Being overweight is a serious medical condition. Along with problems like sleep apnea, shortness of breath, chronic joint pain, and infertility, there are some very serious health risks directly linked to severe obesity. Problems like diabetes, high blood pressure, high cholesterol, and heart disease are common in people who are seriously overweight. These can be life-threatening conditions. If you suffer from any of these conditions, you should seek treatment.

You should also examine the role your obesity plays as an underlying health problem and the treatment options available to you.

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In 1991, the U.S. Government’s National Institutes on Health (NIH) held a consensus conference on surgery for weight loss and established certain minimum criteria. If you are contemplating having the surgery, you must be at least 100 pounds overweight (based upon the Metropolitan Life Insurance charts for an individual of the same sex and height)(*link to Height/weight chart) or 200% of your ideal body weight.
Weight loss surgery candidates must have made prior attempts at weight loss through non-surgical means. They must also have other health problems caused or worsened by their weight. In addition, they must undergo a psychological clearance to assure their compliance with a post-surgical diet. The Center for Comprehensive Weight Loss (CCWL) has established other strict criteria to assure that patients lose the appropriate weight after surgery and to protect patients from unnecessary surgical risks. This comprehensive approach to screening patients is one of the qualities that make the CCWL program better for you.

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There are many different surgical procedures for weight loss. Only two, the Roux-en-Y Gastric Bypass and the Vertical Banded Gastroplasty have been approved by the U.S. Government’s National Institutes of Health. All other procedures are considered experimental and may represent greater risk.

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Your family doctor’s familiarity with weight loss surgery will depend upon his/her training and experience. Some physicians are familiar with older, experimental weight loss surgeries such as stomach stapling, jaw wiring, the jejuno-ileal bypass, or other unsuccessful procedures that are generally not practiced today. Since 1991, the Roux-en-Y Gastric Bypass and the Vertical Banded Gastroplasty are the only approved procedures.

Today, leading medical centers throughout the country perform the Roux-en-Y Gastric Bypass. Physicians who trained at these centers will be very familiar with the procedure and its results. If your family doctor requires more information, please let us know. We will be pleased to provide references from leading medical journals such as The New England Journal of Medicine, The Journal of the American Medical Association, Mayo Clinic Proceedings, and many others. Additionally, your family doctor may wish to speak with a CCWL surgeon that performs weight loss surgery.

The Roux-en-Y Gastric Bypass has steadily gained credibility as the procedure of choice among patients and surgeons alike. After nearly 20 years and hundreds of thousands of procedures, the Roux-en-Y Gastric Bypass has demonstrated a track record of successful long-term weight loss with few complications or side effects. The Roux-en-Y Gastric Bypass combines three elements to induce long-term weight loss. It creates volume restriction, which makes you feel full after eating smaller portions, behavior modification by creating discomfort after consuming foods high in refined sugar, and malabsorption by reducing the number of calories your body will absorb.

Click here for more in-depth information about the Roux-en-Y Gastric Bypass procedure.

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During the Roux-en-Y Gastric Bypass, the stomach is separated into two parts. The top portion becomes a small pouch that will allow you to eat only a few ounces of food before feeling full. The lower portion of the stomach continues to function normally, however it no longer digests food.

Next, one end of the small intestine is attached to the new small pouch of the upper stomach. The other end is reattached further down the small intestine, creating the "Y" junction. This allows the juices that continue to be created by the lower stomach to reach the small intestine further "down stream." This also allows your body to digest and absorb calories at a slower rate.

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The Roux-en-Y Gastric Bypass generally takes 60 to 90 minutes to perform. Following the procedure, you will be carefully monitored and spend an average of 3 to 4 days in the hospital.

A multi-disciplinary team will participate in your care and treatment as part CCWL’s comprehensive weight loss surgery program.

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The Roux-en-Y helps you lose weight in three different ways: volume restriction, behavior modification and malabsorption.

Volume restriction is achieved by reducing the size of the upper stomach. The Roux-en-Y procedure restricts the volume of food you can eat before feeling full. This means you will eat fewer calories, helping you lose weight.

The changes in your small intestine create a behavioral modification component. You will develop an intolerance for foods high in refined sugar due to an effect called "dumping syndrome." Similar to insulin shock in a diabetic patient, this condition causes cold sweats and nausea but no harmful health effects. It will help you avoid foods high in calories and refined sugars, and further contribute to your weight loss.

Besides reducing the volume of food you can eat, the Roux-en-Y will create the effect of malabsorbtion. Because food does not pass through a portion of your small intestine, and the digestive juices from your stomach do not reach the food until it has reached the "Y" junction, your body will absorb calories at a slower rate. This will also help you lose weight.

