Kettering Bariatric specializes in weight-loss surgery for morbidly obese patients in Dayton, Ohio, and the surrounding communities. Successful weight loss surgery depends a great deal on proper preparation. The Kettering Bariatrics team includes a variety of experienced specialists who can help you prepare for surgery and will support you at every step in the process. We’re ready to listen.

We take an active role in your health care, helping to assess your unique situation, analyze your previous attempts at weight management, discuss your specific goals and explore a variety of treatment options. The results of bariatric surgery also depend greatly on your personal dedication. Surgery will help you feel better and live well, but it can also dramatically alter your lifestyle in terms of what and how you eat, your energy and activity levels, attitudes toward yourself and others, and your entire outlook on life. While most of these changes will be positive and welcome, they can still be unsettling.

When you visit our office, you'll be surrounded by a patient-centered, compassionate team of bariatric professionals who are dedicated to helping you to change your body and change your life. Knowing what to expect and planning ahead can greatly improve a patient's chances of success. Part of our patient dedication includes providing information that helps you make informed decisions about your health. To learn more, please register for a free seminar that we present several times every month.

Common insurance requirements:

• 18 years or older
• Failed medically supervised weight loss attempts
• Understands surgery and risks
• Acceptable operative risks (patient and procedure)
• Stable psychological condition: interview, psychotherapy support groups as indicated
• Patients who smoke may not be candidates, depending on requirements by the surgeon

Calculate Your BMI

Body Mass Index (BMI) is currently the best assessment of a person’s obesity. BMI is an accurate way to determine the degree of an individuals obesity, and takes both height and weight into consideration. You can calculate your BMI by using the form below. A good candidate for weight loss surger would have a BMI of > 40, and meet our guidelines for surgical candidates (below right). You should also understand the risks of weight loss surgery.

Calculate Your BMI

Your Height: feet inches
Your Weight: pounds
Gender: Male Female
Your BMI:

BMI Classification Health Risk

• Under 18.5 - Underweight; Minimal
• 18.5 - 24.9 - Normal Weight; Minimal
• 25 - 29.9 - Overweight; Increased
• 30 - 34.9 - Obese; High
• 35 - 39.9 - Severely Obese; Very High
• 40 and over - Morbidly Obese; Extremely High

Who is a Surgical Candidate?

• Meets National Institutes of Health Criteria: BMI > 40 (or >35 with significant obesity-related co-morbidities

WHAT IS MORBID OBESITY

• What is Morbid Obesity? Morbid obesity, or clinically severe obesity, is often defined as being 100 pounds heavier or weighing 100% more than one's ideal body weight (IBW). Having a body mass index (BMI) of 40 or greater is also considered morbid obesity. Formulas that compare a person's weight and height are used to determine both BMI and IBW, and you can click here for a calculators to help you determine your BMI.
• Diet plans and exercise programs can offer varied results, but none has consistently led to lasting weight loss. Weight loss surgery, in contrast, is a proven long-term solution for morbid obesity. While weight loss operations are uniquely effective for many patients, like all surgery, they involve some risks and may not be right for everyone. The current and long-term health hazards of obesity can justify weight loss surgery for many people. We encourage anyone considering bariatric surgery to do thorough research, consult with a primary care physician , and attend one of our free information sessions to help you make the right decision.

Benefits, Risks, Efficacy

• The most obvious benefit of bariatric surgery is weight loss. Most patients lose up to 70% of their excess weight within a year after surgery, and some can lose as much as 95%. Importantly, significant weight loss can be maintained for a decade or more following surgery. The amount and pace of weight loss varies from patient to patient, but our experienced clinical team can help you set a realistic “goal or set weight” and provide ongoing support and encouragement to help you achieve your goal.

Improved Health

• Obesity often causes or complicates serious medical conditions such as diabetes and high blood pressure. Significant weight loss has been shown to greatly reduce or even eliminate many of these conditions, which can allow patients to cut out medication and enjoy greatly improved overall health. Note: Do not stop taking prescribed medications without consulting a doctor familiar with your medical history.

Increased Quality of Life

• In addition to strictly physical benefits, substantial weight loss allows many patients to enjoy life more for a variety of reasons, including increased confidence, improved self-image, the ability to participate in enjoyable activities, and enhanced social relationships.

