I lost 77 pounds since March 15, 2018. I had the gastric bypass. Recovery for me was very rough for about 4 months, but I have many medical issues. I am so happy I did the bypass. I went from 100 mg bp Med to 25 mg
Absolutely best video I've seen in my research re: bariatric surgery! Thank you so much. Just read thru your many responses to the myriad of comments & learned some more! Keep Well & safe. We need you here.
Excellent Video! I appreciate you so much for taking the time in educating us. This video is extremely helpful! Blessings to you and your Family! Thanks
Love this video because it manages to describe more in-depth concepts about the two main bariatric procedures, like the matabolic factors which are rarely discussed in videos this size.
I will be getting the sleeve! This was a very informative video. It helped me to understand better and feel comfortable with my decision, Thank you Dr. John !
Wow this video was amazing I just had bypass done 7/21/21 and I wanted to learn more about the surgery and you were very helpful. San Antonio right here 🙌🏼
I had one option in mind but now that i see this video my gut (ironic) lol, is telling me to do the other i wanted originally. Thabk you this video is amazing...
Hi thank for This video. It help me decide which of the surgeries I should get. And I’ve determined that the bypass is better for me because I have very severe acid reflux and I really would want that to go away. Thank you so much for helping me make a wise choice.
Well I got my first consultation next month... wish me luck but in all honesty I'm leaning towards gastric bypass... Very helpful the video.. thank you..
@@user-rj4ho5yd5d I'm 7 years out still hard to remember to drink water through the day.i still eat small portions like a 1cup of food if I listen to my body and stop eating.
In my experience the recovery for Sleeve and for gastric bypass is the same. I think 10 days is a pretty reasonable estimate, though I ask my patients to plan 2 weeks out of work because it's common to lack stamina during the first 2 weeks.
Thanks for your question Michael. If you’re referring to a hiatal hernia when you ask about stomach hernia, I can say generally that lots of folks have great success w hiatal hernia repair at the time of their sleeve operation. In order to know your particular risks and likely benefits you’ll need to talk with your own surgeon. Best of luck!!
Good evening Dr. Pilcher, I have a question if I may ask. I had a kidney and pancreas transplant in 2011 all due to diabetes as a child. Over the seven year period I have gained a about a hundred pounds due to the anti rejection drug Prednisone. I deal with quite a bit of swelling . Do you think the gastric sleeve would help?
I agree that the weight gain can be a serious medical problem, and that Sleeve surgery could be a useful intervention for you. However, the prednisone that you take for kidney transplant protection does interfere significantly with healing, and the percentage of leak is much higher for patients on prednisone. On balance, I think it would be worthwhile to meet with an experienced bariatric surgeon in your area to discuss the overall risk/benefit. Best wishes!
Hoping the doc still sees this but im looking into getting the gastric bypass and i just wanted to know now i eat a pretty large portion how much will it get cut down cause as much as i want the change its going to be hard every celebration is usually with food and if your at Christmas dinner and can only eat 3 or 5 bites and maybe a few drinks of water or something like i feel like the adaptations would be super hard
Hello Mr. Garcia, and thanks for asking. In my experience, both Sleeve and Gastric Bypass patients are very restricted in their eating for the first 4-6 weeks. Then as the tissues naturally heal, patients with both types of surgery are able to eat "small normal" amounts of food. Patient experience in terms of food capacity seems almost identical between the two, and patients report they are fully satisfied. One of my other TH-cam videos talks a lot about the natural evolution of the gastric pouch and how patients can eat in a basically normal way: th-cam.com/video/vhi-WM1MnKc/w-d-xo.html
Hi Dr. John, I am reading about the prophylactic antibiotic for gastric sleeve and bypass is there a guideline or different medications for sleeve and bypass? Thank you.
Mark, thanks for your question. There are often differences in the prophylactic antibiotics used for gastric bypass vs sleeve. The differences are specific to each practice and may change from time to time, so I'd have a hard time giving you a detailed specific answer. My best recommendation is to speak to your actual surgeon (if applicable) about their practice.
When you refer to "normal absorption of nutrients" does that include medicines as well? Will I have to increase my dosage or will dosage most likely stay the same? (In reference to the gastric sleeve). I would appreciate a reply. Thanks.
Yes ma'am, my experience is that medications are absorbed normally after either the Sleeve or Gastric Bypass. Only a few medications such as coumadin and maybe thryoid medication need dose adjustment, while the vast majority of meds including those for blood pressure, depression, cholesterol, etc are unchanged.
Yes, thank you doctor! If im 19 years old and BMI 45.2 due to antidepressants since 16 i gained weight until 375 pounds my max weight then i lost weight until 310 pounds without exercises and i want to get a bariatric surgery do i qualify this it made me so depressed. i have bcbstx how do i know if it have coverage and what do i need for get it approved... i dont know which one is better for me bypass or sleeve
Hello Margarita! I understand how the weight can be a big burden, and I think it's a really respectable accomplishment to lose 65 pounds as you've done. Still, at 310 pounds you do meet standard insurance criteria for bariatric surgery. The best way to find out if you have coverage and the best way to decide on the right procedure is to go ahead and find a good bariatric surgeon in your area. The surgeon's team will help with the insurance, and you can discuss procedure choice with the surgeon. Best of luck!
After one of these surgeries for patients to keep their vitamin level up, do you recommend using vitamin patches? Vitamin patches are being promoted quite a bit to bariatric patients to cut out the need for a vitamin to go through the digestive tract.
I am torn on which surgery to choose. My upper endoscopy showed gastritis and reflux. The doctor literally said "you take a lot of motrin, don't you?" So I am leaning towards bypass, but I am a severe migraine sufferer and after of not being able to take nsaids ever again. But if I already show signs of gastritis, if I choose sleeve would I still be st risk of developing ulcers if I continued my nsaid use?
Thanks for reaching out. To clarify: the gastric bypass is very sensitive to ulcers when patients take aspirin-related medicines and the Sleeve seems much less susceptible to ulcers. I hope this helps, but this sounds like a judgment call in your case and that will best be done in partnership with your bariatric surgeon.
This was very helpful. doing research for my girlfriend and I found your comments on both the sleeve and gastrectomy. I have my own ? why don't they do the band anymore. I have the band by the way and I love it lost 75pounds
Thanks for your comments! I'm glad the Band is working well for you, but for most patients it stops being helpful after a few years and starts to become a problem instead. Even after it is removed, the Band often leaves permanent damage and that's why it is almost never placed anymore.
Dear Oreo, There is not any broad surgical consensus about cannabis after gastric bypass. My own experience has not showed any harm to patients from occasional use. I’m not aware of any serious concerns about cannabis use in patients who have healed after sleeve. Either way, this is definitely something you should discuss with your surgeon before surgery is actually planned! Best of luck!
This is a smart question to ask. We believe that both the Sleeve and the Gastric Bypass have their main beneficial effects through hormone changes, but the exact mechanism of the hormone changes created by the Gastric Bypass is unclear. There are valid competing theories that are sometimes called the 'foregut' theory and the 'hindgut' theory; it will probably take years more of research to fully understand.
Im 353lbs at 5'6 my bmi is 57 I have high BP and suffer from depression i have heartburn often but not daily what would u recommend the bypass or the sleeve as a doctor.
Thanks for your question Ms. Reed! I think the choice needs to be made in concert with your bariatric surgeon, who will be able to incorporate their experience and their direct evaluation of your case. Best of luck on your journey!
Hi Ms Stoner, I can’t be sure because we need the combination of height and weight together to calculate your body mass index. The body mass index is used to define whether you “qualify“ from an insurance perspective. Unless you are really short, it is unlikely you would meet standard insurance criteria for coverage at a weight of 175 pounds. Nevertheless, depending on your medical conditions and past history it might still be appropriate for you to meet a surgeon in your area to see if surgery is sensible from a risk/benefit standpoint, which is different than the insurance perspective. Thanks for your question!
When assisting a patient to decide which surgery to have, do their co-morbidities and their age have a significant role in best surgery to choose? I am 66 y/o with DM II, HTN, Hypercholesterolemia (unable to take statins due to side effects), and on CPAP. I look at this as my ONE true shot...like I said, I'm 66 y/o. Had originally discussed sleeve with my doc but since then have been reading that often time the RNY can give more long-term co-morbidity positive results. Because I haven't been able to be on statins due to severe muscle pain (cholesterol 240 last time I checked) and likely won't be in the future I am concerned particularly about the potential for my labs to creep up with the sleeve. So..my question is...what is your experience with older Sleevers and RNY'ers in regards to this? Any sharing of your knowledge/experience would be greatly appreciated.