In addition CCWL’s focus on nutrition and exercise will help you establish proper nutrition and exercise habits further improving your weight loss and quality of life.

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At CCWL, our objective is to see you lose at least 75% of your excess weight (the difference between your weight at the time of surgery and your ideal weight) and keep it off permanently. While results vary, patients are expected to lose on average, one-third of their excess weight within three months, two-thirds within twelve months, and at least three-quarters within eighteen months after surgery.

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Post-surgically, patients frequently report an improvement in other health problems they’ve experienced. For example, some insulin dependent diabetics report they no longer require insulin. Also, many patients who previously had high cholesterol, high blood pressure, cardiac problems, joint problems, respiratory problems, and infertility, report major improvement.

Again, results vary by individual and not all patients report improvement.
In addition to weight loss, many patients enjoy increased energy and greater interest in physical activity. Many patients also report increased self-confidence as they lose weight and several have reported professional or career advancement. After surgery, individuals who have not been employed report more job opportunities. Employed individuals generally have reduced absenteeism and tardiness.

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Every surgical procedure has certain risks. Fortunately, at the leading medical centers where the CCWL programs are established, the risks of weight loss surgery are no greater than any other type of major stomach surgery. While they are infrequent and effect only a very small number of patients, some risks include infection, pneumonia, gastric leaks, pulmonary embolism, and in rare cases, death. If you are interested in having weight loss surgery, the surgical risks will be discussed with you in greater detail helping you make an informed decision about the Roux-en-Y Gastric Bypass procedure or other surgical procedures.

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Following surgery, you will be on a clear liquid diet and ultimately progress to normal foods over a 1-2 month period. You will not be able to lift heavy objects for several months and will not be able to return to work for 4-6 weeks. Individual patients may progress at different rates, so keep in mind that these are averages. Additionally, women should not attempt to become pregnant in their first year after surgery.

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Yes. Our nutritionists are registered dieticians who will meet with you prior to surgery, during your hospital stay, and after surgery if you like, to advise you on proper nutrition. Although you will need to advance from a clear liquid diet to normal food over a 1-2 month period, you will be able to eat many of the same foods you enjoy today after your second post-surgical month. You may not be able to eat sweets or red meat.

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No. You will not need to purchase special foods. However, you will be encouraged to select foods lower in fat and sugar when you go to the grocery store. Further, protein supplements and vitamin supplements are encouraged.

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Most insurance companies provide benefits for weight loss surgery. The courts have ruled that being severely overweight is a disability under the Americans with Disabilities Act. They have further ruled that health insurance plans cannot discriminate against the severely overweight in providing health insurance benefits. This means that your insurance carrier is required to provide health insurance benefits for the severely overweight on a non-discriminatory basis. To assist you, we will work with your insurance carrier to assure that your case is pre-approved.

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Selecting a physician and hospital for weight loss surgery is just as important as the decision to have the surgery. It is critical to select a center that provides a comprehensive multi-disciplinary program based upon the right procedure - the Roux-en-Y Gastric Bypass.

Avoid physicians performing experimental procedures or experimental versions of the Roux-en-Y. Surgeons, other physicians, nurses, nutritionists, psychologists and fitness trainers should be routinely available. The staff should also be well trained and experienced.

Surgeons should be board-certified in general surgery, have significant abdominal surgery experience, and be well respected by their peers. Surgeons with subspecialty training and experience are a plus. The Medical Center where your surgery is performed should be licensed and JCAHO accredited, and equipped with an intensive care unit, strong diagnostic capabilities such as CT Scanning, 24-hour physician coverage and a full range of medical specialists on staff to assist you.

Specialized equipment and furnishings should be in place to create a warm comforting environment. Staff should be specially trained and customer service oriented. After your surgery, it is also important that an exercise and fitness component be part of the weight loss effort. Additionally, you will want access to support groups so you can discuss post-surgical issues with other patients.

The Centers For Comprehensive Weight Loss meet these criteria and more to help provide our patients with a comprehensive surgical weight loss experience.

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Your post-surgical results will depend upon selecting the right health care providers for your surgery. Avoid going to an inexperienced physician or hospital that does not provide staff to manage your other medical issues, provide nutritional counseling and offer psychological support. Make sure your hospital has the comprehensive diagnostic support and equipment in place so, in the unlikely event that post-surgical complications occur, you will not need to be transported to another hospital. Smaller hospitals may provide limited services for you, unlike full-service medical centers such as those where CCWL programs are established. Lastly, avoid a program where support groups are not available. You need to meet with fellow patients for support and to discuss common issues.