Bariatric clinic in southern New Hampshire
Morbid obesity can have a significant impact on a person's health and lead to medical conditions, such as high blood pressure, sleep apnea and diabetes. At Appledore Medical Group, our expert surgeons use bariatric surgery, often referred to as weight loss surgery, as a tool to treat obesity and morbid obesity.
However, this is not a decision to make lightly—the success of this surgery will depend on the patient's commitment to changing their lifestyle. To help with this, our doctors offer education, support and experienced surgeons to help patient's make an informed decision that is right for them.
Before visiting one of our locations that offers bariatric surgery, please view our patient health forms.
What is weight loss surgery?
During bariatric surgery, the size of a patient's stomach is reduced, limiting the amount of food they can consume. Needing less food to feel full, the patient should expect a reduction in calorie intake, which leads to weight loss.
When bariatric surgery is coupled with a lifestyle change, including exercise and healthy eating habits, the patient can expect significant, lasting changes. However, interested individuals should meet with a weight loss specialist and evaluate all options, including non-surgical alternatives.
It is important to note that bariatric surgery is not considered a cosmetic procedure but is meant, instead, to be part of a patient's more complete health transformation.
Weight loss surgery benefits
Bariatric surgery can reduce the risk of obesity-related conditions, such as:
- Gastrointestinal reflux disease (GERD)
- Heart disease
- High cholesterol
- Sleep apnea
It is also suggested that weight loss can lower the risk of developing certain cancers, including breast, colorectal and prostate cancers.
Types of weight loss surgery
Our surgical weight loss procedures are performed using minimally invasive techniques. This allows major operations to be performed through tiny incisions with specialized surgical tools, resulting in reduced pain, scarring and hospital stays for patients.
Our bariatric surgeons offer:
The Roux-en-Y Gastric Bypass is the most common and successful type of malabsorptive surgery. Malabsorptive operations restrict both food intake and the amount of calories and nutrients the body absorbs and are the most common gastrointestinal surgeries for weight loss.
How is the gastric bypass procedure performed?
During gastric bypass surgery, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine) and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the amount of calories and nutrients the body absorbs and is both non-reversible and non-adjustable.
On average, more than half of patients lose 70% or more of their extra weight and then settle at a weight that they maintain. Long-term success is dependent on accepting new rules for eating and food selection, which is taught in the follow-up period after surgery.
What are the advantages of the gastric bypass procedure?
Gastric bypass surgery has many advantages, including:
- An average weight loss of 60% or more
- A reduction in the desire to overeat
- Generally higher weight loss than with a sleeve gastrectomy
- Increased changes of maintained weight loss
- No postoperative adjustments required
- The potential to help resolve type 2 diabetes, high blood pressure and obstructive sleep apnea, as well as improve high cholesterol
Potential complications can include nausea or vomiting, a condition called dumping syndrome and small bowel obstructions. As with any surgery, you should review your risks with your care team prior to your procedure.
The vertical sleeve gastrectomy, also referred to as a "gastric sleeve, is a restrictive form of weight-loss surgery in which approximately 85% of the stomach is removed, leaving a cylindrical or sleeve-shaped stomach – about the size of a banana. With this surgery, the outlet valve and the nerves to the stomach remain intact, and while the stomach is drastically reduced in size, it still functions properly.
For obese patients with a relatively low body mass index (BMI)—a persons ratio of height to weight— the vertical sleeve gastrectomy may be a good choice, especially where existing conditions such as anemia or Crohn’s disease prevent them from having other forms of bariatric surgery. In addition, patients may choose this form of surgery if they are concerned about the long-term effects of gastric bypass surgery.
How is the gastric sleeve procedure performed?
Most gastric sleeve procedures are now performed laparoscopically, which means the procedure is minimally invasive and performed through a small incision(s). During the procedure, several small incisions will be made in your abdomen. Gas will be used to inflate your abdomen, making it easier for the doctor to see. A laparoscope (a thin, lighted tool affixed with a tiny camera) and surgical tools will be inserted through the incisions and the surgical site will be viewed on a monitor.
The gastric sleeve results in fewer restrictions on the foods that patients can consume after surgery, although the quantity of food eaten is still considerably reduced. It does not involve any bypass or the intestinal tract.
What are the primary advantages of the gastric sleeve procedure?
The gastric sleeve procedure has many benefits, including:
- An average excess weight loss of 55%
- Food intake limitation
- No postoperative adjustments required
- The absorption of vitamin and nutrients as food will pass through the digestive tract normally
- The potential to help resolve high blood pressure and obstructive sleep apnea, and to help improve type 2 diabetes and hyperlipidemia.
Disadvantages of the sleeve gastrectomy are that weight loss can be slow if a patient does not follow a strict diet, complications can result from stomach stapling and patients with high BMI can require future treatment to achieve their goals. In addition, this procedure is also not reversible. As with any surgery, you should review your risks with your care team prior to your procedure.
Revision weight loss surgery
Revision weight loss surgery is performed on patients who have already received a form of bariatric surgery but have either experienced complications or have still not achieved significant weight loss results. The goal of revision weight loss surgery is to make additional changes to the stomach to achieve the desired weight loss outcomes.
Candidates for weight loss surgery
The need for weight loss surgery is determined by whether or not a patient is considered obese. Obesity is defined by an abnormal or excessive body fat accumulation and identified by a body mass index (BMI) of 30 or higher.
BMI is one way for doctors to determine excess body fat, by comparing and individuals height to their weight—which is then assigned a number.
This number helps patients identify their weight category, knowing that a:
- BMI below 18.5 is considered underweight
- BMI between 18.5 and 24.9 is considered healthy
- BMI between 25.0 and 29.9 is considered overweight
- BMI between 30.0 and 34.9 s considered obese
- BMI between 35.0 and 39.9 is considered severely obese
- BMI of 40+ is considered morbidly obese
Patients could qualify for surgery if they have a BMI of at least 40, or if they have a BMI of at least 35 in addition to other significant health issues related to weight, such as high blood pressure or diabetes.
Note: BMI cannot distinguish between excess fat and muscle. The BMI of an extremely muscular person may be classified as obese, when clearly, he or she is not.
Complete the form below to determine your BMI and see if you qualify for surgery.
Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.
Your BMI Score is:
All information provided by this website is intended to be general in nature and should not be used as a substitute for a visit with a health care professional. No information provided in this site may be considered medical advice. The information may not be relevant for your individual situation and may be misinterpreted. HCA assumes no responsibility for how you use information obtained from this site. Before making any decisions regarding your health care, ask your personal physician.
Bariatric surgery success stories
Our patients benefit from surgeons that have years of experience and expertise when it comes to bariatric surgery, which means that you can expect results. Many of our patients share their experiences with us in hopes to inspire others to be able to take the first step in making a positive change in their lives.