Patti C, You’re asking a great question and I really respect that you’re doing everything you can to get the most out of your operation! I don’t think that age is a big factor that distinguishes between Sleeve vs Gastric Bypass, though in fairness older people have a slower metabolism and typically lose a bit less weight. As you saw in the video, the stats are a bit better for diabetes resolution after Gastric Bypass, but the Sleeve is no slouch and should help you a lot if you choose that option. Last comment - I definitely recommend for you to take your surgeon’s opinion into account. He/she most likely has a reason for a preference. Best of luck!
If you take Thyroid medicine would the sleeve be a better choice because of absorbtion? I have also had 3 c sections and need to lose about 160 more lbs.I have already lost 55lbs.
I understand your question, since gastric bypass has gotten the reputation as a malabsorptive procedure. But in fact, medicines absorb normally for both gastric bypass and Sleeve.
Thanks for your question. Definitely not normal, and likely preventable. Please check my video on this subject: th-cam.com/video/Heu-UG0cZaM/w-d-xo.html
Hello, in the current state of medical knowledge, one should never PLAN to reverse a bariatric operation because it is very likely you will regain all the weight. Having said that, it is possible (though challenging and surgically risky) to undo the gastric bypass by putting the pieces back into place. I emphasize this should NOT be a plan, because you go through two serious challenging operations and it's quite possible to have gastrointestinal problems that never get "right" again. The Sleeve cannot be reversed or undone.
Kym Bee, Thanks for your question! As I'm sure you know, type one diabetes (insulin deficiency) is not directly treated by either sleeve for gastric bypass in the sense that neither one replaces the missing insulin. Nevertheless, the weight-loss assisted by either operation can be very helpful with improving the glucose control and reducing complications. Although there is no settled conclusion in the bariatric surgery community about which operation is a better choice for gastroparesis, my own experience has been more favorable with gastric bypass.
I have to pick between the gastric bypass or the sleeve. Which one is best ? I’m 23 and my BMI is over 40 . I’m trying lose up too 100 pounds that’s all . I don’t want to get too skinny but at a healthy weight
Thanks for checking in Ms. Kendrick! the way you've described yourself I think you're likely to do well with either operation. The next important thing is to have a good conversation with your surgeon when you meet him/her, because they will bring in other factors that may be important. Best of luck to you in your journey back to health!
Thanks for checking in Marilyn. Psoriasis for your husband should not be a factor against surgery, and his weight clearly is a factor in favor of surgery for him. On balance, I would clearly favor surgery, and I wish him the best of luck.
Great video, thanks! Best one I've seen on this subject! One question. Ok, two actually. Is there an advantage to one surgery over the other on the improvement of hypothyroidism or the hormones involving thyroid function? And, with the bypass, will you have dumping syndrome with just one bite of a desert?
Hi Jennifer, and thanks for your comment! I believe that neither Sleeve nor Gastric Bypass has a direct effect on thyroid function and I believe that absorption of thyroid meds is basically normal for both operations. Sometimes patients need "tweaks" of their thyroid meds as their metabolism changes but nothing sudden or dramatic. About dumping - most people with gastric bypass do NOT have dumping during normal daily life and most do have the occasional taste of a sweet. However to be honest there is some variability and just a few folks end up being quite sensitive to sweets....
Hello Lisa - you're correct that bariatric is usually medically appropriate at a BMI above 40. It's really important to stop smoking in order to minimize your surgical risk and for general health purposes. Even with a sting commitment to avoid smoking, those with a smoking history have a fairly high risk of resuming smoking at some point in the future. The Sleeve is a bit more tolerant of future smoking, so that procedure usually has a preference in a former smoker. Of course, a final decision should only be made in consultation with an experienced bariatric surgeon. Best of luck!
Doctor, I am confused between sleeve or bypass. I am 182cm and 146kg, I want sleeve as I am not happy to have vitamins lifetime with bypass, but I am afraid of reflux if I do sleeve. Any advice you can give me?
Thanks for your question, and kudos on doing your research. At this stage, it's best for you to discuss the options with your surgeon. In our experience, patients with a Sleeve need vitamins just as Gastric Bypass patients do. We have come around to recommending the same supplements after surgery for both operations. Best of luck on your journey!
Please explain the part where in the sleeve the stomach is removed son the hunger hormones can’t work, but in the bypass the stomach stays in your body. Won’t those hormones still be produced?
That's a great question Christine, and it will require a fairly complicated answer: 1) We surgeons focus on the removal/reduction of ghrelin when we remove the greater curve of the stomach in the Sleeve procedure, but in fact there's a lot more going on hormonally than just reduced hunger hormones. For example, there is improved insulin sensitivity/effectiveness, a shift of bile composition toward a lean (not overweight) profile, and a shift of the colon microbiome toward a lean profile. In other words, the Sleeve itself has a lot more going on than we surgeons usually describe. 2) There is no universally agreed theory about the hormone/appetite changes cause by the Gastric Bypass. For me, the theory that makes the most sense is the "foregut" theory that proposes that re-routing food flow past the duodenum (the "bypass" part of the operation) allows the body to respond in a more healthy/accurate way to food intake. The idea is that the duodenum, which receives food just out of the stomach in normal non-surgical anatomy, and which is sensory organ for the liver/pancreas, may mis-react or over-react to foods so that the hormones are out of balance in response to food, and so that food leads to more hunger instead of leading to satisfaction. The other leading theory of gastric bypass hormone effect is called the "hindgut" theory, and this has to do with stimulation of GLP-1 (and perhaps other hormones) when food arrives early in the ileum. These and other theories are not mutually exclusive, so it could be that more than one is active. I suspect my reply did not really clear things up, but you seemed to want a real answer. Suffice to say, both the Sleeve and the Gastric bypass have powerful hormonal effects that most often lead to less hunger and improved satisfaction.
Good morning Kristi, Many insurance plans do cover bariatric operations but there is tremendous variation among different employers and plans. The best way to know is to choose a good bariatric team in your area, then call that office and let their team run your insurance plan to check. Even if insurance doesn't cover, you may find that surgery is still a worthwhile investment in your health so check with the team about "out of pocket" prices as well. Best of luck! Dr JP
Hello Ms. Howard. Yes, it's possible to have the gastric bypass reversed but surgically it's a pretty big deal. You would begin the process (and consider if that's the best thing for you) by meeting with an experienced bariatric surgeon in your area. Best of luck on your journey!
@@DoctorJP thanks so much for your prompt response. This was a very informative video. After I posted my question I read that the procedure is for patients who have severe complications. I haven’t but just wanted to know if it was possible.
in your experience as a bariatric doctor i' would lean toward the sleeve except i'm suffer severely from gerd.. i have heard stories of the sleeve making gerd worse....
Thanks for watching! Your question about whether surgery can be done for a person who has had a kidney transplant makes sense, because having had a kidney transplant does add a significant degree of medical complexity. Nevertheless, undertaking a Bariatric Surgery procedure can still be a useful approach as long as it is coordinated between your transplant team and the bariatric team. Most likely, the best way forward is to ask your transplant team for a referral to an experienced bariatric surgeon in your area. Best of luck on your journey!
Thanks for your question. Gastroparesis is a tricky condition and results are not completely reliable with any surgical intervention, but in my experience gastric bypass has been more helpful than Sleeve. I wish you the best.
Thanks for your question Atassa. The medical statistics show that people live longer and live healthier than they do with the obesity disease. The statistics on having a baby after bariatric surgery are also favorable; as long as you take your vitamins before pregnancy you should have the same excellent chance of a healthy baby )or several babies!) as the normal-weight mother population. Best of luck on your journey!
I'm sorry but I'm not familiar with that variation or its purpose. Just looked on the web and found diagrams, but the diagrams did not shed a lot of light for me.
Thanks for asking! We're in the Medical Center in San Antonio. The office address is 9618 Huebner Rd. Suite #202. The office phone number is 210-651-0303. I look forward to meeting you!
Hello Marc, thanks for your question. I don't thing the gastric band is a good option. You can see more about my opinion here th-cam.com/video/gyI1mcG0iDs/w-d-xo.html
@@DoctorJP wow thank you Dr I just watched it. I won’t be getting the Ban. I’m 5’10 275 pounds, My doctor is giving me six months to lose weight otherwise he suggests surgery. If I fail at the gym I will do the surgery I just don’t want to lose weight too fast I do not want the extra skin hanging, how can I avoid that? I see it on people that lose weight too fast.