Keep in Mind

• Bariatric surgery has helped thousands of patients when nothing else could, but it truly is not appropriate for everyone or in all cases. As you consider your own situation and options for treatment, please be aware of the following: Bariatric surgery should only be an option once you and your doctor have considered all other treatments. Weight loss operations are major procedures and should never be considered cosmetic surgery. Complications can arise that will require additional surgery to evaluate or correct. Surgery enables you to lose a great deal of weight over the course of weeks and months. It does not remove fat or provide immediate results. Bariatric surgery is not a cure for obesity or an easy solution. It involves hard work, diligent follow-up care, and lifelong changes to diet. Also, many procedures are not reversible.

Complications and Risks

• All surgery involves risk, and the likelihood of a particular outcome depends greatly on the individual patient and many complicated factors. Our Bariatric surgeons are always happy to discuss the potential risks as well as the expected benefits of weight loss surgery. Our goal is to ensure that you are well-informed and comfortable choosing the best treatment for your unique needs. Possible complications of weight loss surgery may include but not limited to:
  • Allergic reactions—From minor reactions such as a rash to sudden overwhelming reactions, through rare, can cause death.
  • Anesthetic complications—Anesthesia used to put you to sleep for the operation can be associated with a variety of complications, though rare, can include death.
  • Bleeding—From minor to massive bleeding that can lead to the need for emergency surgery, transfusion, or death.
  • Blood clots—Also called deep vein thrombosis and Pulmonary Embolus that can sometimes cause death.
  • Infection—Including wound infections, bladder infections, pneumonia, skin infections and deep abdominal infections that can sometimes lead to death.
  • Leak—After the operation, with injury to stomach or esophagus, the new connections can leak. This can require repeated surgery, intensive care and even death.
  • Narrowing—Narrowing or ulceration of the region of the band.
  • Dumping syndrome—Symptoms include cardiovascular problems with weakness, sweating, nausea, diarrhea and dizziness.
  • Loss of bodily function—Including stroke, heart attack, limb loss and other problems related to operations and anesthesia.
  • Erosion—Any foreign material placed around an abdominal structure may cause erosion, bleeding, stricture and infection that may necessitate removal, re-operation or result in serious complications such as infection, abscess or death.
  • Bowel Obstruction—Any operation in the abdomen can leave behind scar tissue that can put the patient at risk for later bowel blockage.
  • Laparoscopic surgery risks—Laparoscopic surgery uses punctures to enter the abdomen and can lead to injury of any abdominal organ, bleeding and death.
  • Need for and side effects of drugs—All drugs have inherent risks and in some cases cause a wide variety of side effects, though rare, including death.
  • Risks of transfusion—Including Hepatitis, and Acquired Immune Deficiency Syndrome (AIDS), from the administration of blood and/or blood components, though rare.
  • Hernia—Cuts in the abdominal wall can lead to hernias after surgery.
  • Hair loss—Many patients develop hair loss for a short period after operation. This usually responds to increased levels of vitamins.
  • Vitamin and mineral deficiencies—Patients must take vitamin and mineral supplements forever to protect themselves from these problems.
  • Complications of pregnancy—Vitamin and mineral deficiencies can put the newborn babies of LAGB mothers at risk and patients must be certain not to miss any of their vitamins if they decide to go ahead with pregnancy later.
  • Other—major abdominal surgery, including Laparoscopic AGB is associated with a large variety of other risks and complications, both recognized and unrecognized that occur both soon after and long after the operation.
  • Depression—Depression is a common medical illness and has been found to be particularly common in the first weeks after operation.
  • Slippage of band—The band may move down the stomach, though sutures are placed to prevent this, and may require re-operation, removal, infection or abscess.
  • Port complications—The port my become infected making necessary removal, replacement via re-operation, pain or visual appearance through the skin.
  • Conversion to open approach—All patients consented for laparoscopic operations can be converted to an open approach for any reason deemed necessary at the time of the procedure.
  • Failure to lose weight—Even with appropriate adjustment and proper follow-up, failure of weight loss may occur.
  • Death

Effectiveness

• Post-surgery weight loss varies from patient to patient and depends in part on a number of factors:
  • Age
  • Pre-surgery weight
  • Overall health
  • Surgical procedure chosen
  • Ability to exercise
  • Commitment to dietary changes, counseling, and follow-up care
  • Personal motivation and support from family, friends, and others
• In general, patients tend to lose weight quickly following surgery and continue to reduce weight for 1.5 to 2 years. Excess weight can drop by 30% to 50% within six months and increase to 77% by the end of the first year. What's more remarkable is that many patients maintain this weight loss for years or even decades.

