Is there a risk of rejection of the device implanted during a digestive procedure for obesity?

Thus far, there have been no reported cases of the gastric band being rejected. The band is made mainly from silicone and is tolerated very well by the body in the long term. The band never comes into contact with either the blood circulation or food. The body will rapidly form a casing approximately 1 cm thick round it.

Can I get pregnant after surgery for obesity?

Obesity in itself constitutes a major risk in the development of a pregnancy, both for the mother (eclampsia, diabetes, delivery by Caesarean section) and the child (high birth weight). So it is best to approach pregnancy with a weight approaching normal. Nevertheless, no surgical technique used for obesity is without risk. In fact, a gastric band has the enormous advantage of being able to be opened fully and to allow the pregnant woman to eat as she wishes and to manage her nausea better at the beginning of the pregnancy and her acid refluxes at the end. As the gastric band is essentially restrictive, it does not cause any metabolic disorder for either mother or child. The same cannot be said for malabsorptive techniques such as gastric bypasses or biliopancreatic diversions. In fact, it is impossible to halt the effect of this surgery. This means that close metabolic monitoring is essential to identify deficiencies in the ions, proteins and vitamins needed for the baby to develop properly.

Can I do sport after surgery for obesity?

If the procedure is performed by laparoscopy, patients can get back to sport very quickly. When the abdomen is opened up, precautions are necessary to avoid any parietal weakening. Sport is always part of handling obesity because it helps convert fat into leanness, tone the body and allow better control of bulimic urges.

Might I put weight back on after surgery for obesity?

Surgery alone has never been enough to guarantee weight loss. It must always be accompanied by a dietary programme to control calorie intake and control the metabolic disorders brought about by malabsorptive surgery.

Are all surgical procedures for obesity reversible?

Unfortunately NOT! It is important to remind the patient of this when selecting a surgical technique. ?At the current time, the gastric band is the only device that is 100% reversible. In fact, it can be opened fully by simply puncturing it (in case of pregnancy) or, if necessary, it can be removed by laparoscopy. The stomach will not be affected in any way and will allow any other treatment, if necessary. The same cannot be said for other techniques. Any stapling or bowel resection is irreversible. Difficult additional procedures to partially dismantle the device will be required to restore a semblance of normal transit. ?A gastric bypass permanently eliminates any access for investigations to identify ulcers or cancer of the 2nd half of the stomach. The bile ducts and pancreas can also no longer be accessed if there is obstruction by lithiasis and cancer.

Is there a risk of cancer after surgery for obesity?

Currently, there are no studies that establish any correlation between surgery for obesity and an increased risk of cancer. The gastric band does not modify the digestive process and the removal of toxins. A gastric bypass and biliopancreatic diversion themselves determine a digestive disorder. What effect will the regular and prolonged contact of undigested foods from which the toxins have not been removed have on the mucous membrane of the colon? Only the future will tell.

The more diets I go on, the fatter I get! Is that normal?

When you go on a diet, any loss of weight is not linked solely to the reduction in body fat. There is also the loss of water and muscle, which are responsible for rapid weight loss, particularly at the beginning of a diet and especially if the diet is not balanced. Many trendy ?lightning? diets pushed by magazines take advantage of this fact. Also, when your diet is too low in calories, your basal metabolism is reduced in proportion; it?s as though your body has switched to pilot light mode. So when you stop a diet that is too restrictive and poorly balanced, you can be sure of putting the weight back on, along with a good dose of discouragement. ?Every diet can help you lose weight, but none can claim to stop you putting the weight back on, except if you have lost some of your stores of fat. Hence the interest in analysing your body make-up regularly and making sure the diet is followed by a long period of dietary rehabilitation.

Are there any effective appetite suppressants?

