Are wheelchair bound patients candidates for gastric bypass?

Question

I weight about 260 pounds and am 5’6. I’m. Worried about the sagging skin after surgery because the loose skin I have now already gets red, raw, and is very painful. I’m wheelchair bound due to an autoimmune disease. Do you have any suggestions?

Ali Solmaz, MD · Answer

Yes, wheelchair-bound patients can be candidates for gastric bypass surgery, but it depends on multiple factors, including overall health, nutritional status, and ability to recover postoperatively. Since you have an autoimmune disease, your surgeon will likely want to assess how it affects your healing, immune response, and any potential complications.
One of the biggest concerns with weight loss surgery in individuals who are wheelchair-bound is muscle loss and skin changes. Since mobility is limited, maintaining as much muscle as possible through physical therapy, resistance exercises, or electrical muscle stimulation can help reduce the severity of loose skin. Your existing issues with skin irritation and rawness are important to address before surgery. You may want to consult with a dermatologist or wound care specialist to explore preventative treatments, such as barrier creams, prescription-strength anti-chafing products, or medical-grade compression garments.
After surgery, rapid weight loss can make excess skin issues worse, especially in areas prone to friction. You might want to start working with a plastic surgeon early on to explore options for skin removal or body contouring in the future if needed. Some patients with significant skin irritation qualify for insurance coverage for procedures like a panniculectomy, which removes hanging skin from the lower abdomen.
Since your body will be going through major changes, working closely with a dietitian to ensure proper nutrition and hydration is crucial. Protein intake, collagen supplements, and skin-supporting vitamins like C, E, and zinc can help your skin’s elasticity, though they won’t prevent loose skin entirely.

Pablo Garcia, MD · Answer

Hello,
Congratulations on your desire to become healthy and improve your lifestyle. First you need to specify more information but I would definitely consider the case for an evaluation. There are many factors that determine how much loose skin a patient will have after a large weight loss procedure. Worrying about the likelihood of having loose skin is no reason to put off losing weight. Losing weight will leave you healthier and will most likely lead to better and healthy lifestyle. There's nothing worse than working your way through a diet only to end up with skin that hangs. Unfortunately, it's a common byproduct of weight loss. The issue of loose skin begins long before any weight loss occurs. Instead, it starts when a large amount of weight is gained. When you gain weight, your skin's surface area increases to accommodate the new fat tissue (which is why "stretch marks" sometimes occur). While your fat cells shrink when that weight is lost, you still retain the same surface area. The new void under the larger surface area creates a layer of skin that may "hang," because there is less tissue underneath taking up space. This is what's known as loose or "sagging" skin.Remember that the surgery limits the quantity of food you consume and the appetite reduces but doesn't help with the quality of what you eat, this is also a factor that may help you, choose wisely your foods. First of all remember your goal, what is your objective. Don't look back. Have small goals everyday. Live day by day. Look for support groups, it's known that you'll have better results.
Good luck!

Mark Pleatman, MD (retired) · Answer

If you already have dermatitis from your excess skin, it won't get worse after weight loss surgery.  Besides, it can always be removed later by a plastic surgery.  If you want bariatric surgery, you should go ahead and have it done.

Are wheelchair bound patients candidates for gastric bypass?

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Are wheelchair bound patients candidates for gastric bypass?

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