The Hospital Stay

• Traditional bariatric operations typically require a hospital stay of up to 5 days, while laparoscopic procedures may result in an earlier release. Dr. Schumacher and Dr. Brown have operating privileges at both Kettering Memorial Hospital and Sycamore Hospital , both of which feature new specialized facilities designed specifically for bariatric patients. Great care is taken to ensure patients' comfort and safety in the hospital at all times, and attention to detail ranges from roomy gowns and customized beds to the finest high-tech surgical facilities available. All of the hospital staff members who will contribute to your treatment are the very best at what they do, and they combine unmatched medical expertise with sincere compassion and care for you as an individual. You may tour the hospitals specialized bariatric facilities.

Preparing For Surgery

• Successful weight loss surgery depends a great deal on proper preparation. The Kettering Bariatrics team includes a variety of experienced specialists who can help you prepare for surgery and will support you at every step in the process. We will work with you to assess your unique situation, analyze your previous attempts at weight management, discuss your specific goals and explore a variety of treatment options. The results of bariatric surgery depend greatly on a patient's personal dedication.
• Surgery will not simply change the way you look or even feel. It can dramatically alter your lifestyle in terms of what and how you eat, your energy and activity levels, attitudes toward yourself and others, and your entire outlook on life. While most of these changes will be positive and welcome, they can still be unsettling. Knowing what to expect and planning ahead can greatly improve a patient's chances of success. You've already taken an important first step by conducting research online and browsing the many resources we've assembled on this site. Once you're ready to learn more or discuss your unique situation with people who understand and want to help, please consider attending a free information session or scheduling a personal consultation with one of our caring professionals.
• Anyone considering weight loss surgery should consult with a primary care physician who knows your medical history and can evaluate your general health, your need for the surgery, and your fitness to undergo it. In addition, many insurance companies require a doctor's referral, records of previous failed obesity treatments, and a letter establishing medical necessity before authorizing weight loss surgery. In partnership with Weight Loss Surgery at Kettering and Sycamore, we offer regular information sessions that are free and open to the public. Each session features presentations on obesity as a medical condition, various non-surgical treatment methods , current surgical options, and typical short- and long-term results. In addition, you'll learn about unique hospital facilities designed especially for obesity treatment and services such as support groups, dietary counseling, exercise consultation, and lifestyle coaching—all vital to a patient's success.

Paying For Surgery

• Weight loss surgery is often the best or only treatment option for many patients, but the cost of any major operation and associated care can be quite high. Fortunately, many insurance companies offer full or partial coverage for bariatric surgery, and a number of self-payment and financing options are also available through Kettering Bariatrics and our lending partners. Self-Pay Patients can simply pay the program directly for surgery and associated charges, either in itemized form or as part of a global fee. Lender Financing Kettering Bariatrics has partnered with a number of local lenders that offer financing for bariatric surgery. For a list of representatives familiar with the needs of bariatric patients, please contact our office. These trusted partners are eager to help you secure financing to make your life-changing surgery possible.

Getting Certified

• Insurance companies and individual policies are all different, but the process for authorizing surgery is fairly common. You can expect to do some or all of the following:
  • Call your insurance company and ask to speak to someone who can explain your coverage in detail, and outline the requirements for authorizing weight loss surgery. Ask whether your policy covers weight loss surgery. If so, which specific procedures are included and are any excluded? Is your coverage valid at Kettering or Sycamore Hospitals with the surgeon you've chosen? Find out what portion of the cost your policy will cover. Are pre- and post-surgery services such as diet counseling, exercise consultations and physician office visits included? Ask what the requirements are for pre-authorization of the surgery. These often include medical reports, a primary care physician's referral and additional paperwork. You may want to inquire about the average timeframe for securing approval and any common reasons for rejection that you may be able to avoid.
  • Schedule a visit with your primary care physician to secure one, many or all of the following:
    • An official referral to Weight Loss Surgery at Kettering and Sycamore Hospitals and/ or to a participating surgeon.
    • Medical records establishing a history of obesity and the failure of more traditional weight loss treatments.
    • A letter stating the surgery is medically necessary and the best or only course of treatment available.

Weight Loss Surgery Comparison

The following information provides an overview of the differences between surgical weight loss options. Only you and your surgeon can evaluate the benefits and risks of weight loss surgery and choose the most appropriate procedure for you.

