsorption risk, like other procedures. When part of the stomach is removed or the intestines are rerouted, patients’ bodies absorb fewer nutrients which can lead to negative health consequences, especially if they do not follow their vitamin and supplement routine. Because the LAP-BAND has no risk of malabsorption, there would be no extra vitamin deficiencies to worry about.

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Disadvantages Of Lap-Band?

Most patients experienced at least one side effect. Common side effects include nausea and vomiting, heartburn, abdominal pain, and slippage of the band. The most serious side effects required either another operation or hospitalization.

Because of the LAP-BAND design, it can be tempting to ‘cheat’ on your diet. Foods like chocolate or ice cream are easy to eat with the band, so it is important that patients commit to the eating changes that need to go with the surgery in order for it to be successful. It is also possible for food to get stuck if you take bites that are too big or do not chew your food very carefully. This can be uncomfortable and potentially dangerous. Patients must be mindful of eating carefully with the band. Most patients experience at least one side effect when they have a LAP-BAND. Common side effects include nausea and vomiting, heartburn, and abdominal pain. Some side effects are managed in follow up visits, but the most serious side effects require either another operation or hospitalization. There are risks to the gastric band, just like there are with any surgical procedure. These risks include prolapse, pouch dilatation, band erosion, infection of the band, or port leak.

When Should It Not Be Used?

An adjustable band procedure should not be used for people who are poor candidates for weight loss surgery, have certain stomach or intestinal disorders, have an infection, have to take aspirin frequently, or are addicted to alcohol or drugs. It should not be used on patients who are not able or willing to follow the rules for eating and exercise that are recommended by the doctor after surgery.

How To Get Started?

The Insurance experts at the New York Bariatric Group will verify your insurance benefits for you free of charge.
The first step is to call or contact us to make an appointment with one of the experienced surgeons at the New York Bariatric Group.
As a candidate for bariatric surgery, you can expect to undergo a series of consultations and evaluations. A detailed comprehensive program has been developed to ensure your long-term health and safety pre- and post-surgery.
Dr. Garber explains how you can initiate the process to become a new healthier you.
You will receive extensive patient education from our psychologist who will perform a psychological evaluation that is required by the hospital and most insurance providers.
Meet with our registered dietitian to discuss healthy lifestyle changes pre- and post- weight loss surgery.
Participate in studies to determine your pulmonary, gastrointestinal, and cardiovascular health. You can usually complete this entire work-up in one day in our office.
After the work-up is completed you will meet with your surgeon for a second visit to be scheduled for surgery. Our insurance experts will then obtain approval from your insurance company.
You will be scheduled for preadmission testing at the hospital. During this testing, you will meet our bariatric coordinator who will give you a complete educational class on how to prepare for surgery? What is going to happen when you arrive at the hospital on your surgery day, as well as what to expect when you go home from the hospital.

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Day of Surgery and Recovery

It is important to remember that The New York Bariatric Group and its affiliate Bariatric Center has been recognized as a “MBSAQIP and its Accredited Center-Comprehensive”. This designation provides the public with the assurance that our practice provides complete care for patients before, during, and after bariatric surgery, and we have a proven track record verified by an independent review organization. Based on this designation, we have proven that your hospital stay, will provide all that is necessary for a fast and pleasant recovery. From our full time bariatric nurse coordinator to specialized equipment that is needed to fulfill the needs of patients post-bariatric surgery, including bariatric chairs, beds, gowns, and other specialized equipment. At the end of your hospital stay, you will find that our program is designed solely for the purpose of the bariatric patient. The surgery usually takes only 25 – 35 minutes and is performed under general anesthesia. You will usually spend one night in the hospital or sometimes can go home the same day. Once you are tolerating pureed food you will be discharged home.