@@marcg777 To be honest, the skin will do what it's going to do, and at this point there's nothing you can do to affect it. Working out is great for weight loss and building muscle is good for all kinds of reasons as well as filling out the skin, but probably doesn't affect the end result. The pace of weight loss looks like a factor, because the skin shrinkage is very slow and steady, over about 18 months. However, it seems that each person's skin has 'X' ability to shrink and it's just going to do that (slowly) regardless of the pace of the weight loss. The favorable factors for skin shrinkage are: 1) younger age 2) no smoking history 3) skin not already too stretched out So, the best results will come from intervention sooner rather than later.
im 19 years old and my BMI is 51.4 i know its really high that s why i wanna make a surgery but idk which one i should choose, any possible help? also quick info , i dont smoke at all , i dont have any diseases except obesity, i only drink alcohol but not that much and not even daily
Hi Ozz LB, at your young age and large weight, the idea of a bariatric operation definitely is appropriate for you to consider. While I think it's smart to get informed about your surgical options, the final decision is one you should make together with an experienced bariatric surgeon. So, I recommend that you research in your local area and find a surgeon who seems like a good fit for you. Best of luck!
Good questions! Iron absorption is diminished for both operations, seemingly in equal measure. For sure, a patient who has had either Sleeve or Gastric Bypass should take supplemental Iron in some form and should have their levels monitored over time to ensure successful Iron maintenance. Regarding Hashimoto's - this condition is unlikely to be impacted by either Sleeve or Gastric Bypass. Thyroid replacement medications are often recommended as a part of the treatment for Hashimoto's, and the absorption of thyroid meds seems to be normal after both operations.
lol not really! If you eat the wrong type of food (lots of carbs), you're likely to have foul gas, but mostly bowel function is normal. There is another operation call the Duodenal Switch that is well known for foul gas.
Nice video thanks Dr. I am 56 years old men and I don’t gave any medical problems , but I am 120kg weight and 172cm height.I have started to have knees tired and sometime a little uncomfortable. I don’t know if I am fit to do this operation or not? Since some of my brothers have diabetic problems and pressure, and my mother and dad died few years back with diabetes and pressure. I will appreciate your advice thanks .
Thanks very much for your question! At the height and weight you've described you certainly do meet established criteria for which one of these bariatric procedures would be very likely to improve your health. It's actually a good thing that you don't yet have diabetes, high blood pressure, or other serious medical conditions because you will have the least risk and the best chance to return to fully normal health. It would make sense to consult with a bariatric surgery specialist in your area. Best of luck!
Im soon getting gastric sleeve or gastric bypass what ever my dr decides which is best for me I did my research about gastric sleeve and gastric bypass for many years now ❤
Julie, I'm really sorry to hear the Sleeve is not working well for you. As you've probably seen in my other videos, research is showing that different interventions (both meds and different operations) can have a different "fit" depending on each person's specific metabolic imbalance. There's a good chance that a bariatric/metabolic specialist in your area can still help you. In Health, Dr JP
@@DoctorJP me too *tears*....im ALWAYS Still hungry...it feels like nothing changed...in a year i went from 260 to only 225....my friend went from 360 to 240 in a year. I cant understand why Im not losing weight.
Yes Kimberly that can be super frustrating. It could be that the Sleeve is not having the hormone impact that you need (sometimes it "misses the target") but obviously you've invested a lot of time and energy into the Sleeve so the smart move is to get all the benefit you can from the established surgery. My other video here th-cam.com/video/m6yc2opPOf4/w-d-xo.html may have some pertinent thoughts.
Hello doc. Nice video Just wanted to ask few questions ... I get stomach pain every month and that pain is worst pain of my life. I don't know if it's acid reflux or it happens because of shitt i eat outside. One thing i observed that it mostly happen when i eat lots of sweets and sugary products. Does that make sense ? Have you ever encountered someone like me ? Well the question was since i get this panic ache every month , would it be wise to with gastric bypass ? I hv heard that acid reflux is less in gastric bypass My height 5'10 Weights 120kg Age 21 BMI 37 No other diseases.
Thanks for checking in! Those intermittent pains could be due to reflux and spasm of your esophagus, but teasing out exactly what is going on will require a visit in person with a Gastro doc or a Bariatric surgeon. If you have reflux, then absolutely yes I agree the gastric bypass would be preferred over a Sleeve. Since you're a younger guy and your weight has not gone TOO high, you should have very low surgical risk and we would expect excellent outcomes from surgery. Best of luck!
@@DoctorJP thank you very much for your explanation Sir. Soon i am getting appointment at surgeon in Mumbai, India. Your reply gave me positive vibes. thanks again ! Good day
Thanks for asking Taylor. Sometimes patients who have complications from the sleeve like reflux need to change over to the gastric bypass. Sometimes people who have complications with the gastric bypass like an ulcer need to change over to the sleeve. These changes definitely are not “plan a“ but they are options if patients need a revision surgery over time.
The segment referring to absorption begins at approximately 2:10 on the video, and I tried to emphasize that I'm referring to normal FOOD absorption for the Sleeve and the Gastric Bypass. Both these operations result in reduced absorption of Iron, Vitamin B12, and probably some other micronutrients. I hope this is helpful for better clarity.
Thanks for your question Amber. There are probably different causes for the metabolic imbalance in different people, generally there is an interaction between susceptible genetics and early environmental factors. There is still lots of research that needs to be done, but you can get an expanded idea of my understanding from these two videos: Understanding the Obesity Disease - th-cam.com/video/X3B3UHTmGGk/w-d-xo.html Thermodynamics of Weight Loss - th-cam.com/video/7Vk_FoYSXJg/w-d-xo.html And yes, the gastric bypass is reversible because all the "parts" are still there. Reversal surgery is kind of a big deal, so it's something to be considered very cautiously.
Yes, the Sleeve does have a powerful positive effect on diabetes. But, long term results seem to show that the Sleeve impact on diabetes is not quite as durable as the Gastric Bypass. In other words, there seems to be a bit higher chance of Diabetes recurrence after initial remission for the Sleeve in comparison to Gastric Bypass.
Thanks for checking in Sagar. It's best for you to get advice from your own bariatric team since plans do vary from place to place. Nevertheless, I believe I'm safe in stating that tobacco use is very likely to cause an ulcer and that taking aspirin or similar meds (ibuprofen, naproxen, etc) also creates a large risk of ulcer.
Everyone has a little treat from time to time. The key thing from my perspective is to be intellectually honest, and make it up some other way if you do have a treat. You may also want to check my TH-cam about food relationships after bariatric surgery: th-cam.com/video/71f4E3dF0UE/w-d-xo.html
The bypass is more sucessful. I got the sleeve and wish I would've got the bypass. The bypass is way more successful than the sleeve. You are more likely to have permanent weightloss whereas the bypass your body doesn't really absorb any calories, that's why... I'm doing a revision from the sleeve to the bypass
He is not correct. I had the gastric bypass 18 years ago (2003) I have the melabsorption..I can't absorb alot..lost alot of vitamins during those years. Severe bone degenerative. 7 back surgeries..
Thanks for sharing your experience Brenda. As I mention in the video, there have been versions of the gastric bypass (and there still are) that involve malabsorption. Also, at the time you had your gastric bypass, we in the bariatric community had not learned how prevalent and how important Vitamin D deficiency is in the bariatric population.
I sincerely wish you the best of luck on your journey, though I feel compelled to say that my partners and I have not seen lasting favorable results with the balloon.
