Tests and Procedures
The Bariatric Center team works with you to determine the best course of care for your situation. Medical interventions include:
The bariatric team counsels you to create a calorie-controlled meal plan. You will learn guidelines for healthy food selection and portion control.
You will learn about behaviors contributing to your struggle with weight and strategies to change those behaviors. Problematic behaviors can include:
- Skipping meals
- Snacking between meals
- Eating out daily
- Frequently consuming indulgence foods
- Eating in response to stress or negative emotion
- Not participating in physical activity
Weight-loss medications can be a helpful addition to a healthy low-calorie diet and exercise plan. The bariatric team can advise you whether medications are an appropriate treatment option and provide you with a prescription and monitoring plan.
Weight-loss (bariatric) surgery
Weight-loss procedures, including minimally invasive surgery and endoscopic (through the mouth) procedures, are for people who are obese and have obesity-related health problems. The bariatric team helps people decide if this is a good option and which procedure is best.
The most common weight-loss surgeries performed at the Mayo Clinic Bariatric Center in Florida are:
- Adjustable gastric banding
- Gastric bypass
- Sleeve gastrectomy
All surgeries are performed using minimally invasive procedures whenever possible.
Endoscopic weight-loss (bariatric) procedures
The Bariatric Center in Florida also offers endoscopic bariatric therapies (EBTs), non-surgical weight-loss procedures for certain people who do not qualify for bariatric surgery or who may not be able or willing to undergo a weight-loss operation. Currently, three procedures are being offered. It should be emphasized that any of these EBTs must be implemented under the care of a multidisciplinary team in the Bariatric Center in order to help one effectively lose weight, sustain the weight loss and be monitored for any issues.
Intragastric balloon therapy (IGB):
IGB therapy is a weight-loss procedure performed completely through the mouth using an endoscope. This physician-supervised procedure may be a good option for those with a body mass index (BMI) between 30 and 40 or an even higher BMI. The intragastric balloon placement procedure involves an upper endoscopy and placement of a silicone balloon inside the stomach. The balloon is inflated with sterile fluid and left in the stomach for up to six months. Another upper endoscopy is then performed to remove the balloon. The balloon limits the amount of food you can eat and has also been shown to slow down the emptying of food from the stomach into the intestine, further enhancing the sensation of early satiety. IGB therapy ultimately helps with portion control, leading to weight loss. Intragastric balloon placement is performed in the endoscopy lab.
Endoscopic sleeve gastroplasty (ESG):
ESG is another weight-loss procedure also performed completely through the mouth with an endoscope. This procedure involves the use of a suturing device attached to the endoscope to place full-thickness sutures inside the stomach. In doing so, the size of the stomach is significantly reduced, limiting the amount of food one can eat, leading to earlier satiety and portion control. In other words, the stomach becomes shorter and narrower, like an accordion. The ESG is performed in the endoscopy lab. The sutures placed are nonabsorbable and stay there permanently unless they need to be removed. This procedure may be a good option for people with a body mass index (BMI) of 30 or greater.
Transoral outlet reduction (TORe)
The TORe procedure, also known as the gastric outlet reduction procedure, is an EBT specifically for people who have had successful gastric bypass surgery but start to regain weight several years later. Gastric outlet reduction reduces the size of the opening between the stomach and small intestine. This reduces the amount of food that can be eaten, promotes early satiety and portion control, and results in weight loss. Mayo Clinic researchers have demonstrated that in some cases, over-dilation of this opening is responsible for weight regain after gastric bypass surgery. This procedure is nonsurgical and is performed in the endoscopy lab.
Evaluations for these endoscopic weight-loss procedures usually take one to eight months from initial appointment to procedure. Before you decide to go through with the surgery or the endoscopic weight-loss procedure, it's important to understand that these successful procedures require a lifelong commitment to changing diet and exercise habits. In large part, you determine the success of the treatment.