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Meet Our TeamWhat You Should Know About Exercise After Bariatric Surgery
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For those who struggle with weight loss, surgery can offer a new, healthier lease on life. Whether you’re considering surgery or have recently recovered, you might be wondering — what’s next? Is it safe to exercise, or can I just watch what I eat? In this podcast, bariatric surgeon Anthony Davis, MD, tells you what you can expect after surgery. He gives listeners an idea of what an exercise plan can look like and discusses safe activities, those to avoid, and how often a post-op patient should work out. In addition, Dr. Davis breaks down the minimally invasive options for weight-loss surgery — gastric sleeve, lap-band, and gastric bypass. He explains how surgeons decide which is best for you, what makes you a good candidate, and how to prepare for surgery.
In this episode of the HealthTalks NOW podcast, Dr. Anthony Davis joins the HTN host to share about a crucial component of the bariatric surgery process, namely, the post-operative stage. Dr. Davis provides many post-operative tips, but most specifically focuses on the role exercise plays after surgery. He explains to listeners an exercise plan for use after surgery, what types of exercise to do or avoid, and how often to exercise.
Before moving into the main content of the conversation, though, Dr. Davis provides some personal background. He has been a bariatric surgeon for more than 10 years, having been drawn to this line of work because of the way it impacts a patient’s overall health. He loves to see patients make lifestyle changes that will provide long-term positive change in their health. He resides with his family in western Kentucky, which he appreciates for its welcoming community.
Moving forward, Dr. Davis begins to field questions about bariatric surgery. First, the host wants to discuss pre-surgery, hoping to give listeners a sense of the whole surgery process leading up to the post-operative stage. Dr. Davis clarifies that a patient’s body mass index (BMI) is used to determine obesity; if a person has a BMI of 30 or higher, that person has the diagnosis of obesity, and would contribute to making a patient a good candidate for surgery. Comorbidities and severity of obesity are also factors in determining whether or not surgery is a strong option for a patient, and as far as preparation for surgery is concerned, Dr. Davis highlights the fact that bariatric surgery is really only one piece of a larger project. Patients who elect to undergo the surgery need to be prepared to make lifelong changes in their habits.
The surgery itself is performed laparoscopically; this minimizes invasiveness and makes the procedure conducive to a relatively smooth and quick recovery. Three types of bariatric surgery are most common: gastric sleeve, lap band, and gastric bypass. The invasiveness of surgery depends on what type is performed. In other words, it depends on how much a patient’s gastrointestinal tract is manipulated. The lap band procedure is the least invasive of the three, and the gastric bypass is the most invasive, involving more surgical change to a patient’s body. Dr. Davis explains the processes of each operation, detailing what each entails and how each impacts physical functioning.
Each surgical option impacts the absorption of calories in some way. The lap band procedure ultimately uses an inserted apparatus to restrict how much food a person can consume. The sleeve is more surgical, involving removal of part of the stomach and impacting calorie absorption by reducing some hormones; while more invasive, it is more effective for treating obesity than the band. The gastric bypass restricts calorie absorption the most, which is of course helpful for maintaining a healthy weight. However, there are also challenges in living with such restricted-calorie absorption, as needed vitamins and minerals may not be absorbed properly. While all of the procedures require lifelong dietary care, the gastric bypass requires the most attention because of the danger of poor vitamin and mineral absorption.
Narrowing in again on the lap band procedure, Dr. Davis clarifies that the band does not actually impact a patient’s anatomy. Rather, the inserted device functions to accomplish the same goal as the other procedures without removing any of the gastrointestinal tracts. Since it is inert, the body will not reject the band, though it will develop a shield to separate itself from the foreign object. Additionally, the artificial device is not as effective a treatment option for obesity as a more invasive surgical option. It is intended to last for a lifetime, but there are times when people require further surgery because of device slips.