- A Estrogenic obese body is created by sugar and all high carbs ,refine carbs , frutose in fruit , toxic fatory food , fast food , The biggest problem with controlling diabetes and weight through diet is that people are lazy . You can lead a horse to water but can't force them to drink. Most people rather eat fast food , factory frozen food ,protein powder and dairy full of casein that destroy the cells in the pancreas and cause cancer (dairy is toxic) and take pills or shoot insulin than to change their shitty eating habits. We live in an "instant gratification" society full of lazy people with 0 discipline or work ethic. Sad but true. If you want to lose weight watch your intake of "carbs" , but be careful since the equivalent of 12 teaspoons of sugar happens very quickly. For example: 1 cup of milk equals = 2 teaspoons of sugar * 1 cup of rice (cooked) equals = 9 teaspoons of sugar* 1 banana equals equals = 5 teaspoons of sugar • 1 baked potato equals = 7 teaspoons of sugar • 1 sweet potato = 8 teaspoons of sugar • 1 cup of strawberries equals = 2.5 teaspoons of sugar (low sugar)* 1/2grapefruit = 2 teaspoons of sugar - Coca cola (one can) - 8.25 teaspoons of sugar - Raisin Bran cereal - 7.75 teaspoons of sugar (per 100grams) - Grapes fruit - 4 teaspoons of sugar (per 100grams) - Tomatoes - 0.7 teaspoons of sugar (per 100grams) - 1 Muffin (one chocolate chip muffin) - 4.75 teaspoons of sugar - Special K cereal - 3 teaspoons of sugar (per 100grams) - Corn Flakes - 2.4 teaspoons of sugar (per 100grams) - Alpen cereal - 5.75 teaspoons of sugar (per 100grams) - Mangos fruit - 3.2 teaspoons of sugar (per 100grams) - A cup of seedless prunes has, in effect, 25 teaspoons of sugar ! Scientists find in comparing the sugar levels in the blood after the consumption of a snickers bar that has 8.5 teaspoons of sugar the same as two bread slices ! . The sugar equivalent is of 1 large bagel a whopping 12 teaspoons of sugar ! Lastly, it is worth noting that there are many breads that a single slice of which will raise your blood sugar more than a US Snickers bar (which has a GI of 68/97)…if the Glycemic Index can be believed. to be healthy you must keep your blood sugar below 110 ..everything including eating protein will raise your insulin only water will not raise insulin , so eat small !! and do intermittent fasting . No carbs no cookies no excuse ! the less you eat the better you control your insulin and blood sugar and you gain no weight . if you're addicted to carbs and sweets you will not lose weight .Get rid of your addiction ! and control you mental health ...Cortisol and stress . You can browse the table yourself to see. I’ve included some of the more interesting ones below.Breads that have a higher Glycemic Index than a Snickers bar: Also don't eat fruit if your plan is to lose weight ; all fruit will cause your insulin to go up . Every morning Instead eat one lime or lemon (organic) with warm filtered water everyday , natural vitamin c from lime or lemons make your arteries strong and healthy and cleans your liver and kidneys water and lemon (warm) cold water is bad for your liver . For breakfast eat a high protein diet ..No refine carbs ,no fruit but eat salads every day ....If you feel hungry eat oat meal with no sugar this will calm down your hunger spams . anything you eat should be organic close to mother nature . Atkins diet ,paleo diet ,...or eat for your blood type are good diets for losing weight .Very important If you eat high protein diet make sure you take vitamin B-6 ,folic acid ,B-12 , choline , Vitamin C 3 grams a day to keep your homocysteins low in your blood so you dont get heart disease .Avoid all white flour and corn .Avoid damaged fats ,no cheese , no frying , no mayonnaise . no salad dressings. To detox your liver and bring down estrogen eat sulfur vegetables ,Brocollie ,cabage ,onions ,garlic ,Red beets et.. Best supplement for the liver is ..; ""Trimethylglycine"" (TMG) and "liopic cacid" take 600 mg a day best for liver health to lose weight and drink no acohol. Excess sugar eventually affects every organ in the body, but initially, it is stored in the liver in the form of glucose (glycogen). Since the liver’s capacity is limited, a daily intake of refined sugar (above the required amount of natural sugar) soon makes the liver expand like a balloon. When the liver is filled to its maximum capacity, the excess glycogen is returned to the blood in the form of fatty acids. These are taken to every part of the body and stored in the most inactive areas: the belly, the buttocks, the breasts and the thighs. But then it affects vital organs like the heart and the kidneys. Avoid all soy and flax seeds oils supplements : Though not a chemical estrogen, but it is a plant-based estrogen, and can throw off your hormonal balance. Eat a anti-estronic diet ,Vitamin B-6 ,100 mg a day its good to take to lower estrogen ; Work out: Studies show that exercise lowers estrogen levels. A 2011 study, for instance, found that premenopausal women who engaged in aerobic exercise for 300 minutes a week lowered total estrogen by nearly 19 percent. A 2013 study also found that aerobic exercise helps the body break down estrogen so it’s easier to flush away. Get enough sleep: When you don’t get enough sleep, you can not lose weight .. levels of the so-called “sleep” hormone melatonin are disrupted. Turns out that melatonin has a protective effect against excess estrogen. A 1999 study, for example, showed that melatonin helped block the growth of estrogen-induced cancer cells. Use a water filter: Public water supplies often contain chlorine, fluoride, and other industrial chemicals that act as xenoestrogens. Use a quality filter to reduce your exposure best book for weight lose ; The Obesity Code: Unlocking the Secrets of Weight Loss .www.amazon.com/Obesity-Code-Unlocking-Secrets-Weight/dp/1771641258 ,,,, jfproost
By far the most informative. Smoking and aspirin related medication were both mentioned. I’m using transdermal nicotine patches but it’s the first time I’ve heard those mentioned. Thank you 🙏
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This was by far the most informative and helpful video that I have seen!!
So glad this was helpful!
I agree! Thank you Doc!
I lost 77 pounds since March 15, 2018. I had the gastric bypass. Recovery for me was very rough for about 4 months, but I have many medical issues. I am so happy I did the bypass. I went from 100 mg bp Med to 25 mg
WOW !!! This doctor KNOWS his stuff! By FAR, the BEST informative Medical advice video I've EVER seen! ❤ THANK YOU !
Thanks so much! Best of luck, and Merry Christmas!!
So glad this was helpful! You are correct that for many patients, both the Sleeve and the Gastric Bypass are good choices.
Best of luck!
Absolutely best video I've seen in my research re: bariatric surgery! Thank you so much. Just read thru your many responses to the myriad of comments & learned some more! Keep Well & safe. We need you here.
Thanks very much, and best of luck on your journey!
Literally the best video ever. Even the photos and the explanations. Just wow. Thanks Doc.
Thanks for watching!
Excellent Video! I appreciate you so much for taking the time in educating us. This video is extremely helpful!
Blessings to you and your Family!
Thanks
Olympia StarGazer - thanks for your kind feedback!
Love this video because it manages to describe more in-depth concepts about the two main bariatric procedures, like the matabolic factors which are rarely discussed in videos this size.
Thanks very much for watching!
I will be getting the sleeve! This was a very informative video. It helped me to understand better and feel comfortable with my decision, Thank you Dr. John !
So glad it was helpful. Best of luck on your journey!
Thank you Dr. I just started this journey and I am looking at all of my options. This is a great video!
I’m glad this was useful!
Thank You Doctor
Wow this video was amazing I just had bypass done 7/21/21 and I wanted to learn more about the surgery and you were very helpful. San Antonio right here 🙌🏼
Thanks for watching, and best of luck on your journey!
Thank you Dr Pilcher. for the information.very helpful.
My pleasure. Thanks for watching!
THANK YOU...
FOR ALL THE...
INFORMATION....
My pleasure. Thanks for watching!
This is an amazing video and calmed my nerves. Thank you for this wonderful information.
So glad it was helpful - best of luck on your journey!
Thank you so much for this informative & easy to understand video!
So very welcome, and thanks for your feedback!
Thank you for such a great video. This was very informative.
You are so welcome! Best of luck with your journey!
great video doc i have to pick one of these surgeries.. in time...
Thanks for the thumbs up, and best of luck to you!
Such a helpful video !! Thank you!
Glad it was helpful! Best of luck on your journey!
Thank you for this information; very informative.
Carlett Jones You are most welcome, and thanks for looking in!
Very informative. Thank you!
Thanks for watching!
Thank you very much! Really informative video! :)
You're very welcome! Thanks for checking in!
I had one option in mind but now that i see this video my gut (ironic) lol, is telling me to do the other i wanted originally. Thabk you this video is amazing...
Thanks for checking it out. Best of luck on your journey!
Which one did you choose and how has it been?
Hi thank for This video. It help me decide which of the surgeries I should get. And I’ve determined that the bypass is better for me because I have very severe acid reflux and I really would want that to go away. Thank you so much for helping me make a wise choice.
Did you get the procedure? How did it effect you?
Very pleasant and informative , thank you
Thanks very much for watching!
Great video!!
So glad it was useful. Best of luck on your journey!
Well I got my first consultation next month... wish me luck but in all honesty I'm leaning towards gastric bypass...
Very helpful the video.. thank you..
Best of luck on your Journey!
I had the sleeve done and lost 100lbs the best thing I have done for myself.
Mommy 4 Life p mk xzliiixi aaaOpoooox. @yahoo"";,Opio@oo
@Carrie Davis is it hard to follow the program?
I just got approved cant wait to start my journey
@@rhondajohnson8062 it is but I gained and lost weight but haven't went back to my highest weight 277lbs. Good luck
@@user-rj4ho5yd5d I'm 7 years out still hard to remember to drink water through the day.i still eat small portions like a 1cup of food if I listen to my body and stop eating.
Wow such an informative video thankyou
Glad it was helpful!
Thank you very much...very good to understand
Thanks for watching, and best of luck on your journey!
