BMI, or body mass index, is a calculation to assess your weight-height relationship and make a preliminary determination of underweight, normal weight, overweight, or obese. Enter your weight and height to calculate your BMI.
Body Mass Index Chart
BMI
Weight Status
Below 18.5
Underweight
18.5-25.0
Normal
25.0-30.0
Overweight
30.0-40.0
Obese
40 and Above
Morbidly Obese
Gateway to long-term weightloss... Gateway to a NEW YOU!
Laparoscopic adjustable gastric banding is a newer weight loss surgery that can be done at less risk than gastric bypass. In fact, worldwide, laparascopic gastric banding is the most common weight loss surgery done. One of the companies that make these devices is the Allergan Incorporation and they manufacture what is called the Lap-Band and the Lab-Band is relatively new to America. It was approved for use by the FDA in June of 2001. What the Lap-Band is, is basically a silicone band that we will put around the top of the stomach. Inside of this band is a balloon, and that balloon is connected to a tubing which is then connected to a port. We put this port underneath the skin, onto the muscle layer of the belly wall. This port is completely hidden from view. No one will ever see it, no one will ever know it is there. After surgery, we are able to access that port and then we can blow up the balloon on the inside of the Lap-Band. When we blow up that balloon on the inside of the Lap-Band, we call that an adjustment, and it turns out that adjustments are critical for success after Lap-Band surgery. Once that Lap-Band is placed, a person typically eats about six bites of food, the pouch gets full, and the person stops eating. In addition, the longer that food sits in the pouch, the longer that person stays full. Commonly, a person will stay full for 3 to 4, even 5 hours after eating about six bites of food. That is the magic of the Lap-Band. It allows a person to eat less food and to stay full longer. The issue with a Lap-Band is, is simply the Lap-Band can be defeated. The Lap-Band can be defeated far easier than gastric bypass and that is a limitation of Lap-Band surgery. Not everyone who gets a Lap-Band is going to have success. For a person to have success, they really need to have consistent lifestyle changes and our office goes into great detail of what a person needs to do for success with Lap-Band surgery and how people can defeat the Lap-Band.
One of the most amazing advancements in medical care has been the use of laparoscopic techniques to perform surgery, what we call minimally invasive surgery. Now, when I started doing bariatric surgery in 2002, I started doing the open gastric bypass, but as years went by and I learned the laparoscopic technique, one thing became very clear, a laparoscopic gastric bypass is vastly better than the open gastric bypass. There are simply so many reasons why. First of all, there is much less scarring, the recovery is much quicker. Also, complications, I believe are diminished with a laparoscopic approach. Having a hernia or infections are very unusual after the laparascopic gastric bypass. In addition, I also believe that you can create a much smaller pouch laparoscopically than you can with the open procedure and I believe that really does have an impact on the long-term weight loss. I believe the laparascopic gastric bypass is so much better than the open that I no longer will perform that open operation. In fact, it has been since 2004 that I have done my last open gastric bypass.
Clearly today, gastric bypass is the best weight loss surgery available today. There is no question about it. Gastric bypass is the best and it is also the most common weight loss surgery done in America. When we do a gastric bypass, what we are doing is at the very top of the stomach, we are creating a smaller stomach or what we call a pouch and we are creating this pouch at the very top of the stomach so it is about the size of an egg. In a gastric bypass, we staple that off and completely separate it from the rest of the stomach. The pouch is completely divided from the rest of the stomach. Then, we go to the small intestine. We disconnect the small intestine, we bring one end of the small intestine up and we re-attach it to the pouch. The other end of the small intestine is reconnected down below. So, after gastric bypass when you eat food, food goes from your mouth into the pouch, then it goes straight into your small intestine. You bypass majority of your stomach, you bypass the duodenum and early small intestine, and that is where your digestion and absorption occurs, in your duodenum and early small intestine. So, after gastric bypass, there are actually two mechanisms whereby people lose weight. One, there is a small pouch that causes restriction and secondly we re-route your intestine so you have what is called a malabsorption, meaning after gastric bypass when you eat food, the body simply does not digest and absorb it normally. After gastric bypass, patient’s typically lose a lot of weigh and they lose it quickly. It is common for people to lose 50 or 80 pounds in the first few months after gastric bypass, because you are eating food and the body simply is not absorbing it normally and the body relies on the fat stores to fuel the body. After about six months, the effects of the malabsorption start to go away and after about a year to year and half, patients typically stop losing weight after gastric bypass.
When a person becomes morbidly obese, it turns out that nothing seems to work so that the person will lose substantial weight and keep the weight off year after year. Nothing seems to work. The only thing that does work happens to be weight loss surgery and weight loss surgery is not new. It has actually been around since the 1950s, but a lot of the early weight loss surgeries, which were called intestinal bypass procedures, a lot of those patients died and a lot of those patients had bad complications. So, from the very beginning, weight loss surgery had a pretty bad reputation. Now, the first operation that came along that was fairly good operation and that could be done fairly safely was the vertical banded gastroplasty and most people know that because it is also called the stomach stapling and the stomach stapling has been around since the 1960s. When you do a stomach stapling, what you are doing is, you are making a very small pouch at the very top of the stomach and once you have a very small pouch, then a person can only eat a small amount of food, the pouch gets full, the person feels full and the person stops eating and that is exactly how the stomach stapling works. It is called a restrictive procedure. Now, a lot of people did lose weight after stomach stapling but the problem was, a lot of things could happen and the bottom line is a lot of people gained their weight back after stomach stapling. Nowadays, it is very rare to find any surgeon in America who would do a stomach stapling for one very simple reason, there are other operations.