Next, Dr. Davis comments on the factors that go into determining what option is best for a given patient. Comorbidities weigh into the discussion of options, as does the patient’s BMI. Ultimately, the decision is highly individualized, and it requires a thorough conversation between you and a physician who knows your case well. For three to six months prior to surgery, Dr. Davis’s facility requires patients to participate in a weight loss program to help with not just weight, but also education about bodily functioning and help with developing healthy habits. This process helps those who go on to have surgery do so with lifestyle changes in place that will need to be maintained after the operation.
The host then turns her attention to the recovery and post-operative stage. Dr. Davis and his colleagues recommend at least four weeks of weight restrictions and also suggest a number of dietary restrictions. Right after surgery, patients adopt a liquid diet before going through a three-to-four week process of increasing the density of their foods.
With regard to exercise, Dr. Davis has a nuanced approach to muscle building and weight training. Of course, none of this sort of exercise is helpful right away, but once weight limits are lifted, patients will need to determine how to navigate such exercise going forward. Dr. Davis does not encourage building muscle to the point of gaining weight, but does encourage building muscle and maintaining a lower weight and BMI, which are associated with heart health. Dr. Davis says that a patient does not necessarily have to work out after bariatric surgery, but that he recommends making exercise part of each patient’s life for the sake of general health.
Moving on to the topic of nutrition after surgery, Dr. Davis says that he and his colleagues do not recommend one diet plan to fit all patients, but that they work with patients to settle on tailor-made plans. In general, these plans involve limiting volume of food intake and taking special care over what foods are consumed. Patients are advised to eat protein and vegetables in each meal, and Dr. Davis testifies to the importance of vegetables in people’s diets in general.
Another concern that many patients feel the need to address after surgery is that of loose skin. Dr. Davis explains how some people experience a great deal of loose skin after their operations, how some others experience skin recoil, and how the extent of one’s weight loss impacts the amount of loose skin left. Loose skin can lead to issues with rashes, can feel like it gets in a patient’s way, and can make a patient feel less like himself/herself. There are surgical options for patients dissatisfied with loose skin to deal with it. While the new issue of skin looseness may develop after surgery, many comorbidities may improve. Dr. Davis addresses the top three: hypertension, diabetes, and sleep apnea. He has seen a number of patients require less medication for blood pressure and diabetes, and even see the resolution of their sleep apnea.
As the conversation moves toward a conclusion, the host raises some final questions. First, they wonder whether or not it’s safe to become pregnant after surgery. Dr. Davis recommends that his patients wait for a time to see the resolution of their disease of obesity and heal. It may also prove helpful for women to avoid the weight change of pregnancy until becoming more established in new post-surgery patterns. Additionally, both men and women may be more fertile with established weight loss. Dr. Davis dives in again to considerations of medications and comorbidities, considers the possibility of a patient developing depression after surgery, and finally points out that bariatric surgery is just one part of a larger project – a project with the end goal not of weight loss, but of impacting how patients process calories.
Key Takeaways:
[1:37] – The conversation begins with Dr. Anthony Davis’s background as a bariatric surgeon in western Kentucky.[2:30] – Before diving into the topic of post-surgery life, the process of moving toward and going through surgery must be addressed.
[4:07] – All the procedures are laparoscopic, but they do not all function the same. Dr. Davis explains the three most common options.
[7:42] – Dr. Davis clarifies some questions about how the lap band option works.
[9:29] – How is the best option for a given patient determined? Dr. Davis navigates the relevant factors.
[13:32] – The conversation turns toward the recovery and post-operation stage, focusing first on the recovery process and timeline.
[14:54] – Dr. Davis considers muscle building, weight training, and exercise in general after surgery.
[18:03] – The next pose-surgery topic is nutrition, which is an important aspect of life after bariatric surgery.
[19:15] – Loose skin is a concern of many patients, and Dr. Davis talks about how that issue arises and can be handled.
[20:47] – Comorbidities play into determining whether or not a person is a good candidate for surgery, and can also see much improvement after surgery.
[22:48] – Dr. Davis and the host consider the uniqueness of this field.