Hi Dr. Plicher , thank you for your insight. I’m interested in the sleeve, but what is the recovery for this procedure? Same as bypass ? (10days)
In my experience the recovery for Sleeve and for gastric bypass is the same. I think 10 days is a pretty reasonable estimate, though I ask my patients to plan 2 weeks out of work because it's common to lack stamina during the first 2 weeks.
I have a stomach hernia and I chose to do sleeve, is this a good choice? What are the risks? as I am not a fan of the by bass
Thanks for your question Michael. If you’re referring to a hiatal hernia when you ask about stomach hernia, I can say generally that lots of folks have great success w hiatal hernia repair at the time of their sleeve operation. In order to know your particular risks and likely benefits you’ll need to talk with your own surgeon.
Best of luck!!
Thank u for the info my op is next week x
Best of luck!
Good evening Dr. Pilcher, I have a question if I may ask. I had a kidney and pancreas transplant in 2011 all due to diabetes as a child. Over the seven year period I have gained a about a hundred pounds due to the anti rejection drug Prednisone. I deal with quite a bit of swelling . Do you think the gastric sleeve would help?
I agree that the weight gain can be a serious medical problem, and that Sleeve surgery could be a useful intervention for you. However, the prednisone that you take for kidney transplant protection does interfere significantly with healing, and the percentage of leak is much higher for patients on prednisone. On balance, I think it would be worthwhile to meet with an experienced bariatric surgeon in your area to discuss the overall risk/benefit. Best wishes!
John Pilcher Thank you so much!
Hoping the doc still sees this but im looking into getting the gastric bypass and i just wanted to know now i eat a pretty large portion how much will it get cut down cause as much as i want the change its going to be hard every celebration is usually with food and if your at Christmas dinner and can only eat 3 or 5 bites and maybe a few drinks of water or something like i feel like the adaptations would be super hard
Hello Mr. Garcia, and thanks for asking. In my experience, both Sleeve and Gastric Bypass patients are very restricted in their eating for the first 4-6 weeks. Then as the tissues naturally heal, patients with both types of surgery are able to eat "small normal" amounts of food. Patient experience in terms of food capacity seems almost identical between the two, and patients report they are fully satisfied.
One of my other TH-cam videos talks a lot about the natural evolution of the gastric pouch and how patients can eat in a basically normal way:
th-cam.com/video/vhi-WM1MnKc/w-d-xo.html
Hi Dr. John, I am reading about the prophylactic antibiotic for gastric sleeve and bypass is there a guideline or different medications for sleeve and bypass? Thank you.
Mark, thanks for your question. There are often differences in the prophylactic antibiotics used for gastric bypass vs sleeve. The differences are specific to each practice and may change from time to time, so I'd have a hard time giving you a detailed specific answer. My best recommendation is to speak to your actual surgeon (if applicable) about their practice.
When you refer to "normal absorption of nutrients" does that include medicines as well? Will I have to increase my dosage or will dosage most likely stay the same? (In reference to the gastric sleeve). I would appreciate a reply. Thanks.
Yes ma'am, my experience is that medications are absorbed normally after either the Sleeve or Gastric Bypass. Only a few medications such as coumadin and maybe thryoid medication need dose adjustment, while the vast majority of meds including those for blood pressure, depression, cholesterol, etc are unchanged.
Excellent info
Thanks very much!
John Pilcher You are welcome 😊
Yes, thank you doctor!
If im 19 years old and BMI 45.2 due to antidepressants since 16 i gained weight until 375 pounds my max weight then i lost weight until 310 pounds without exercises and i want to get a bariatric surgery do i qualify this it made me so depressed. i have bcbstx how do i know if it have coverage and what do i need for get it approved... i dont know which one is better for me bypass or sleeve
Hello Margarita!
I understand how the weight can be a big burden, and I think it's a really respectable accomplishment to lose 65 pounds as you've done. Still, at 310 pounds you do meet standard insurance criteria for bariatric surgery. The best way to find out if you have coverage and the best way to decide on the right procedure is to go ahead and find a good bariatric surgeon in your area. The surgeon's team will help with the insurance, and you can discuss procedure choice with the surgeon.
Best of luck!
Hello, do you know ketogenic diet? Give it a go before surgery
After one of these surgeries for patients to keep their vitamin level up, do you recommend using vitamin patches?
Vitamin patches are being promoted quite a bit to bariatric patients to cut out the need for a vitamin to go through the digestive tract.
Thanks for your question. To my knowledge, there are not any vitamin patches that have been proven to actually absorb.
I am torn on which surgery to choose. My upper endoscopy showed gastritis and reflux. The doctor literally said "you take a lot of motrin, don't you?" So I am leaning towards bypass, but I am a severe migraine sufferer and after of not being able to take nsaids ever again. But if I already show signs of gastritis, if I choose sleeve would I still be st risk of developing ulcers if I continued my nsaid use?
Thanks for reaching out. To clarify: the gastric bypass is very sensitive to ulcers when patients take aspirin-related medicines and the Sleeve seems much less susceptible to ulcers. I hope this helps, but this sounds like a judgment call in your case and that will best be done in partnership with your bariatric surgeon.
This was very helpful. doing research for my girlfriend and I found your comments on both the sleeve and gastrectomy. I have my own ? why don't they do the band anymore. I have the band by the way and I love it lost 75pounds
Thanks for your comments! I'm glad the Band is working well for you, but for most patients it stops being helpful after a few years and starts to become a problem instead. Even after it is removed, the Band often leaves permanent damage and that's why it is almost never placed anymore.
If you use cannibus for anxiety can you still use it once you have healed? I know cigarettes are a no no but what about that?
Dear Oreo,
There is not any broad surgical consensus about cannabis after gastric bypass. My own experience has not showed any harm to patients from occasional use. I’m not aware of any serious concerns about cannabis use in patients who have healed after sleeve. Either way, this is definitely something you should discuss with your surgeon before surgery is actually planned!
Best of luck!
with Bypass, does the stomach that's still there but disconnected at the top, still pump out Ghrelin to the brain?
This is a smart question to ask. We believe that both the Sleeve and the Gastric Bypass have their main beneficial effects through hormone changes, but the exact mechanism of the hormone changes created by the Gastric Bypass is unclear. There are valid competing theories that are sometimes called the 'foregut' theory and the 'hindgut' theory; it will probably take years more of research to fully understand.
Im 353lbs at 5'6 my bmi is 57 I have high BP and suffer from depression i have heartburn often but not daily what would u recommend the bypass or the sleeve as a doctor.
Thanks for your question Ms. Reed! I think the choice needs to be made in concert with your bariatric surgeon, who will be able to incorporate their experience and their direct evaluation of your case. Best of luck on your journey!
Dr. Pilcher . Do I qualified for sleeve surgery. I'm 175.00 lbs. Thanks for the information.
Hi Ms Stoner,
I can’t be sure because we need the combination of height and weight together to calculate your body mass index. The body mass index is used to define whether you “qualify“ from an insurance perspective. Unless you are really short, it is unlikely you would meet standard insurance criteria for coverage at a weight of 175 pounds. Nevertheless, depending on your medical conditions and past history it might still be appropriate for you to meet a surgeon in your area to see if surgery is sensible from a risk/benefit standpoint, which is different than the insurance perspective.
Thanks for your question!
When assisting a patient to decide which surgery to have, do their co-morbidities and their age have a significant role in best surgery to choose? I am 66 y/o with DM II, HTN, Hypercholesterolemia (unable to take statins due to side effects), and on CPAP. I look at this as my ONE true shot...like I said, I'm 66 y/o. Had originally discussed sleeve with my doc but since then have been reading that often time the RNY can give more long-term co-morbidity positive results. Because I haven't been able to be on statins due to severe muscle pain (cholesterol 240 last time I checked) and likely won't be in the future I am concerned particularly about the potential for my labs to creep up with the sleeve. So..my question is...what is your experience with older Sleevers and RNY'ers in regards to this? Any sharing of your knowledge/experience would be greatly appreciated.
Patti C,
You’re asking a great question and I really respect that you’re doing everything you can to get the most out of your operation!
I don’t think that age is a big factor that distinguishes between Sleeve vs Gastric Bypass, though in fairness older people have a slower metabolism and typically lose a bit less weight.
As you saw in the video, the stats are a bit better for diabetes resolution after Gastric Bypass, but the Sleeve is no slouch and should help you a lot if you choose that option.
Last comment - I definitely recommend for you to take your surgeon’s opinion into account. He/she most likely has a reason for a preference.
Best of luck!
If you take Thyroid medicine would the sleeve be a better choice because of absorbtion? I have also had 3 c sections and need to lose about 160 more lbs.I have already lost 55lbs.
