YOUR FIRST CONSULTATION WITH DR SAFA
Before Weight Loss Surgery in Lebanon, at Advanced BMI: you will be required to make an appointment with Dr Safa for the following reasons:
- In order to verify your health condition, your current body mass index (BMI) and a physical exam: you will be weighed and your height will be measured in order to determin your body mass index (BMI)
- With this information Dr Safa will determine if you are a viable candidate for bariatric surgery.
- The next step is for you to ask questions of your own. Dr Safa will clarify different surgical techniques, including the benefits and risks of each one. It is at this time that you should ask any questions you may have and ensure that you fully understand what the surgery entails.
Once your surgery type is determined, appointments will be made. These include pre-admission testing and evaluations, and cover:
- Blood tests
- Chest X-ray
- Other Consultations if needed (Dietitian, Psychologist, Kinesiologist…)
- Pre-operative instructions from our Patient-Coordinator.
You will be provided with either a one-week or a two-week supply of a low carbohydrate/high protein diet, depending on your current weight. This will cause a reduction in the size of the liver, thus limiting the risk of surgery complications. The diet is crucial before weight loss surgery and will result in a small weight reduction, giving you a great ‘head start’ in achieving your weight loss goals.
Appropriate Steps Before and After Surgery
- If you are a smoker, you must quit smoking a minimum of one month prior to surgery.
- Be very vigilant in following your specialized low-carbohydrate, high-protein diet.
- Regarding any current medications for other health conditions, follow your surgeon’s advice.
In The Hospital, before weight loss surgery: What Should I Bring In With Me?
Bring all your medications and your sleep apnea machine if you use one.
Depending on your BMI, your operation should last from 40 to 90 minutes. This will also depend on what type of surgery has been chosen, plus any previous surgeries you may have had. Following your operation, you will be taken to a recovery room where you will awaken from the anaesthetic. During this period, the nursing staff will be checking on you very closely.
After your time in the recovery room, you will be taken to your own room where you will receive oxygen for the first day, with your blood oxygen levels being continuously monitored using an oxygen saturation-monitoring device. This is purely a precaution, because at least 40% of very obese patients have sleep apnoea, or Obesity Hypoventilation Syndrome. These conditions, together with anaesthetic, can result in harmful low blood oxygen levels.
The Dietitian’s Role
It is the role of the Advanced BMI’s dietitian to assist you in making appropriate dietary changes, consistent with your surgery.
Before weight loss surgery, the Advanced BMI dietitian will help prepare your kitchen and ensure you have the appropriate appliances – such as a food processor, a blender, measuring cups and spoons – and he/she will check that you have the correct foods for your transition diet once discharged from the hospital. The dietitian will also be available to you for counseling during the first three-month post-surgery period, and thereafter when required.
Advanced BMI Dietitian will perform a nutritional assessment, which will include the following:
- The history of your weight
- Any previous weight-loss attempts
- The social, professional, and cultural factors that may be affecting your weight
- Your alcohol intake
- Dietary patterns
- Your physical activity levels
- Your physical limitations
- Your level of motivation in making long-term changes
With all the above information at hand, the dietitian can accurately identify any barriers that could affect the success of your bariatric surgery.
Besides, the dietitian will work with you to create a preoperative nutritional plan, which will be in effect until your surgery date has been set. Recommendations could include the reduction of high-in-fat foods, having meal-replacement shakes for breakfast, reducing your intake of sweet foods, packing a lunch instead of eating fast food on the run, having fruit as snacks, replacing your evening snack for half a meal-replacement shake, and taking some dietary supplements. The dietitian’s role is vital to the success or failure of your bariatric surgery.
The Psychologist’s Role
Some patients seeking bariatric surgery have a history of depression and/or compulsive eating (psychological disorders). However, psychological disorders do have a tendency to improve following weight loss surgery.
Morbid obesity is the result of a combination of many factors, all coming together to create problems that never end. Compulsive eating is a very common disorder and it plays a huge role in gaining weight: it is responsible for poor outcomes following surgery for weight loss.
The weight loss surgery does make it difficult to consume large quantities of food, but it does not make it impossible, nor does it make the compulsion to eat go away. This, unfortunately, is the reason why many compulsive eaters will regain a lot of their lost weight around ten years post-surgery. Psychological screening provides an accurate sense of which patients should do well after surgery, and which patients could struggle. If Dr Safa refers you to the psychologist pre-surgery then he is looking for a psychological baseline in order to help you more effectively following surgery.
Again, following surgery, Dr Safa may request a follow-up appointment with the psychologist for one or more of several reasons:
- compulsive overeating
- marital or sexual problems
- dissatisfaction with body image
- suicidal thoughts, and/or
- ‘Addiction Transfer’