[23:28] – The conversation ends with some final questions – the first concerning pregnancy.
[25:26] – Another question returns to the topic of medication and comorbidities.
[27:15] – The final question pertains to depression and its possible development after surgery.
Links:
Learn more about Baptist Health and take the free weight loss assessment.
For more information on bariatric surgery, listen to episode 2 of HTN.
You can connect with Dr. Anthony Davis at 270.845.4087 or by reaching out to Baptist Health Paducah.
View Transcript
Welcome to HealthTalks NOW, bringing you the facts you need to keep you and your family well. We’re happy you’re tuning in today. Baptist Health is committed to providing compassionate, high-quality care that is centered on you. Listen to all of our podcasts to hear from Baptist Health physicians about the latest medical advancements and treatments and get trusted information on timely health topics from our healthcare professionals.
Speaker 1:
Whether you want to learn more about a specific condition or procedure or find tips for living a healthy lifestyle, Baptist Health is here to help you become a healthier you.
Speaker 2:
We’re joined today with guest Dr. Anthony Davis to discuss a critical part in the bariatric surgery process, the post-operative stage, and specifically, we’re diving into the importance of exercise after bariatric surgery.
Speaker 2:
That’s right. Along with other post-operative tips we want to give you, our listeners, a clear idea of what an exercise plan looks like, what should be done, what to avoid, and how often patients should work out.
Speaker 2:
Dr. Davis, thank you for joining us today.
Dr. Anthony Davis:
Thank you for having me as your guest. I appreciate this opportunity to participate in your discussion today.
Speaker 2:
Of course. It’s our pleasure. Could you start by introducing yourself, maybe telling our listeners what drew you into the field of medicine, specifically bariatric surgery, and what you enjoy the most about western Kentucky?
Dr. Anthony Davis:
I specialize in bariatric surgery. I’ve been in this field for over 10 years now. What drew me to this specialty is the effects that it has on patients’ overall health. What I enjoy most about it is that I can participate in life-altering behavior modifications for patients long term, not just for that short treatment plan that I used to do as a general surgeon.
Dr. Anthony Davis:
What I enjoy most about western Kentucky is the community itself. Where I live they’re very welcoming and they received myself and family quite well.
Speaker 2:
Before we get into the specifics of post-operative care, we’d be remiss to not cover pre-surgery. What makes someone a good candidate for weight loss surgery and what preparation is required?
Dr. Anthony Davis:
Okay. First, you should have seen a primary care provider, your family doctor, who might have made the diagnosis of morbid obesity. That diagnosis is based on your body mass index or BMI for short. If you have a BMI of 30 or greater you have the diagnosis of obesity. What makes you a surgical candidate would be having a diagnosis of obesity.
Dr. Anthony Davis:
Now the severe your obesity is is based on how high your BMI is calculated. So, again, if you have a body mass index of 30 or greater but you have a comorbid condition like diabetes, sleep apnea, hypertension, you could be a candidate for surgery.
Dr. Anthony Davis:
Or if you have a body mass index of 40 or greater without any diagnosed comorbid condition or disease associated with obesity you would be a candidate for bariatric surgery.
Dr. Anthony Davis:
You asked about the preparation that is required. I think patients need to understand that this is a lifelong process and they have to be prepared for making lifelong changes and behavior modifications for the rest of their life when they’re going into the treatment of this disease.
Speaker 2:
Yeah, it’s really a lifestyle, not just a quick fix like I think some people think it is.
Dr. Anthony Davis:
Exactly. I agree with that 100%.
Speaker 2:
I understand that all of our procedures are performed laparoscopically. For someone who’s not familiar with that term, that just means it’s minimally invasive, involving tiny incisions and a shorter recovery time, which plays into a better recovery and it ultimately allows patients to return to their life faster.
Speaker 2:
Let’s layout the specific types of those procedures. Can you break down the differences and explain a bit about the most common three, gastric sleeve, lap band, and gastric bypass?
