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Everyone Plays a Role: Patients and Their Care Teams Work Together to Improve Weight Loss Surgery Outcomes

For those who have struggled to lose weight through diet and exercise, or even medication, weight loss surgery (also called bariatric surgery) is often the best option for long-lasting weight loss. Recent advances have now made both laparoscopic sleeve gastrectomy and laparoscopic gastric bypass surgery safer and even more effective choices than ever before. In fact, at Brigham and Women’s Faulkner Hospital, most patients who undergo laparoscopic sleeve gastrectomy and many who undergo laparoscopic gastric bypass surgery are discharged after just one night in the hospital and allowed to finish recovering in the comfort of their own home.

“Weight loss surgery is not just about treating obesity,” says bariatric surgeon Thomas C. Tsai, MD, MPH. “These procedures treat the cardiovascular risk associated with obesity and improve the quality and longevity of our patients’ lives.”

But, like all surgery, there are risks associated with bariatric surgery. Luckily, years of research have led the team at the Center for Weight Management and Wellness at BWFH to develop a standard course of best practices. Through pre-operative screening, education and diet, patients come to their surgery prepared for the best possible outcome. It takes the entire team—which includes surgeons, physician assistants, registered dietitians, psychologists and the patient—all working together.

According to Dr. Tsai, there are several key factors that improve outcomes and help patients get home faster. The first is preparation. Before surgery, patients meet with their surgeon where their health is evaluated. They then meet with a registered dietitian who explains the pre-surgery, low-carbohydrate diet that is necessary to prepare the body for surgery. Finally, each patient is evaluated by a psychologist to ensure they are mentally fit for the lifestyle changes that accompany weight loss surgery.

On the day of surgery, patients cannot eat but they are asked to drink a carbohydrate-rich drink which helps with recovery from anesthesia. “We’ve also taken a multimodal approach to treating pain, moving toward an opioid-free pathway,” says BWFH’s Director of Bariatric Surgery David Spector, MD. All of this is with the aim of getting patients back on their feet as soon as possible. Patients are asked to begin walking the halls of the hospital on the same day as their surgery.

“I like to think that you’re not recovering from an operation. The operation is empowering you to be more active,” says Dr. Spector. “This work has decreased our length of stay. People can get home sooner to be home with their loved ones and begin a better quality of life as a result of the operation.”

After surgery, follow-up care is important. Patients receive a call from their care team a few days after discharge to make sure things are going well at home. Within two weeks, patients meet with their surgeon or physician assistant and registered dietitian.

“Throughout the process, we focus a lot on setting patient expectations,” explains Bariatric Program Manager Meghan Ariagno. “We find that, for most patients, the key to success is their own participation. Patients who are motivated to recover and move on with their lives usually do.”

To learn more about surgical weight loss options at the Center for Weight Management and Wellness at Brigham and Women’s Faulkner Hospital, click here. To schedule an appointment or virtual visit at the Center for Weight Management and Wellness, call 617-525-3597.

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