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I have a 38 year old daughter with spastic diplegia CP. The…

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Answer 1

Bariatric Physician: Dr Basu, Board Certified Physician replied 9 years ago

Hello,
Mysticdoc : Thanks for your question.
Mysticdoc : Most people who have weight loss surgery will meet with several specialists before surgery is scheduled. This often includes a dietitian, mental health counselor, a doctor who specializes in care of obese people, and a surgeon who performs weight loss surgery (bariatric surgeon). You may need to work with these providers for several weeks or months before surgery.
The nutritionist will explain what and how much you will be able to eat after surgery. You may also need to lose a small amount of weight before surgery.
The mental health specialist will help you to cope with stress and other factors that can make it harder to lose weight or trigger you to eat
The medical doctor will determine whether you need other tests, counseling, or treatment before surgery. He or she might also help you begin a medical weight loss program so that you can lose some weight before surgery.
The bariatric surgeon will meet with you to discuss the surgeries available to treat obesity. He or she will also make sure you are a good candidate for surgery.
Mysticdoc : Lap banding — Laparoscopic adjustable gastric banding (LAGB), or lap banding, is a surgery that uses an adjustable band around the opening to the stomach. This reduces the amount of food that you can eat at one time.
Lap banding is done through small incisions, with a laparoscope. The band can be adjusted after surgery, allowing you to eat more or less food. Adjustments to the size and tightness of the band are made by using a needle to add or remove fluid from a port (a small container under the skin that is connected to the band). Adding fluid to the band makes it tighter which restricts the amount of food you can eat and may help you to lose more weight.
Lap banding is a popular choice because it is relatively simple to perform, can be adjusted or removed, and has a low risk of serious complications immediately after surgery. However, weight loss with the lap band depends on your ability to follow the program closely.
You will need to prepare nutritious meals that "work with" the band, not against it. For example, the lap band will not work well if you eat or drink a large amount of liquid calories (like ice cream). The band will not help you to feel full when you eat/drink liquid calories.
Weight loss ranges from 45 to 75 percent after two years. As an example, a person who is 120 pounds overweight could expect to lose approximately 54 to 90 pounds in the two years after lap banding.
Mysticdoc : Gastric sleeve, also known as sleeve gastrectomy, is a surgery that reduces the size of the stomach and makes it into a narrow tube. The new stomach is much smaller and produces less of the hormone (ghrelin) that causes hunger, helping you feel satisfied with less food.
Sleeve gastrectomy is safer than gastric bypass because the intestines are not rearranged, and there is less chance of malnutrition. It also appears to control hunger better than lap banding. It might be safer than the lap banding because no foreign materials are used.
The gastric sleeve has a good success rate, and people lose an average of 33 percent of their excess body weight in the first year. For a person who is 120 pounds overweight, this would mean losing about 40 pounds in the first year.
Mysticdoc : Best wishes and Happy Holidays,
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Mysticdoc : Excerpts taken from:
Mysticdoc : http://www.uptodate.com/contents/weight-loss-surgery-beyond-the-basics?source=search_result&search=weight+loss+surgery&selectedTitle=7~108

Answer 2

Bariatric Physician: Dr. Dan, Bariatric Physician (MD) replied 9 years ago

Dr. Dan, Bariatric Physician (MD)

Category: Bariatrics

Satisfied Customers: 393

Experience: ASMBS Centers of Excellence Bariatric Surgeon

Verified

Hello to the original poster,
Mystic doc has provided you with some excellent information about the process of getting weight loss surgery and how to adapt to it. I will not add to that information, as Mysticdoc was very thorough in his explanation. I would like to add one piece of information specific to your daughter.
In order for any patient to qualify for weight loss surgery, that patient has to have a thorough understanding of the lifestyle change needed in order to accommodate that operation. This is critical for the patient, because if the patient cannot understand how and why they have to chew differently, eat slower, and stop eating when they get full, that patient will eventually rupture their gastric pouch or esophagus.
There is a wide range of cognitive function in patients with cerebral palsy. Some patients have a normal ability to think and interact with themselves and others, while some patients have very little awareness of themselves or their surroundings. I have no way of gauging where your daughter lies on that spectrum. The best advice I can give you would be for you to seek the closest Centers of Excellence bariatric surgeon and sit down for a frank discussion. That surgeon will be able to determine your daughter's candidacy for weight loss surgery.
You can find the closest bariatric surgeon through the webpage: www.asmbs.org
Click on the radio button that says "find a surgeon" on the homepage, and it will search via your zip code. Look for a surgeon that has "centers of excellence" next to his/her name.
Mysticdoc answered your question perfectly well, and he should get the credit; I just wanted to add that one extra piece of information that specifically dealt with your daughter.
Good luck,
Dr. Dan

I have a 38 year old daughter with spastic diplegia CP. The…

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