Dr. Anthony Davis:
Yes. I’ll work in terms of quote-unquote the invasiveness of the surgery. They’re all performed laparoscopically, but what I mean by invasiveness is how much we as surgeons manipulate your gastrointestinal tract.
Dr. Anthony Davis:
The band is quote-unquote the least invasive in terms of what we’re doing to your GI tract. We are placing a device around the top portion of your stomach and it is connected to a port that is buried underneath your skin.
Dr. Anthony Davis:
Now, this port allows the physician or provider to titrate or increase the fluid that is around that balloon of the band by placing saltwater in the apparatus. This tightens around the stomach with the end result of limiting or restricting the amounts of food the individual can consume.
Dr. Anthony Davis:
The sleeve is more of a surgical change, where we are resecting or cutting a portion of the stomach to a cylinder shape. Not only do you cut the stomach and remove that portion of the stomach, you’re also affecting your physiology and how your body is processing calories by reducing certain hormones.
Dr. Anthony Davis:
This surgery is a lot more effective in terms of the treatment of the disease of obesity. It is a restrictive surgical procedure, but it does have some physiological effects on how you’re processing calories.
Dr. Anthony Davis:
Then finally the gastric bypass, a little bit more involved with manipulating your gastrointestinal tract by not only creating a smaller stomach but also rerouting, if I may, the pathway of your calories and how your body is processing those calories.
Dr. Anthony Davis:
I put it in this order because the more we do to your gastrointestinal tract the more we affect the absorption of your calories. The gastric bypass I put at the end is because you absorb fewer calories, so that is one advantage. However, there is a price. Your body cannot discern which calories are good and which calories are bad. It can’t discern certain vitamins and minerals, so the price with the gastric bypass is the fact that you can have malabsorption or inappropriate absorption or adequate absorption of vitamins and minerals because of the rerouting of the intestinal tract.
Speaker 2:
So you have to be really conscientious of your diet?
Dr. Anthony Davis:
You do. You have to with all of the surgeries, but you are… I don’t want to say that you shouldn’t be with any of the surgeries, but with the gastric bypass, you have to be more diligent on following your vitamins and minerals and making sure you’re consistent with that.
Speaker 2:
The lap band is actually not changing your anatomy, you’re just using that device to kind of accomplish the same goal without actually removing any part of the GI tract. Did I get that correct?
Dr. Anthony Davis:
That is a great way of saying it. But the issue with the gastric band is you’re leaving an artificial apparatus in someone’s body and it’s not as effective in reversing or treating the disease of obesity compared to the other two.
Speaker 2:
Do you run the risk of someone’s body rejecting that device?
Dr. Anthony Davis:
There should not be an issue with having the artificial apparatus in your body. It is considered inert or foreign, so your body should not respond in terms of having an infectious process or a rejection type scenario, but naturally your body will separate itself from a foreign object, so that’s where it will develop a shield, per se, to separate the band from its actual tissue.
Speaker 2:
Is there any followup surgery required or is that device intended to last a lifetime?
Dr. Anthony Davis:
Yeah, statistically it’s supposed to last a lifetime in terms of… You know, once you put it in and if it’s set perfectly in the body it should last for a lifetime. However, we are finding out that this is not true for all people and this device can move, change, just like your body changes and grows and shrinks, so the apparatus won’t be seated in the same position and it could quote-unquote slip, and when it slips you can have problems with it.
Speaker 2:
How do you determine which of those options is best for the specific patient?
Dr. Anthony Davis:
That’s where you would require to be a participant in a bariatric surgical program. Your surgeon would be sitting down with you after reviewing your medical history and discussing what your risks are and what those surgeries could increase or worsen or improve upon.
Dr. Anthony Davis:
We do know that the gastric bypass, for example, is a great surgical procedure for those type two diabetics, because there’s a significant reversal of your type two diabetes after having that surgery. Longer-term, the sleeve would provide that also, as well as the band. However, if you’ve had inflammatory bowel issues, for example, multiple intestinal surgeries, you may not be a candidate for the gastric bypass.