Thus far, no-one has come up with a miracle drug that can stop you feeling hungry without creating serious side-effects. The drugs already on the market have side-effects, which limits their use. These are Orlistat (Xénical®), which acts by limiting the absorption of 30% of the fat ingested, but which also causes numerous unpleasant side-effects, and Sibutramine (Réductil®), which is only prescribed for patients with a BMI of over 30. The main side-effects of this drug are an increase in blood pressure and palpitations. The weight loss generated by dieting will gradually lower this pressure. And shortly there will be a new drug to bring new hope: Accomplia. The average weight loss observed using this drug and demonstrated in numerous studies, varied between 8 and 9% of the total starting weight. These drugs reduce the difficulty of keeping to a restrictive diet. But whatever, these drugs are limited to certain indications and are subject to strict medical checks. Other appetite suppressants, diuretics, thyroid hormones, and amphetamines have disappeared from pharmacy shelves to the relief of the medical world. Not forgetting those ?miracle? pills sold without prescription that are certain at least to make your wallet thinner.

What cosmetic damage do I have to worry about after losing weight ? and how can I avoid them?

The cosmetic damage caused to your body after losing weight depend on age, skin quality and speed with which the weight was lost. This last point alone ? speed ? is the only factor that can be controlled. We tend to support a slow but effective treatment, especially one that can be maintained in the long term. The body has often already suffered from rapid weight loss, so it serves no purpose to traumatise it again by sudden slimming. We believe that a weight loss of 2 kg per month is a correct and acceptable average.

What cosmetic damage do I have to worry about after losing weight ? and how can I avoid them?

Losing weight is one of the essential elements of treating high blood pressure in obese or overweight patients. A loss of 5 to 10% of body weight is often accompanied by a reduction ? and even the normalisation ? of blood pressure in over half of cases. With diabetes, getting obese patients with the disease to lose weight is the most effective treatment if it can be maintained over time. Reducing or returning glycaemia levels to normal significantly reduces the chances of cardiovascular diseases or damage to the retina from occurring.

Does my family doctor have the skills to monitor my nutrition?

Your GP is your best ally. In fact, Eurobesity operates as a huge network of doctors who work together by exchanging information immediately with one another and taking part in specific training courses for treating obesity. Your family doctor has signed up to a charter (click) that sets out a whole new approach to treatment and brings together a number of specialist areas that improve success levels and maintain your results in the long term.

What is the importance of exercise?

Physical activity in the broad sense includes all forms of movement and is not limited solely to doing sport. Walking at a sustained pace (walking fast) is an example of sustained physical exercise. Walking a minimum of 30 minutes a day, if possible every day of the week, helps burn off an additional 150 Kcal a day, representing a loss of approximately 8 kg over the year. When the amount of excess weight is high, physical activity should be resumed gradually after achieving sufficient weight loss to enable the patient to improve his physical ability ? and also after a cardiac assessment. That half-hour of walking can be split up across the day. To maintain a steady weight after slimming, it is also important to do a form of activity that enables you to develop muscle mass. Also, and this is important, the amount of energy you expend at rest (basic metabolism de base) will be high.

"Light" foods: worthwhile or hogwash?

Light products - a pure manufacturing creation - were developed at the beginning of the 1980s. There is no denying that "light" foods and dishes do meet "a need": to control your weight if you are prone to putting it on, and to replace "pleasure" foods by foods with fewer calories. These products meet the demand for food with less fat and sugar, and which hence have fewer calories. But in fact, the light products you can buy currently only reduce the number of calories we take in by the actual number taken away. For example, 10 g of light chocolate contain 50 Kcal, compared with 54 Kcal for ordinary chocolate. Most foods that are light in fat are much less pleasant to taste, hence the increase in glucides in the composition of these food to compensate for the flavour deficiency. This is the case with no-fat fruit yoghurt and fromage frais and cereal bars, which are sold with much advertising support. Most of these "light" products increase our blood sugar levels so that as the result of rather complex hormonal action, we are storing more and more body fat. So, rather than offering products that are somewhat out of balance, we would do better to develop balanced products whose impact on the body would maintain its hormonal balance thanks to a judicious choice of lean proteins, complex glucides and good lipids.

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