Dr. Bhoyrul shares the factors that lead to successful weight loss with bariatric surgery and discusses how a woman can determine which bariatric surgery procedure is best for her.
I tell my patients this is a 50/50 deal. My 50 percent: doing an excellent operation and choosing the right operation for you. Your 50 percent: making the exercise, lifestyle and food choices to go with the surgery.
So in order to get a successful operation you and your doctor need to have a great mutually accountable relationship. I need to be accountable to your concerns, you need to be accountable to mine. If we get that relationship off the ground we are going to have a great time. We will have very successful results.
From my part you know that means the experience doing the right surgery and then doing what we do and doing it often and well. From your part it means complying with the program.
It means making the right food choices. It means working with our dietician to know how to eat and what to eat, when to eat. It means working on some sort of exercise program, and it means taking part of all the resources that we have in the office.
It’s not just the surgery. We have dieticians, clinical psychologists, support groups. The successful patient will take advantage of all these resources. The successful patient will empower herself and will say, “I am going to make my health my priority. I am going to make time to exercise. I am going to make time to avoid some of the food choices that could defeat the surgery.”
So again, a woman who is very self-empowered, a woman who is very accountable to her doctor, a doctor is very accountable to his patient, I think that’s what leads to extra long-term result, that 50/50 deal, if you like.
Well one recommendation I have is that, see a group or a surgical group that offers more than one operation. I think sometimes many surgeons will offer just operation, will say, you’ve got to have a LAP-BAND®, or you’ve got to have a bypass.
And the truth is as surgeons or as doctors we need to find the right operation for the right patient. That’s not always straightforward, and ultimately we listen to the patient. Ultimately I might say that I think that the bypass is the best operation for you and you might decide you want the LAP-BAND® and as long as you are going into it with your eyes opened, that’s okay.
But there are certain things, patients whose body mass index, whose overall size is greater than about 60, patients who have really bad diabetes, who are on say more than a 100 units of insulin a day, patients who cannot have access to Band adjustments because of where they live, that group of patients might be much better off getting a gastric bypass.
Then there are other things – patients who want to have children, patients who want to have a quick procedure so they can get back to work really fast, patients who want to have an operation that is easily reversible, that group of patient might be better off with the LAP-BAND®.
So again, and there are different characteristics, different patient needs and characteristics that favor one operation in some instances, and another operation in other instances. And the important thing is to have a medical group that has more than one surgery and can tailor the right surgery to the right set of circumstances.
About Dr. Sunil Bhoyrul, M.D.:
Dr. Sunil Bhoyrul, M.D., is the award-winning surgeon in charge of the bariatric surgery program at La Jolla Weight Management. He is a fellowship-trained specialist in laparoscopic surgery and an attending surgeon at Scripps Memorial Hospital in La Jolla, California and Alvarado Hospital in San Diego. Previously, Dr. Bhoyrul was the head of general surgery and surgical director of bariatric surgery at the Scripps Clinic. Each year since 2005, Dr. Bhoyrul has been selected by his peers as one of the “Best Doctors in America.” He was also honored with San Diego’s “Top Doctor” award for 2008.
Visit Dr. Bhoyrul at Alvarado Hospital