Dr. Anthony Davis:
The same for the sleeve. The sleeve is a great surgical procedure with great results. However, if you are suffering from, for example, something called Barrett’s Esophagus you would not be a candidate for this surgery.
Dr. Anthony Davis:
The band, it really depends, especially in our program, what your BMI is at. If you have a larger body mass index I would not recommend the gastric band because, again, it can’t compare in terms of successful reversal of the disease of obesity, so you’re not going to lose as much weight with the band, and if you have a heavier weight you may not want to consider having the gastric band as a procedure.
Speaker 2:
So it’s really individualized? I think that’s really a good point to make because… Especially if you’re not intimately familiar with each of these procedures, you may think that they are all equally effective or equally right for you, and it’s a matter of just choosing. So I think it’s really good to make the distinction that no, it’s really a collaboration with your physician and a dialog back and forth to figure out what are your risk factors, what’s going to work best for your body.
Dr. Anthony Davis:
You’re right on that. There are times I have patients come in and say, “Well, my sister had this,” or, “My best friend had this type of surgery,” and you can’t base it only on the fact that your friend or family member had that surgery. You really have to look at your overall health.
Speaker 2:
Yeah. That’s one important thing, as Kendra mentioned about our bariatric program, is the counsel and the interaction that is going on between your office and the patient well before the surgery takes place.
Dr. Anthony Davis:
Yes. Absolutely. Or facility requires three to six months of participating in a medically managed weight loss program, but during that time we’re not only just helping you lose weight. What we’re really focusing on during that time is educating patients about their bodies what their body is doing during this time that they’re suffering from obesity.
Speaker 2:
And helping them establish new patterns and habits and really make it something that’s a lifestyle that’s sustainable for them after surgery I’m sure?
Dr. Anthony Davis:
Absolutely.
Speaker 2:
We’ll be right back.
Speaker 1:
At Baptist Health Bariatric Surgery and Weight Loss we can help you make the lifestyle changes needed to reclaim your freedom. Our expert surgeons, dieticians, and mental health professionals have the tools, experience, and the compassion needed to help you make a lasting change.
Speaker 1:
We offer the latest surgical and non-surgical weight loss options in a professional, caring, and nurturing environment. Take the first step towards a healthier, happier version of you. Learn more about our program and treatment options or sign up for a free weight loss seminar at baptisthealth.com.
Speaker 2:
We’re back with Dr. Anthony Davis. Let’s talk now about the recover and post-operative stage, when patients are excited about the possibilities of a new, fresh start and a healthier life, ready to make changes for a lasting benefit. Assuming no complications, what does the recovery process and that timeline look like?
Dr. Anthony Davis:
In our facility we recommend that after surgery you wait at least four weeks of weight restrictions. What that means is no heavy lifting greater than 15 pounds for four weeks, no pushing, pulling, straining during that time. The four weeks is really to begin learning your new body and developing habits so that you can relearn how to eat.
Dr. Anthony Davis:
There are also dietary restrictions as well. You have to imagine now your stomach is a lot smaller than it was before. You can’t haphazardly just eat as much as you want to. You have to get accustomed to eating smaller meals and being okay with it as well.
Dr. Anthony Davis:
Right after surgery we have a liquid diet that patients follow just so that their stomachs can heal. Then with time we gradually increase the density of that food from clears to solids, and that usually takes about three to four weeks.
Speaker 2:
Okay. How about muscle building and weight training? We know that they have to wait those four weeks before they lift anything over 15 pounds, but after that time period has passed do you encourage that they focus on muscle building? I think people frequently associate intense cardio with weight loss, but we know that’s not always the best method. What’s your take on that?
Dr. Anthony Davis:
Okay, so that is a very slippery slope. When we talk about muscle building, I encourage that, but for different reasons. We’re treating a disease of weight, and we all know that when you develop muscle you’re actually building mass, and mass is weight.
Speaker 2:
Okay. True.