Gastric banding / Sleeve gastrectomy / Gastric bypass

Procedure description

The REALIZE® Adjustable Gastric Band wraps around the upper part of the stomach, dividing the stomach into a small upper pouch that holds about ½ cup of food and a larger lower stomach. The degree of band tightness affects how much food you can eat and the length of time it takes for food to leave the stomach pouch. During the sleeve gastrectomy procedure, a thin vertical sleeve of stomach is created using a stapling device. The sleeve is about the size of a banana. The rest of the stomach is removed. In this procedure, the surgeon creates a small stomach pouch and attaches a section of the small intestine directly to the pouch. This allows food to bypass a portion of the small intestine.

How it works to help you lose weight

By creating a smaller stomach pouch, the REALIZE Band limits the amount of food that can be eaten at one time, so you feel full sooner and stay full longer. As you eat less food, your body will stop storing excess calories and start using its fat energy supply. By creating a smaller stomach pouch, a sleeve gastrectomy limits the amount of food that can be eaten at one time, so you feel full sooner and stay full longer. As you eat less food, your body will stop storing excess calories and start using its fat supply for energy. By creating a smaller stomach pouch, a gastric bypass limits the amount of food that can be eaten at one time, so you feel full sooner and stay full longer. By bypassing a portion of the small intestine, it also causes your body to absorb fewer calories. As you eat less food, and absorb fewer calories, your body will stop storing excess calories and start using its fat supply for energy.

How it affects digestion

Allows for normal digestion and absorption. Food passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body. Allows for normal digestion and absorption. Food passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body. Changes the body’s normal digestive process to reduce the number of calories and nutrients that are absorbed.

Reversible?