I understand your question, since gastric bypass has gotten the reputation as a malabsorptive procedure. But in fact, medicines absorb normally for both gastric bypass and Sleeve.
Is it normal to get low blood sugar after bypass waking up 3 5 am due to low blood sugar feeling shaky and weak?
Thanks for your question. Definitely not normal, and likely preventable. Please check my video on this subject: th-cam.com/video/Heu-UG0cZaM/w-d-xo.html
Hello Doctor i wanted to ask can this procedures be re done if i want to go back to my normal state as before after the surgery in few years to come
Hello, in the current state of medical knowledge, one should never PLAN to reverse a bariatric operation because it is very likely you will regain all the weight. Having said that, it is possible (though challenging and surgically risky) to undo the gastric bypass by putting the pieces back into place. I emphasize this should NOT be a plan, because you go through two serious challenging operations and it's quite possible to have gastrointestinal problems that never get "right" again.
The Sleeve cannot be reversed or undone.
Dr Pilcher Which WLS is best for Type 1 patients with Gastroparesis?
Kym Bee,
Thanks for your question! As I'm sure you know, type one diabetes (insulin deficiency) is not directly treated by either sleeve for gastric bypass in the sense that neither one replaces the missing insulin. Nevertheless, the weight-loss assisted by either operation can be very helpful with improving the glucose control and reducing complications.
Although there is no settled conclusion in the bariatric surgery community about which operation is a better choice for gastroparesis, my own experience has been more favorable with gastric bypass.
Thank you Dr Pilcher for your reply and knowledge...
I have to pick between the gastric bypass or the sleeve. Which one is best ? I’m 23 and my BMI is over 40 . I’m trying lose up too 100 pounds that’s all . I don’t want to get too skinny but at a healthy weight
Thanks for checking in Ms. Kendrick! the way you've described yourself I think you're likely to do well with either operation. The next important thing is to have a good conversation with your surgeon when you meet him/her, because they will bring in other factors that may be important.
Best of luck to you in your journey back to health!
Great Question! As I am in the same boat of trying to decide!
My husband weighs 482lbs we are considering surgery because he is a nationwide truck driver. My husband suffers from psoriasis would that be a factor?
Thanks for checking in Marilyn. Psoriasis for your husband should not be a factor against surgery, and his weight clearly is a factor in favor of surgery for him. On balance, I would clearly favor surgery, and I wish him the best of luck.
Great video, thanks! Best one I've seen on this subject! One question. Ok, two actually. Is there an advantage to one surgery over the other on the improvement of hypothyroidism or the hormones involving thyroid function? And, with the bypass, will you have dumping syndrome
with just one bite of a desert?
Hi Jennifer, and thanks for your comment! I believe that neither Sleeve nor Gastric Bypass has a direct effect on thyroid function and I believe that absorption of thyroid meds is basically normal for both operations. Sometimes patients need "tweaks" of their thyroid meds as their metabolism changes but nothing sudden or dramatic. About dumping - most people with gastric bypass do NOT have dumping during normal daily life and most do have the occasional taste of a sweet. However to be honest there is some variability and just a few folks end up being quite sensitive to sweets....
@@DoctorJP Also, this was one of the studies I had in mind in posing my question. Thanks!
www.ncbi.nlm.nih.gov/m/pubmed/28255851/
Hi John!
Im 20 years old and have a BMI 46.6.
I have smoked before but just quiting.
Which operation is to prefer ?
Hello Lisa - you're correct that bariatric is usually medically appropriate at a BMI above 40. It's really important to stop smoking in order to minimize your surgical risk and for general health purposes. Even with a sting commitment to avoid smoking, those with a smoking history have a fairly high risk of resuming smoking at some point in the future. The Sleeve is a bit more tolerant of future smoking, so that procedure usually has a preference in a former smoker. Of course, a final decision should only be made in consultation with an experienced bariatric surgeon.
Best of luck!
Choose keto
Lisa Karlsson to do is
If
Doctor, I am confused between sleeve or bypass. I am 182cm and 146kg, I want sleeve as I am not happy to have vitamins lifetime with bypass, but I am afraid of reflux if I do sleeve. Any advice you can give me?
Thanks for your question, and kudos on doing your research. At this stage, it's best for you to discuss the options with your surgeon.
In our experience, patients with a Sleeve need vitamins just as Gastric Bypass patients do. We have come around to recommending the same supplements after surgery for both operations.
Best of luck on your journey!
Please explain the part where in the sleeve the stomach is removed son the hunger hormones can’t work, but in the bypass the stomach stays in your body. Won’t those hormones still be produced?
That's a great question Christine, and it will require a fairly complicated answer:
1) We surgeons focus on the removal/reduction of ghrelin when we remove the greater curve of the stomach in the Sleeve procedure, but in fact there's a lot more going on hormonally than just reduced hunger hormones. For example, there is improved insulin sensitivity/effectiveness, a shift of bile composition toward a lean (not overweight) profile, and a shift of the colon microbiome toward a lean profile. In other words, the Sleeve itself has a lot more going on than we surgeons usually describe.
2) There is no universally agreed theory about the hormone/appetite changes cause by the Gastric Bypass. For me, the theory that makes the most sense is the "foregut" theory that proposes that re-routing food flow past the duodenum (the "bypass" part of the operation) allows the body to respond in a more healthy/accurate way to food intake. The idea is that the duodenum, which receives food just out of the stomach in normal non-surgical anatomy, and which is sensory organ for the liver/pancreas, may mis-react or over-react to foods so that the hormones are out of balance in response to food, and so that food leads to more hunger instead of leading to satisfaction. The other leading theory of gastric bypass hormone effect is called the "hindgut" theory, and this has to do with stimulation of GLP-1 (and perhaps other hormones) when food arrives early in the ileum. These and other theories are not mutually exclusive, so it could be that more than one is active.
I suspect my reply did not really clear things up, but you seemed to want a real answer. Suffice to say, both the Sleeve and the Gastric bypass have powerful hormonal effects that most often lead to less hunger and improved satisfaction.
Dose insurance such as partnership pay for these types of surgery’s
Good morning Kristi, Many insurance plans do cover bariatric operations but there is tremendous variation among different employers and plans. The best way to know is to choose a good bariatric team in your area, then call that office and let their team run your insurance plan to check. Even if insurance doesn't cover, you may find that surgery is still a worthwhile investment in your health so check with the team about "out of pocket" prices as well. Best of luck!
Dr JP
I had gastric bypass. What would need to happen or is it really possible to have my bypass reversed?
Hello Ms. Howard. Yes, it's possible to have the gastric bypass reversed but surgically it's a pretty big deal. You would begin the process (and consider if that's the best thing for you) by meeting with an experienced bariatric surgeon in your area.
Best of luck on your journey!
@@DoctorJP thanks so much for your prompt response. This was a very informative video. After I posted my question I read that the procedure is for patients who have severe complications. I haven’t but just wanted to know if it was possible.
in your experience as a bariatric doctor i' would lean toward the sleeve except i'm suffer severely from gerd.. i have heard stories of the sleeve making gerd worse....
Thanks for your feedback Rose! I agree that the Gastric Bypass is a better treatment for reflux. Best of luck to you!
Very well explained.
Can a person who has had a kidney transplant have this done?
Thanks for watching! Your question about whether surgery can be done for a person who has had a kidney transplant makes sense, because having had a kidney transplant does add a significant degree of medical complexity. Nevertheless, undertaking a Bariatric Surgery procedure can still be a useful approach as long as it is coordinated between your transplant team and the bariatric team. Most likely, the best way forward is to ask your transplant team for a referral to an experienced bariatric surgeon in your area. Best of luck on your journey!
Would you recommend the sleeve over the bypass with someone who has idiopathic gastroparesis?
Thanks for your question. Gastroparesis is a tricky condition and results are not completely reliable with any surgical intervention, but in my experience gastric bypass has been more helpful than Sleeve. I wish you the best.
John Pilcher Thank you very much for your answer! This is helpful information for me, as I am in the beginning stages of bariatric surgery.
Thanks dr i want to do it but am afraid how long you live after doing the sleeve can you make kids after
Thanks for your question Atassa. The medical statistics show that people live longer and live healthier than they do with the obesity disease. The statistics on having a baby after bariatric surgery are also favorable; as long as you take your vitamins before pregnancy you should have the same excellent chance of a healthy baby )or several babies!) as the normal-weight mother population.
Best of luck on your journey!
Doctor, what do you think of gastric sleeve with loop bipartition?
I'm sorry but I'm not familiar with that variation or its purpose. Just looked on the web and found diagrams, but the diagrams did not shed a lot of light for me.