Dr. Anthony Davis:
I don’t encourage building muscle mass to the point where you’re gaining weight. I do promote and encourage developing your muscle and maintaining a lower weight, a lower body mass index.
Dr. Anthony Davis:
The reason why the body mass index… And this is what people really need to understand. When you’re calculating the body mass index you’re calculating specifically just your weight versus your height. It does not differentiate or separate muscle weight or fat weight, it just talks about weight.
Dr. Anthony Davis:
So the reason behind that is true because of your heart. Your heart has to push 250 pounds for it to work. To move 250 pounds, whether it’s 250 pounds of muscle or 250 pounds of fat, your heart is the organ that has to work against that, so the reason is really associated with your heart as well, so you do want to have less weight.
Speaker 2:
That makes total sense. For someone who has not yet gone through the pre-education and pre-surgery seminars and counseling, so they don’t understand yet the lifestyle changes, what would you say to someone who’s wondering do I have to work out after bariatric surgery? Isn’t this surgery enough for weight loss? Can’t I just watch what I eat?
Dr. Anthony Davis:
Yeah. My response to that would be no, you don’t have to work out after bariatric surgery, but we recommend incorporating exercise as part of your journey for long term success. Exercise, again, is something that is important not necessarily for weight loss. There’s so many other benefits that come with exercise. The myth is I could just exercise, but you and I both know that you can’t exercise or out-exercise a bad diet.
Speaker 2:
Absolutely.
Dr. Anthony Davis:
So I encourage exercise to be incorporated into their lifestyle after having bariatric surgery for other benefits.
Speaker 2:
Just for overall health?
Dr. Anthony Davis:
Yes.
Speaker 2:
That’s a good segue into nutrition. Obviously, we know that the two go hand-in-hand, but what are some of the nutrition guidelines and recommendations that patients are going to be presented with post-surgery?
Dr. Anthony Davis:
We don’t have a diet plan that’s a one size fits all, but we do discuss with our patients specific guidelines tailored to their needs when they visit with us. I will say this, the general recommendations are to limit their total volumes after having surgery because their stomachs are smaller, and consistently measuring those volumes, or their portions per meal, and what they put in those meals are very important.
Dr. Anthony Davis:
We emphasize incorporating vegetables and proteins with each meal, because I believe that… And this is a fact. Our society as a whole are poor vegetarians. We don’t eat enough vegetables in our diets. We focus on high protein diets to lose weight, low carb diets, high fat diets, but we need to really get to the crux of nutrition, and vegetables are essential for that.
Speaker 2:
Can we talk about loose skin? As patients continue on their journey and they’re seeing some of their excess weight fall off loose skin becomes concerned I would imagine. How is that addressed?
Dr. Anthony Davis:
Loose skin is a concern, but the best way I explain it to patients are twofold. One, what you’ve created you cannot un-create, right? So if you have a significant amount of weight loss because of the fat cells shrinking that skin is not necessarily going to go anywhere. Well, it won’t.
Dr. Anthony Davis:
Some people are fortunate, if I may say, that they can medically have skin recoil back so that they don’t have significant excess skin, that the skin actually rebounds back. Others aren’t as fortunate. There is a correlation to the amount of weight that they’ve lost to the amount of excess skin that they might have.
Dr. Anthony Davis:
If it becomes an issue in terms of developing rashes, it’s getting in the way, they feel as though they’re not themselves because of this excess skin, there are surgical options to help remove that excess skin. We recommend talking to a plastic surgeon who is a sculptor of skin to help them make that decision.
Speaker 2:
Okay. Earlier in the episode, you mentioned the comorbidity. Let’s talk about that for a moment, because we did have an episode just a few backs about sleep disorders, and sleep apnea was one. You mentioned high blood pressure. Do you find that those issues resolve with lifestyle changes and bariatric surgery?
