WakeMed Bariatric Surgery & Medical Weight Loss

Overview

WakeMeds Bariatric Surgery and Medical WeightLoss program is a comprehensive, evidencebased approach designed to help adults with obesity achieve lasting weight loss and improve overall health. The program combines surgical options, medically supervised lifestyle modification, nutritional counseling, and ongoing support from a multidisciplinary team.

Why Choose WakeMed?

• Accredited Center: Recognized by the American Society for Metabolic and Bariatric Surgery (ASMBS) for high standards of care.
• Multidisciplinary Team: Surgeons, endocrinologists, dietitians, psychologists, and exercise physiologists work together.
• StateoftheArt Facilities: Minimally invasive technology, 24hour intensive care, and sameday discharge for select procedures.
• PatientCentric Care: Individualized treatment plans that focus on longterm success, not just the operation.

Who Qualifies?

Eligibility is based on Body Mass Index (BMI) and health status. Typical criteria include:

• BMI 40 kg/m (with or without obesityrelated conditions).
• BMI 3539.9 kg/m with at least one serious comorbidity (type2 diabetes, hypertension, sleep apnea, etc.).
• BMI 3034.9 kg/m for patients with uncontrolled type2 diabetes or metabolic syndrome, evaluated on a casebycase basis.

A comprehensive evaluationincluding medical history, psychological assessment, and nutritional reviewis required before any procedure is recommended.

Surgical Options

1. Laparoscopic Sleeve Gastrectomy (LSG)

Removes ~80% of the stomach, creating a tubeshaped sleeve that restricts food intake. It is the most commonly performed bariatric operation at WakeMed and has a strong track record for weight loss and diabetes remission.

2. Laparoscopic RouxenY Gastric Bypass (LRYGB)

Creates a small gastric pouch and bypasses a portion of the small intestine, providing both restriction and malabsorption. It is especially effective for patients with severe gastroesophageal reflux disease (GERD) or need for rapid diabetes control.

3. Laparoscopic Adjustable Gastric Band (LAGB) Limited Availability

Adjustable silicone band placed around the upper stomach. It is less commonly performed due to lower longterm weightloss outcomes compared with LSG and LRYGB.

4. Endoscopic Sleeve Gastroplasty (ESG)

A minimally invasive, incisionfree option performed via an endoscope. It reduces stomach volume through suturing and is suitable for patients with BMI 3040 who prefer a reversible procedure.

All surgeries are performed laparoscopically (keyhole) whenever possible, resulting in shorter hospital stays, less pain, and quicker return to daily activities.

Medical WeightLoss Program

For patients who are not surgical candidates or who prefer a nonoperative route, WakeMed offers a structured medical weightloss program that includes:

• Pharmacotherapy (GLP1 agonists, SGLT2 inhibitors, etc.)
• Personalized nutrition counseling
• Behavioral counseling and cognitivebehavior therapy
• Physical activity coaching
• Regular monitoring of labs, vital signs, and progress

The program is tailored to each individuals lifestyle, medical history, and weightloss goals.

PreOp Preparation

Preparation begins with a thorough evaluation:

1. Medical Review: Blood work, cardiac screening, sleep study if indicated.
2. Psychological Assessment: Ensures readiness and identifies support needs.
3. Nutrition Education: Patients learn about the postoperative diet stages (liquid, pureed, soft, regular).
4. PreSurgery Weight Loss: Most surgeons ask for a modest loss (510%) to reduce liver size and surgical risk.