Do I Have To Quit Smoking For Bariatric Surgery?

smoking and bariatric surgery
Bariatric surgery and smoking are not a good combination. Individuals who do not quit smoking before having bariatric surgery pose risks of serious complications and long-term risks during and after surgery.
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Obesity and Smoking

Having bariatric surgery can literally save a person’s life. Obesity has reached epidemic proportions in the United States with only 28% of the entire adult population falling within a healthy BMI range. BMI is a calculation of body mass index and is used to determine if an individual is of a healthy weight.

The rest of the adult population in the United States is considered overweight or obese. Obesity is one of the leading causes of type 2 diabetes and is associated with other serious, potentially life-threatening illnesses. Between 30-38% of individuals that are obese also smoke or use tobacco regularly.

Several studies over the years have proven that smoking and tobacco use causes many health issues and are also the number one cause of preventable death in the world.

Approximately 16 million individuals are currently living with a disease directly related to smoking, reports the CDC. For every person that smoking kills, there are thirty more people seriously affected by an illness related to smoking.

Smoking increases the chances of many different types of cancer, emphysema, heart disease, etc. Reading these facts, it would make sense that an individual who is obese and also smokes would have a much-increased chance of developing serious health issues.

Weight Loss Surgery and Smoking

Deciding to undergo bariatric surgery is a huge step in the right direction to improve your health and well-being. If you are a smoker or you use tobacco products regularly, this is the time to choose to leave those behind in your old life as well.

Aside from the standard risks that smoking poses to your health, it also can quadruple your risks of experiencing serious surgical complications. This is why bariatric surgeons have mandates regarding smoking before they will consider candidacy for weight loss surgery.

Many doctors require patients to quit smoking ranging anywhere from a few weeks to a year before they will commit to performing the surgery.

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What Happens If I Smoke before Bariatric Surgery?

Studies have shown a correlation between surgery-related complications for weight loss patients who smoke compared to non-smoking patients. This situation is serious enough that some bariatric surgeons perform nicotine level tests on patients before they will proceed with surgery and if levels are high they will not go through with the surgery.

Nicotine consumption is associated with higher risks of heart attack, pneumonia, lung disease, stroke, blood clots, many types of cancer, marginal ulcers, infection. More specifically:

Respiratory complications – the use of tobacco or smoking disrupts the normal functioning of the lungs and reduces an individual’s breathing capacity. Bariatric surgery patients who smoke are at a greater risk of developing pneumonia.

Dangerous blood clots – individuals who smoke have a 23% +higher risk of developing venous thromboembolism. The more cigarettes consumed in a day, the higher the risk. Blood clots that develop in the body (pulmonary embolism) and clots that form in the deep veins (deep vein thrombosis) can break off and travel to another area of the body resulting in a blockage.

Blockages can cause strokes or heart attacks If left untreated the mortality rate is 30%, if diagnosed and treated mortality reduces to 8%, and 10% of individuals who experience a pulmonary embolism die suddenly with no warning.

Prolonged healing of wounds – smoking or the use of tobacco products can also affect how fast your body can heal itself. Cigarettes contain toxic ingredients that impede wound healing including:

  • Carbon monoxide;
  • Nicotine;
  • Hydrogen cyanide.

When we are injured, our white blood cells act as little paramedics carrying oxygen and overseeing the repair process of the injured site. The toxic ingredients in cigarettes diminish their ability to do their job and therefore wounds take longer to heal and prolong the recovery period.

Ulcers – smoking cigarettes can cause the formation of ulcers and complications resulting from ulcers such as bleeding, obstruction of the stomach, and perforation of the stomach. These can be life-threatening and require emergency surgery. Smoking is also one of the main causes of the failure of ulcer medication.

What Happens If I Smoke after Bariatric Surgery?

Choosing to undergo bariatric surgery and commit to a total lifestyle change should include quitting smoking. Having weight loss surgery provides you with an amazing tool and opportunity to get healthy. It would not make sense to go through everything weight loss surgery entails becoming healthy, only to sabotage the whole process by smoking.

Smoking can adversely affect your ability to lose weight and also compromise your health. Not only can smoking increase surgical risks, but it also increases the risk that patients will have complications after bariatric surgery.

Side Effects of Smoking after Weight Loss Surgery

Patients have experienced severe pain, nausea, and vomiting due to strictures (narrowing) of the entrance to the stomach pouch caused by smoking.

There have been patients who experienced ulcer formations several years after bariatric surgery due to smoking. Ulcers are a commonly known side effect of smoking but bariatric surgery reduces the stomach size, making ulcers even more prevalent. If the complications are severe enough, surgery to reverse the bypass(if possible) may have to be performed.

As mentioned previously, smoking causes the blood vessels to shrink and decreases the amount of blood flow that is getting to your smaller stomach. The carbon monoxide that is produced due to smoking restricts the red blood cells’ ability to transport oxygen. These two issues not only affect your ability to heal from surgery but can be problematic for years after surgery.

Patients who resumed smoking after bariatric surgery have been plagued with many of the complications listed above; several resulting in additional surgery, and some resulting in death.

Smoking Relapse and Bariatric Surgery

A 7-year study was conducted by the University of Pittsburgh Graduate Public School Of Health on 1,770 patients that underwent gastric bypass surgery. 45% of the patients reported a pre-surgery smoking history but almost all the patients were able to quit smoking by at least the month before surgery.

A year after surgery about 10% of patients were smoking again. Not only did they relapse but they were smoking more cigarettes per day than before surgery. At the seven-year mark 14.5% of the patients that had gastric bypass surgery were smoking and interestingly, this included 3.8% of people who had never smoked before.

Patients Need Ongoing Support to Avoid Smoking after Bariatric Surgery

The findings from this study coupled with a second study that observed the effects of different drugs on individuals who had undergone gastric bypass surgery suggest that after surgery patients’ systems handled the nicotine quite differently than previous to surgery.

The study concluded that a great deal of emphasis is put on abstaining from smoking prior to surgery, however, there needs to be ongoing long-term support for these patients after surgery to avoid or quickly respond with help to relapses.

If you are interested in bariatric surgery or want to know if you are a candidate take this quick quiz to find out. IBI Healthcare Institute provides wrap-around support before, during, and after your weight loss surgery. Contact us today and set up a consultation to learn more about weight loss options that are right for you.

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