@@DoctorJP Thank you Doctor, It's like a combination of both sleeve and bypass.
My doctor asked me to choose he did not offer opinion to which surgery to choose .
Thanks for your comment Lamia. I hope this video is helpful in your decision. Best of luck in your weight loss journey!
Where is your office located? I'm interested in a consultation
Thanks for asking! We're in the Medical Center in San Antonio. The office address is 9618 Huebner Rd. Suite #202. The office phone number is 210-651-0303. I look forward to meeting you!
Thank you Dr . What do you think about these 2 compare to the Ban ?
Hello Marc, thanks for your question. I don't thing the gastric band is a good option. You can see more about my opinion here th-cam.com/video/gyI1mcG0iDs/w-d-xo.html
@@DoctorJP wow thank you Dr I just watched it. I won’t be getting the Ban. I’m 5’10 275 pounds, My doctor is giving me six months to lose weight otherwise he suggests surgery. If I fail at the gym I will do the surgery I just don’t want to lose weight too fast I do not want the extra skin hanging, how can I avoid that? I see it on people that lose weight too fast.
@@marcg777 To be honest, the skin will do what it's going to do, and at this point there's nothing you can do to affect it. Working out is great for weight loss and building muscle is good for all kinds of reasons as well as filling out the skin, but probably doesn't affect the end result.
The pace of weight loss looks like a factor, because the skin shrinkage is very slow and steady, over about 18 months. However, it seems that each person's skin has 'X' ability to shrink and it's just going to do that (slowly) regardless of the pace of the weight loss.
The favorable factors for skin shrinkage are:
1) younger age
2) no smoking history
3) skin not already too stretched out
So, the best results will come from intervention sooner rather than later.
im 19 years old and my BMI is 51.4 i know its really high that s why i wanna make a surgery but idk which one i should choose, any possible help?
also quick info , i dont smoke at all , i dont have any diseases except obesity, i only drink alcohol but not that much and not even daily
Hi Ozz LB, at your young age and large weight, the idea of a bariatric operation definitely is appropriate for you to consider. While I think it's smart to get informed about your surgical options, the final decision is one you should make together with an experienced bariatric surgeon. So, I recommend that you research in your local area and find a surgeon who seems like a good fit for you.
Best of luck!
Ketogenic diet?
@@AlmazulVortex Keto doesn't work for everyone
@@dr.farahali6375 Ayurveda then
What about Iron and hypothyroid Hashi's sufferers?
Good questions! Iron absorption is diminished for both operations, seemingly in equal measure. For sure, a patient who has had either Sleeve or Gastric Bypass should take supplemental Iron in some form and should have their levels monitored over time to ensure successful Iron maintenance.
Regarding Hashimoto's - this condition is unlikely to be impacted by either Sleeve or Gastric Bypass. Thyroid replacement medications are often recommended as a part of the treatment for Hashimoto's, and the absorption of thyroid meds seems to be normal after both operations.
I'm thinking about it,but I'm kind of nervous of being too small after it, I know I need to do more Homework on it
Great that you're looking it over. Best of luck!
Is it true that farts smell more bad with gastric bypass surgery?
lol not really! If you eat the wrong type of food (lots of carbs), you're likely to have foul gas, but mostly bowel function is normal. There is another operation call the Duodenal Switch that is well known for foul gas.
Nice video thanks Dr. I am 56 years old men and I don’t gave any medical problems , but I am 120kg weight and 172cm height.I have started to have knees tired and sometime a little uncomfortable.
I don’t know if I am fit to do this operation or not? Since some of my brothers have diabetic problems and pressure, and my mother and dad died few years back with diabetes and pressure.
I will appreciate your advice thanks .
Thanks very much for your question! At the height and weight you've described you certainly do meet established criteria for which one of these bariatric procedures would be very likely to improve your health. It's actually a good thing that you don't yet have diabetes, high blood pressure, or other serious medical conditions because you will have the least risk and the best chance to return to fully normal health.
It would make sense to consult with a bariatric surgery specialist in your area.
Best of luck!
Thank you a lot Dr for your advice.God bless you and your family.thanks
Which operation do you advice me bypass or sleeve?.
@@mytube3687 I appreciate your question, but the best option for you should be decided with the bariatric surgeon that you choose. Stay well!
Im soon getting gastric sleeve or gastric bypass what ever my dr decides which is best for me I did my research about gastric sleeve and gastric bypass for many years now ❤
Best of luck!
Is dual a mini gastric?
I had the sleeve done I'm always still hungry and still have cravings it sucks
Julie,
I'm really sorry to hear the Sleeve is not working well for you. As you've probably seen in my other videos, research is showing that different interventions (both meds and different operations) can have a different "fit" depending on each person's specific metabolic imbalance.
There's a good chance that a bariatric/metabolic specialist in your area can still help you.
In Health,
Dr JP
Me too
@@DoctorJP me too *tears*....im ALWAYS Still hungry...it feels like nothing changed...in a year i went from 260 to only 225....my friend went from 360 to 240 in a year. I cant understand why Im not losing weight.
Yes Kimberly that can be super frustrating. It could be that the Sleeve is not having the hormone impact that you need (sometimes it "misses the target") but obviously you've invested a lot of time and energy into the Sleeve so the smart move is to get all the benefit you can from the established surgery. My other video here th-cam.com/video/m6yc2opPOf4/w-d-xo.html may have some pertinent thoughts.
Hello doc. Nice video
Just wanted to ask few questions ...
I get stomach pain every month and that pain is worst pain of my life. I don't know if it's acid reflux or it happens because of shitt i eat outside. One thing i observed that it mostly happen when i eat lots of sweets and sugary products.
Does that make sense ? Have you ever encountered someone like me ? Well the question was since i get this panic ache every month , would it be wise to with gastric bypass ? I hv heard that acid reflux is less in gastric bypass
My height 5'10
Weights 120kg
Age 21
BMI 37
No other diseases.
Thanks for checking in! Those intermittent pains could be due to reflux and spasm of your esophagus, but teasing out exactly what is going on will require a visit in person with a Gastro doc or a Bariatric surgeon. If you have reflux, then absolutely yes I agree the gastric bypass would be preferred over a Sleeve. Since you're a younger guy and your weight has not gone TOO high, you should have very low surgical risk and we would expect excellent outcomes from surgery.
Best of luck!
@@DoctorJP thank you very much for your explanation Sir. Soon i am getting appointment at surgeon in Mumbai, India. Your reply gave me positive vibes. thanks again ! Good day
jack meHoff 8
Has anyone had both done?
Thanks for asking Taylor. Sometimes patients who have complications from the sleeve like reflux need to change over to the gastric bypass. Sometimes people who have complications with the gastric bypass like an ulcer need to change over to the sleeve. These changes definitely are not “plan a“ but they are options if patients need a revision surgery over time.
I have thyroid problem can I do sleeve
As long as your medical doctor has your thyroid in balance, it should not interfere with bariatric surgery. Best of luck!
Will thyriod Cure permanently if we bypass ......can you please it will be helpful for my mom
Bariatric surgery typically does not affect thyroid function.
If the patients get normal absorption from the bypass and the sleeve then why do they have to take minerals and vitamins for life?
The segment referring to absorption begins at approximately 2:10 on the video, and I tried to emphasize that I'm referring to normal FOOD absorption for the Sleeve and the Gastric Bypass. Both these operations result in reduced absorption of Iron, Vitamin B12, and probably some other micronutrients. I hope this is helpful for better clarity.
Thank you for replying and clearing my misconception.
You mentioned that our control system gets out of control. Can you explain how that happens?
Is bypass surgery reversible?
Thanks for your question Amber. There are probably different causes for the metabolic imbalance in different people, generally there is an interaction between susceptible genetics and early environmental factors. There is still lots of research that needs to be done, but you can get an expanded idea of my understanding from these two videos:
Understanding the Obesity Disease - th-cam.com/video/X3B3UHTmGGk/w-d-xo.html
Thermodynamics of Weight Loss - th-cam.com/video/7Vk_FoYSXJg/w-d-xo.html
And yes, the gastric bypass is reversible because all the "parts" are still there. Reversal surgery is kind of a big deal, so it's something to be considered very cautiously.
@@DoctorJP thank you for the response! The video is very informative.
So does the sleeve surgery works for type 2 diabetes ???
Yes, the Sleeve does have a powerful positive effect on diabetes. But, long term results seem to show that the Sleeve impact on diabetes is not quite as durable as the Gastric Bypass. In other words, there seems to be a bit higher chance of Diabetes recurrence after initial remission for the Sleeve in comparison to Gastric Bypass.
