I want to be a good example for my daughters.

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2 I want to be a good example for my daughters. I chose weight loss surgery because I want to be healthy. I was very overweight, often short of breath and experienced hip and knee pain from carrying around extra weight. I tried 11 different weight loss programs. I would lose five to 20 pounds but gain it right back. I am a middle school teacher and spend time walking around a large building. I didn t want to be winded walking up the stairs; I didn t want my feet to hurt; and I didn t want to feel self-conscious. I want to be a good example for my daughters on how to eat healthy and live an active lifestyle. Surgery was right for me. Nothing else worked. Patient Kelly B., Lost Over 120 Pounds

3 Dear Future Bariatric Patient, You probably don t have to be convinced that for most of us, diets don t work. If they did, you wouldn t be seeking assistance in achieving permanent weight loss. Our skilled, dedicated team at Michigan Bariatric Institute (MBI) would like the opportunity to guide you through a life-changing permanent weight loss experience. At MBI, we pride ourselves in delivering comprehensive, coordinated and compassionate care. Our team includes fellowship-trained laparoscopic surgeons, a program director who is a successful bariatric patient, specially-trained registered nurses, registered dietitians, behavioral specialists and exercise physiologists. We are committed to guiding patients through every aspect of the bariatric surgical process, which includes educational seminars, comprehensive pre-surgical classes, postsurgical follow-up visits and support groups. Let our patients successes lift your heart and give you hope. We measure the success of our program with each wonderful weight loss story our patients are living every day. You have the opportunity to create your own story. Why Weight? Sincerely and in good health, Your Michigan Bariatric Institute Team

4 Laparoscopic Gastric Bypass Laparoscopic gastric bypass is the most frequently performed weight loss surgery in the United States. The gastric bypass has been performed since the 1970s and its success has been extensively validated. It has been performed laparoscopically since 1994 and has exponentially increased in popularity since then. Laparoscopic gastric bypass involves creating an approximately one-ounce stomach pouch at the uppermost portion of the stomach and then connecting this to a bypassed portion of the intestine. The small pouch size limits caloric intake and, by bypassing the stomach, some hormones that normally stimulate appetite are decreased and therefore the person feels less hungry. Individuals on average lose 70 percent of their excess body weight. It cures diabetes in 84 percent of individuals even some of those who are on insulin injections. Sleep apnea is resolved in nearly 87 percent of individuals, high blood pressure and reflux disease is eliminated in nearly 75 percent of individuals, joint disease is resolved in 40 percent and the list of health improvements continues. Laparoscopic Sleeve Gastrectomy The laparoscopic sleeve gastrectomy has been performed for several years. It was initially introduced as a first-stage operation in super morbidly obese patients considered too high risk to undergo the standard weight loss surgeries. However, it has been found to result in good weight loss as a sole operation and offered individually. It involves the removal of approximately 85 percent of the stomach, leaving about a three-ounce stomach tube. The normal continuity between the esophagus, stomach and small intestine is not changed. Therefore, food is absorbed and there is a decreased risk of malabsorption. The small size of the remaining stomach limits caloric intake. Removal of 85 percent of the stomach decreases some of the hormones that stimulate appetite, and individuals feel less hungry, helping with weight loss. The sleeve gastrectomy is nearly as effective as the gastric bypass with regard to weight loss.

5 Laparoscopic Adjustable Gastric Banding The laparoscopic adjustable gastric banding or LapBand involves the placement of a silicon band around the uppermost portion of the stomach. The band is then tightly adjusted to limit intake and hunger. This procedure has less surgical risk, no anatomical changes to the body and is more easily reversed. It does not cause malabsorption and can be adjusted to allow for more food intake during pregnancy. The band is adjustable and allows for an individualized degree of food restriction. It can be removed at any time and anatomy is restored to its original form. The band has fewer side effects and risks. Nationally, there is lower mortality risk and nutritional deficiencies with the lap band than with more involved bariatric surgeries. Laparoscopic Duodenal Switch Laparoscopic Duodenal Switch (DS) is a two-step bariatric surgery involving both restriction and malabsorption. First, a laparoscopic sleeve gastrectomy is performed to reduce the stomach s volume and caloric intake. Next, 80 percent of the small intestine is bypassed and connected to the duodenum to limit the number of calories absorbed by the body. Although DS leads to the best weight loss, the significant extent of malabsorption prevents the DS from becoming more widespread. Patient compliance is crucial to receive adequate nutrition and achieve a healthy lifestyle. For questions about a procedure, please call: 877-Why-Weight ( )

6 What to Expect Michigan Bariatric Institute provides a comprehensive, team approach to treatment and care: Free monthly educational seminars Pre-surgical consultations with your surgeon and MBI team Pre-admission and pre-surgical classes provide information about post-surgery nutritional needs and what to expect upon returning home Shorter post-surgery hospital stay for recovery and education Follow-up appointments with a surgeon and dietitian Monthly support group for bariatric patients and supporters Companionship of a BariPartner, a patient who has already experienced surgery and who is willing to mentor you I am so grateful for the life I have. In my late 40s, my weight hit an all-time high and I was diagnosed with type two diabetes. I tried several diets and exercise programs but they weren t very helpful. In June 2012, I underwent bariatric surgery. Recovery was relatively quick and painless, and my type two diabetes was gone in a week. I committed to a healthier lifestyle. The pounds started coming off and I was thinner, healthier and happier. I even began to run. I have now run in many races from 5Ks to marathons. Patient Mark L., Lost 130 Pounds

7 Results you can Count On Minimal pain Less scarring Shorter hospital stay Faster recovery Support from specially-trained registered nurses, dietitians, behavioral specialists and exercise physiologists Lose on average 70 percent of excess body weight in the first year No one loves me more than me. In October 2013, I was told I was borderline diabetic. As a single parent, all I could think about was my daughter and our quality of life. That s when I had a sleeve gastrectomy. At my one-year anniversary of surgery, I was down 202 pounds. Before weight loss surgery, it was a struggle to simply stand up. Now, I have my mobility back. I have a new mindset one of healthy thinking and exercise. Frances M., Lost Over 200 pounds

8 SURGERY CENTERS AND CLINICS LIVONIA LOCATION Five Mile Road, Suite 202, Livonia, MI ST. JOSEPH MERCY LIVINGSTON 620 Byron Road, Suite 1200, Howell, MI stjoeshealth.org/mbi 877-Why-Weight ( ) Visit us on Facebook DiscoverRemarkable