Dr. Anthony Davis:
Absolutely. I’ll get into the top three. We’ve got hypertension or high blood pressure. We’ve seen patients who have been on multiple blood pressure medications start developing symptoms after having their surgery. These symptoms of lightheadedness, fatigue, and the correlation actually is the fact that when they’ve been losing their weight their body has become more sensitive to those blood pressure medications and they have to have been tailored off of these medications to resolve these symptoms of lightheadedness and fatigue.
Dr. Anthony Davis:
Now, this is a disclaimer. If you’re having lightheadedness and fatigue you should still see your physician make sure that it really is your body rejecting or becoming more sensitive to the blood pressure issues because it could be something else, but with our patients who’ve lost a significant amount of weight these are some of the signs that they’re having, and it’s actually a great thing because that’s what they’re here for. They’re here to get off of these medications.
Dr. Anthony Davis:
Diabetes is the same. Their blood sugar has become lower because they’ve been losing weight. They’re more sensitive to their Metformin and their insulin and requiring less dosages of these medications.
Dr. Anthony Davis:
Then with sleep apnea, I will say this. I’ve had several patients that actually have had resolution of their sleep apnea, less snoring as they lost the weight, feeling more energized, feeling more refreshed when they sleep. But believe it or not, some of them still enjoy wearing their CPAP machine because they’ve just been used to it.
Speaker 2:
Really? That’s interesting. I can understand now why you were drawn to this field and the impact that you’re making on patients and the gift that you’re giving back of not just the surgery, but the total overhaul on their life, as well as the impact that they have on their family.
Speaker 2:
It’s a unique field too, that you get to say with them on the entire journey. You’re not treating an illness or a disease and then sending them on their way and not knowing what happens to them after that. You’re continuing that relationship throughout the entire process, plus in the family, like you’re giving someone their dad back and their grandpa, their mom back, of all the memories to be created because they have more energy in life to live.
Speaker 2:
Let’s wrap up this episode providing some listeners some additional questions and concerns about life after bariatric surgery. One common question is is it safe to get pregnant after surgery?
Dr. Anthony Davis:
Yes, it is. But I recommend for my patients to at least wait for… Or for women to at least wait a year and a half prior to getting pregnant. So during that time after surgery, they should use some form of a barrier contraceptive or hormone contraceptive to avoid getting pregnant within that first year and a half.
Dr. Anthony Davis:
The reason behind that is to give their body an opportunity to have a resolution of the disease of obesity, which clearly will give them a healthier and safer pregnancy with fewer complications.
Speaker 2:
That makes sense.
Dr. Anthony Davis:
So giving their bodies a chance to heal before getting pregnant. I warn them that when they start losing weight during this process they become more fertile as well.
Speaker 2:
That makes sense.
Dr. Anthony Davis:
Yes. So there are times where men, their sperm counts are lower, they have lower testosterone levels, and when they start losing weight they become more fertile as well. You have a resolution of the polycystic ovarian syndrome with this disease, which is very important.
Speaker 2:
Yeah, I can see that. I can imagine that as they… Once a woman does get pregnant after having this procedure, that as they inevitably will gain some weight with the pregnancy, that that could be detrimental in their long term progress or it could set them back certainly, so that makes sense, that you would want them to really establish in the lifestyle and let their body adjust and heal before they make another drastic exchange to their body.
Dr. Anthony Davis:
Absolutely. It’s another investment in their health.
Speaker 2:
We mentioned a little bit about the changes in medication, but what effect does weight loss surgery have on medications, and how does that play into those needing those to change?
Dr. Anthony Davis:
Ideally, when you have a resolution of the disease of obesity you should have a reversal of those diseases, we call it comorbid conditions, associated with obesity. We know that obesity causes high blood pressure, diabetes, sleep apnea, for example, and high cholesterol.
Dr. Anthony Davis:
When you’re having this disease treated, then those diseases that were caused by this disease of obesity improve, and as a result you may not need blood pressure medications anymore because you may be too sensitive to them. You may not need those diabetic medications. You might need to have them tailored down. Cholesterol medications could be stopped. There’s a significant amount of resolution of these diseases when you fix the main cause of those other conditions.