@@DoctorJP thank you so much 🙏
What about daily living issues?
Thanks for your question, but I don't really understand what you're asking?
Forgot to say, BMI 42.
What is the price to a Sleeve Gastrectomy?
Here in San Antonio, for patients who are at the earlier stages of the obesity disease (not too many surgery risk factors), the rate is $9,400
Ok...Thank you for responding :)
€3000 euros in turkey
New sub here🎉
Thanks for watching - best of luck on your journey!
Hey doctor i am from nepal and i had a gastric bypass what types of food should i eat to stay away from ulsar ??
Thanks for checking in Sagar. It's best for you to get advice from your own bariatric team since plans do vary from place to place. Nevertheless, I believe I'm safe in stating that tobacco use is very likely to cause an ulcer and that taking aspirin or similar meds (ibuprofen, naproxen, etc) also creates a large risk of ulcer.
This is big with people that are over sized
i wish i was half as cool while talking as this guy.
lol thanks. Just putting on video, the conversations I have with patients every day.
Can I ever eat sugar again?
Everyone has a little treat from time to time. The key thing from my perspective is to be intellectually honest, and make it up some other way if you do have a treat. You may also want to check my TH-cam about food relationships after bariatric surgery: th-cam.com/video/71f4E3dF0UE/w-d-xo.html
I came for info about gastric bypass, and stayed for your book selection:
Lord of the Rings
The Watchmen
Blah Blah Blah
Well done, sir. :)
lol, thanks. All the background is supposed to be out of focus!
The bypass is more sucessful. I got the sleeve and wish I would've got the bypass. The bypass is way more successful than the sleeve. You are more likely to have permanent weightloss whereas the bypass your body doesn't really absorb any calories, that's why... I'm doing a revision from the sleeve to the bypass
Best of luck on your journey Kimberly!
For More Information :
th-cam.com/video/3InULDDKuVw/w-d-xo.html
Wish I have money to do it
Yes, and I'm so sorry that financial factors are a barrier to so many people getting the care they need and deserve. No easy solutions...
He is not correct. I had the gastric bypass 18 years ago (2003) I have the melabsorption..I can't absorb alot..lost alot of vitamins during those years. Severe bone degenerative. 7 back surgeries..
Thanks for sharing your experience Brenda. As I mention in the video, there have been versions of the gastric bypass (and there still are) that involve malabsorption. Also, at the time you had your gastric bypass, we in the bariatric community had not learned how prevalent and how important Vitamin D deficiency is in the bariatric population.
I'm just going to get the balloon
I sincerely wish you the best of luck on your journey, though I feel compelled to say that my partners and I have not seen lasting favorable results with the balloon.
Okk.me too.
Off subject, but you look like Michael J. Fox.
lol thanks!
- A Estrogenic obese body is created by sugar and all high carbs ,refine carbs , frutose in fruit , toxic fatory food , fast food , The biggest problem with controlling diabetes and weight through diet is that people are lazy . You can lead a horse to water but can't force them to drink. Most people rather eat fast food , factory frozen food ,protein powder and dairy full of casein that destroy the cells in the pancreas and cause cancer (dairy is toxic) and take pills or shoot insulin than to change their shitty eating habits.
We live in an "instant gratification" society full of lazy people with 0 discipline or work ethic. Sad but true. If you want to lose weight watch your intake of "carbs" , but be careful since the equivalent of 12 teaspoons of sugar happens very quickly. For example:
1 cup of milk equals = 2 teaspoons of sugar *
1 cup of rice (cooked) equals = 9 teaspoons of sugar*
1 banana equals equals = 5 teaspoons of sugar •
1 baked potato equals = 7 teaspoons of sugar •
1 sweet potato = 8 teaspoons of sugar •
1 cup of strawberries equals = 2.5 teaspoons of sugar (low sugar)*
1/2grapefruit = 2 teaspoons of sugar -
Coca cola (one can) - 8.25 teaspoons of sugar -
Raisin Bran cereal - 7.75 teaspoons of sugar (per 100grams) -
Grapes fruit - 4 teaspoons of sugar (per 100grams) -
Tomatoes - 0.7 teaspoons of sugar (per 100grams) -
1 Muffin (one chocolate chip muffin) - 4.75 teaspoons of sugar -
Special K cereal - 3 teaspoons of sugar (per 100grams) - Corn Flakes -
2.4 teaspoons of sugar (per 100grams) - Alpen cereal -
5.75 teaspoons of sugar (per 100grams) - Mangos fruit -
3.2 teaspoons of sugar (per 100grams) -
A cup of seedless prunes has, in effect, 25 teaspoons of sugar ! Scientists find in comparing the sugar levels in the blood after the consumption of a snickers bar that has 8.5 teaspoons of sugar the same as two bread slices ! .
The sugar equivalent is of 1 large bagel a whopping 12 teaspoons of sugar !
Lastly, it is worth noting that there are many breads that a single slice of which will raise your blood sugar more than a US Snickers bar (which has a GI of 68/97)…if the Glycemic Index can be believed.
to be healthy you must keep your blood sugar below 110 ..everything including eating protein will raise your insulin only water will not raise insulin , so eat small !! and do intermittent fasting . No carbs no cookies no excuse ! the less you eat the better you control your insulin and blood sugar and you gain no weight . if you're addicted to carbs and sweets you will not lose weight .Get rid of your addiction ! and control you mental health ...Cortisol and stress .
You can browse the table yourself to see. I’ve included some of the more interesting ones below.Breads that have a higher Glycemic Index than a Snickers bar: Also don't eat fruit if your plan is to lose weight ; all fruit will cause your insulin to go up .
Every morning Instead eat one lime or lemon (organic) with warm filtered water everyday , natural vitamin c from lime or lemons make your arteries strong and healthy and cleans your liver and kidneys water and lemon (warm) cold water is bad for your liver .
For breakfast eat a high protein diet ..No refine carbs ,no fruit but eat salads every day ....If you feel hungry eat oat meal with no sugar this will calm down your hunger spams . anything you eat should be organic close to mother nature .
Atkins diet ,paleo diet ,...or eat for your blood type are good diets for losing weight .Very important If you eat high protein diet make sure you take vitamin B-6 ,folic acid ,B-12 , choline , Vitamin C 3 grams a day to keep your homocysteins low in your blood so you dont get heart disease .Avoid all white flour and corn .Avoid damaged fats ,no cheese , no frying , no mayonnaise . no salad dressings.
To detox your liver and bring down estrogen eat sulfur vegetables ,Brocollie ,cabage ,onions ,garlic ,Red beets et.. Best supplement for the liver is ..; ""Trimethylglycine"" (TMG) and "liopic cacid" take 600 mg a day best for liver health to lose weight and drink no acohol.
Excess sugar eventually affects every organ in the body, but initially, it is stored in the liver in the form of glucose (glycogen). Since the liver’s capacity is limited, a daily intake of refined sugar (above the required amount of natural sugar) soon makes the liver expand like a balloon. When the liver is filled to its maximum capacity, the excess glycogen is returned to the blood in the form of fatty acids.
These are taken to every part of the body and stored in the most inactive areas: the belly, the buttocks, the breasts and the thighs. But then it affects vital organs like the heart and the kidneys.
Avoid all soy and flax seeds oils supplements : Though not a chemical estrogen, but it is a plant-based estrogen, and can throw off your hormonal balance. Eat a anti-estronic diet ,Vitamin B-6 ,100 mg a day its good to take to lower estrogen ; Work out: Studies show that exercise lowers estrogen levels. A 2011 study, for instance, found that premenopausal women who engaged in aerobic exercise for 300 minutes a week lowered total estrogen by nearly 19 percent.
A 2013 study also found that aerobic exercise helps the body break down estrogen so it’s easier to flush away. Get enough sleep: When you don’t get enough sleep, you can not lose weight .. levels of the so-called “sleep” hormone melatonin are disrupted.
Turns out that melatonin has a protective effect against excess estrogen. A 1999 study, for example, showed that melatonin helped block the growth of estrogen-induced cancer cells. Use a water filter: Public water supplies often contain chlorine, fluoride, and other industrial chemicals that act as xenoestrogens. Use a quality filter to reduce your exposure best book for weight lose ; The Obesity Code: Unlocking the Secrets of Weight Loss .www.amazon.com/Obesity-Code-Unlocking-Secrets-Weight/dp/1771641258
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jfproost
By far the most informative. Smoking and aspirin related medication were both mentioned. I’m using transdermal nicotine patches but it’s the first time I’ve heard those mentioned.
Thank you 🙏
Thanks for watching - best of luck on your journey!