No

Total excess body weight lost

43% 33% to 85%, with an average of 55% 61.6% Type 2 diabetes 47.8% resolved1 80.2% resolved or improved3 56% resolved2 37% improved2 83.8% resolved3 90.6% resolved or improved3 High blood pressure resolved 43.2%3 49%2 67.5% 3 High cholesterol resolved 78% improved3 In addition, patients in the U.S. clinical trial experienced a 22% increase in good cholesterol (HDL) 36 months after surgery1 43% resolved2 94.9% improved3 Obstructive sleep apnea resolved 94.6%3 60% resolved2 86.6%3 Read more Read more Read more Resolution statistics above reflect observations in the confines of studies; EES has no independent data to suggest permanent resolution. 1. REALIZE Adjustable Gastric Band: Summary of safety and effectiveness data. Available at: http://www.accessdata.fda.gov/cdrh_docs/pdf7/P070009b.pdf. Accessed on November 11, 2009. 2. EES summary of data contained in review article: Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469-475. 3. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724-1737. 4. Crémieux PY, Buchwald H, Shikora SA, Ghosh A, Yang HE, Buessing M. A study on the economic impact of bariatric surgery. Am J Manag Care. 2008;14:589-596. 5. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859-863. 6. Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232:515-529. Nutritional Guidelines A person's diet after weight loss surgery tends to be self-regulated, because the body may react to certain foods with discomfort, nausea, or diarrhea. With a little care and planning, however, patients can enjoy a wide variety of their favorite foods while enhancing the weight loss process. You can consult with dietary specialists on the Kettering Bariatrics team before and after surgery, and they will develop an effective diet plan for you based on your individual requirements and restrictions. In general, you can expect the following: Hydration is essential following surgery. It is important to drink a minimum of 64 oz per day. Sip fluids often, but stop if you feel pain, fullness, or nausea, and wait a few minutes before trying to drink again. Your first few meals after surgery will consist of clear liquids. Most patients eat soft, easily digested foods for 3 months after surgery. In many cases, the stomach is reduced to a 2- to 3-oz pouch that makes patients feel full faster and prevents consumption of a large amount of food at once. Meal size is very important. You should eat 3 daily meals, each consisting of 1/2 cup of food or less. You also will need 2 small protein snacks to ensure you get 60-80 grams of protein per day to promote healing and prevent malnutrition. See Protein Sources for more details. You should only introduce one new food item at a time to be sure your new digestive system will tolerate it. Every patient is unique, so pay attention to your body's cues. By one year after surgery, you will be eating 3 daily meals consisting of 1 cup of food or less. Be careful not to overeat. This can stretch out the stomach pouch dangerously and cause you to regain weight. Links In addition to our own website, there are other resources on the Internet that provide a great deal of information on weight loss surgery and the options available today. Because we are committed to improving the overall health knowledge of our patients, we are providing the following selection of website links you might find useful and informative. We have organized the links into categories in order to provide quick access to the topics of greatest interest to you. If you have a suggestion for a new link, please send us an email, as we are always looking for good resources to pass along to our valued patients and visitors to our website. We hope you find these sites helpful! Bariatric Associations The following links provide updated information on bariatric surgery by the largest bariatric assocations across the country. American Obesity Association The American Obesity Association (AOA) is an organization focused on changing public policy and the overall perceptions about obesity. The AOA serves as an advocate for obese people across the country with a goal to re-conceptualize obesity to be viewed as a disease rather than an individual failure. American Society of Bariatric Physicians Formed in 1950, The American Society of Bariatric Physicians (ASBP) is a non-profit international medical association of allied health care professionals with special interest and experience in the treatment of obesity and related disorders. The ASBP provides useful information to their members, the health care industry, and the general public. American Society For Metabolic And Bariatric Surgery The vision of the Society is to improve public health and well being by lessening the burden of the disease of obesity and related diseases throughout the world. Bariatric Interests The following links provide some good information on topics of interest to bariatric patients. Bariatric Advantage Nutritional Supplements Bariatric Advantage® provides a complete line of dietary supplements that have been specifically formulated to meet the unique demands of both the pre-operative bariatric surgical candidate, as well as the post-operative bariatric surgical patient. BariatricEdge.com Detailed bariatric (weight loss) surgery information, resources, and tools for people struggling with morbid obesity seeking to lose excess body weight for good. The site provides information on the health risks of obesity, diseases caused by morbid obesity, and the effectiveness and risks of bariatric surgery options available today. HealthWiseMetabolic HealthWiseMetabolic offers a wide variety of great tasting nutritional products. At HealthwiseMetabolic.com, great taste is our contribution to your success and to your goal of nourishing the new you. Quality, selection and flavor delivered directly to your home. Please check out the widest selection of protein products for surgical patients on the net. International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) IFSO is growing into a professional organization, with the goal to support its members in aspects directly related to their profession. IFSO's main activity is currently the organization of the yearly World Congress, which provides a forum to exchange knowledge on surgical treatment of severely obese patients, to present new techniques, research and concepts, and to meet the experts in the field. ObesityHelp.com ObesityHelp.com is dedicated to the education, empowerment and support of all individuals affected by obesity, along with their families, friends, employers, surgeons and physicians. Membership to ObesityHelp.com is free and provides patients with weight loss resources, message boards, chat rooms, and other interactive features. Post Surgery Instructions A complete physical recovery from weight loss surgery can take time, and it is only one factor in determining a patient's long-term success. The full benefits of bariatric surgery are possible only with diligent attention to post-surgery diet and lifestyle requirements. Click Here for Nutritional Guidelines Even a minimally invasive surgery such as laparoscopic Roux-en-Y is considered a major medical procedure, and your body will require time to recover. In addition, the result of your surgery is a dramatic restructuring of your digestive system involving surgical alteration of several internal organs. A full recovery and improved health are always expected, but the healing process can take time. Here's what you can anticipate: You will remain in the hospital for up to 4 days for monitoring and care during the critical post-surgery period. The ususal stay is 2-3 days. This allows time to address any complications that arise and help you adjust to your new situation and focus on what lies ahead. You may feel weak, drowsy, or nauseous occasionally for several days. Once home, you're welcome to walk, use stairs, shower, and engage in normal light activities as you feel comfortable and your physician allows—but refrain from lifting more than 5-10 pounds during the first week. The timeframe to resume driving depends on the type of surgery, the patient's physical comfort, and medication prescribed. If your job is not physically demanding, you could return to work in as little as 2-3 weeks. If your job involves a lot of physical activity, it may take 4-6 weeks before you can return. You should avoid strenuous activity for 4 weeks or longer. You should plan on several follow-up appointments to ensure the surgery was effective and help maximize its benefits. It is a good idea to consult your primary care physician within the first few weeks after surgery. Pain and Complications Patients are likely to experience some pain following surgery due to the extensive changes to their bodies. You may have a prescription for medication to help ease the pain or address other post-surgery needs. Be sure to call your doctor if you experience excessive pain or any of the following: Recurring nausea/vomiting Signs of infection around your incision(s)—redness, drainage, swelling, warmth, pain Fever (101 degrees) and chills Signs of dehydration—decreased urine, increased heart rate, flushed face, anxiety Severe shoulder pain Difficulty breathing Pain in the chest or calves