Speaker 2:
Is it possible that say someone is on a medication that is not one that can be discontinued after the surgery, is it possible that their dosage would need to be changed based on their new weight?
Dr. Anthony Davis:
Yes. I’ll talk about diabetes a bit. Statistically, for example, if you’ve been receiving insulin for over seven years there’s a low probability that you’ll be able to stop insulin for other physiological issues. So we tell our patients that your dosages of insulin will decrease, but there is a low chance that you will be off of insulin indefinitely.
Speaker 2:
That makes sense. Is there a possibility that patients could become depressed post-surgery?
Dr. Anthony Davis:
Yes. There is a chance that you can become depressed, which is another reason why I recommend that you incorporate exercise after having surgery once you have that weight restriction off. We do know for a fact that one of the benefits of exercise is actually increasing your endorphins, giving you more self-confidence throughout life.
Dr. Anthony Davis:
So you incorporate exercise not just for the physical health benefits, but also for the mental health benefits that come with exercise. That’s one of the reasons why we encourage exercising after surgery.
Speaker 2:
Is there anything else you can share with us today that we may have missed?
Dr. Anthony Davis:
I want to say this if I may. Bariatric surgery is just a piece of the big picture of this disease of obesity. We have to remember that we’re not trying to just have patients lose weight. That’s not the end goal. The end goal is actually trying to affect how patients process calories, because these patients, take in calories and they store them, store them too efficiently, and that’s where they’re gaining the weight.
Dr. Anthony Davis:
So if we can fix that process of storage we can fix the disease of obesity. We always go to hey, let’s lose weight. Well, remember any and every one of us can lose weight. The secret is how to lose weight and not regain it, so that’s what we want to focus on at our facility and how we combat this disease of obesity.
Speaker 2:
Yeah, I like that distinction and I think it’s really important. I imagine there are a lot of people who seek out something like this because the self-confidence or they want to look a certain way or be able to do the things they used to be able to do, and it really does go deeper than that.
Dr. Anthony Davis:
It does. It really does.
Speaker 2:
Well, thank you again for joining us today Dr. Davis. How could people get in touch with you?
Dr. Anthony Davis:
They can contact my office. The number is 270-845-4087. Or they can always go online and look up Baptist Health Paducah, and our office and information is online as well, so it’s easy enough to do either way.
Speaker 2:
Great. Thank you so much again.
Speaker 2:
Thanks for tuning in today. A new way of life is possible and Baptist Health is committed to walking with you every step of the journey. If you’re unsure about how to get started take our free weight loss surgery assessment. You’ll find out about your weight category with your BMI, you can identify weight related conditions and discovery if weight loss surgery is an option for you. Take the assessment today at baptisthealth.com/health risk assessment.
Speaker 2:
If you enjoyed today’s episode share it with a friend or hit the subscribe button. If you’re interested in bariatric surgery you may want to check out episode two, What Even Is a Laparoscopic Sleeve Gastrectomy, where we take a deeper look at the gastric sleeve procedure with another Baptist Health bariatric surgeon.
Speaker 2:
We’ll catch you next time for another episode of Health Talks NOW, a podcast brought to you by Baptist Health.
Speaker 1:
Thanks for tuning in to HealthTalks NOW. Staying healthy is a lifelong commitment and Baptist Health can provide the support you need to lower your risks, improve your quality of life, and protect your long term health. Visit baptisthealth.com to hear our other podcasts, learn about our services, and find more tips to help you stay a step ahead of your health. Baptist Health, be a healthier you.
Speaker 1:
This podcast is for informational purposes only and should not be relied upon as medical advice. The content in this podcast is not intended to be a substitute for professional medical advice, diagnosis or treatment. This podcast is not designed to replace a physician’s medical assessment and medical judgment. Always seek the advice of your physician with any questions or concerns you may have related to your personal health or regarding specific medical conditions.
Speaker 1:
To find a Baptist Health provider please visit baptisthealth.com.
