Published May 07, 2013
I am very pleased that Gov. Chris Christie came out publicly to talk about his weight-reduction surgery. I know that for years he has struggled with his weight, but one thing is for sure now: He will add years to his life.
By doing this at the age of 50, he could potentially reverse all the negative side effects of obesity, such as type 2 diabetes, hypertension, early joint-degeneration and cardiovascular disease.
I am also very happy that he is the governor of the state of New Jersey, because he continues to show us that pragmatism and common sense always works.
I spoke with Dr. Hans Schmidt, the director of the bariatric surgery center at Hackensack Medical Center in Hackensack, New Jersey, to find out more about the lap-band procedure.
What is lap band surgery?
“It’s a laparoscopic procedure, meaning it is done through small incisions. The gist of it is that you’re putting an adjustable band – a circular ring – around the upper stomach. It is then connected through tubing that goes to a port under the skin, which doctors can use to adjust the band.”
Who qualifies for this surgery?
“There is pretty defined criteria. You have to have a BMI (body mass index) of over 40, which is about 100 pounds over your ideal weight. Or, you could (qualify with a) BMI of over 35 if you have weight-related medical conditions like diabetes, high blood pressure, sleep apnea or severe arthritis.”
How do you prepare for the surgery?
“Once you meet the medical criteria for surgery, each program has their own procedure. Most of the time, you have to be evaluated by a nutritionist beforehand and undergo medical clearance with your doctor to make sure you’re safe for surgery. Sometimes, you even go through a psychiatric evaluation to make sure you don’t have depression, an eating disorder or any other underlying reasons for overeating. Once the surgery is approved, some places encourage a modified diet a week or two before surgery – a liquid diet or a lighter diet to lose a few pounds beforehand.”
What is the recovery process like?
“The recovery process for the band is very quick. Many go home the same day, (but) some stay in the hospital overnight. Most people can go back to their normal activity within one to three days after surgery. That includes most normal activities – not going to the gym or doing heavy exercise – but most day-to-day activities.”
What are the risks associated with lap-band surgery?
“There are risks associated with any surgery, of course. It is under general anesthesia, so you have to be asleep, and there are always cardiopulmonary risks with that. But of the bariatric surgeries, it is probably the safest in the short-term. There are few immediate risks, other than injury to surrounding organs – but that’s very rare.”
How much can patients expect to slim down?
“We shoot for a loss of between a half and two-thirds of their excess body weight. With the band, the weight loss is typically pretty slow and steady. There’s a rapid weight loss after the first few months – maybe 10 pounds a month. And then with the band, it’s usually 1 to 2 pound per week, so 4 to 8 pounds per month over many months. Some other operations have really rapid weight loss, whereas weight loss with the band is slow and steady over time. If you lose weight slowly enough, the (excess) skin may be less of an issue.”
How do your lifestyle and eating habits change afterwards?
“That’s where the challenges come. You have to get the band adjusted every four to six weeks for the first year, (and) less as time goes on. The point of the band is to eat less food. It may take away your hunger to a degree, but the bottom line is you will get full faster and eat much less food throughout the day. If you’re a good patient, you should incorporate exercise too.”
What are the repercussions if you don’t follow a new diet?
“If you eat too much, or too fast, food tends to get stuck. It is trying to go down the esophagus into the stomach, which has the band around it. The food can get stuck in your throat and some people end up regurgitating or throwing up. But the bottom line is if you don’t follow the rules, you won’t lose weight. It does require effort on behalf of the patient to lose the weight. If you do, the results are pretty good.”
Is this for everyone?
“You have to meet the BMI criteria; it’s not just overweight people but those who are morbidly obese. There are several different types of weight loss operations available. The band is good for people who are compliant, able to follow up and come every four to six weeks, and are devoted to losing the weight and doing the follow-up. People who aren’t may be better served with other procedures.”