Common Questions (FAQs)
Losing weight and keeping it off is a lifetime undertaking. Your body will always remember its peak weight and your metabolism will adapt to drive you back to this weight. We understand that weight regain (relapse) is part of obesity, being a chronic disease, and needs to be proactively managed.
The key to preventing weight regain after any intervention is proactive management. On completion of our program you will be provided with an action plan to monitor your weight with a stepwise approach to preventing its rise. We expect to continue to see you at least on an annual basis after you graduate from our program to monitor your progress and to help you avoid regaining weight.
Endoscopy is an internal examination performed with a camera by a specialist doctor, and in this case it refers to the examination of the stomach. All endoscopies must be performed in accredited hospitals and by accredited doctors. Before the endoscopy begins, the patient is deeply sedated by a specialist anaesthetist. The camera (or endoscope) is then inserted through the mouth and into the stomach where an examination is performed to ensure it is safe to proceed with the procedure.
In total, the endoscopy can generally be expected to take approximately 20 minutes for balloon procedures (including insertion, adjustment or removal of the balloon). Some procedures, such as an ESG (Endoscopic Sleeve Gastroplasty) may take up to an hour or sometimes even a little longer. Once the procedure is finished, the patient is allowed to wake up and returns home the same day.
The risks relating to endoscopy are very low: typically, the risk of any complication is much less than 1%, and the risk of major complication is less than 0.1%. Your doctor will discuss endoscopy and any relevant risks specific to your health in your consultation.
During the first week of the procedure you should not plan any heavy activities. Once you are able to manage adequate amounts of fluids, you can continue your normal activities. Starting a regular exercise program is highly recommended and will improve your success.
We generally recommend about 5 days off work following the procedure to ensure the symptoms have resolved. If you are travelling from interstate, you will be required to remain in Sydney for 7-10 days post-procedure, as it is during this time that you are most at risk of an uncommon complication.
We require all patients to remain in Sydney for 7-10 days following their procedure, as the first two weeks are when a patient is most at risk of an uncommon complication. Once you have progressed to a solid diet, you are able to travel.
Portion creep can compromise your weight loss efforts, as it leads to a greater number of calories being consumed. Regular contact with your Dietitian and Bariatric Physician provides a valuable point of accountability to ensure you are maintaining small portion sizes and not experiencing symptoms after eating (symptoms of reflux, bloating and cramping can suggest your portions are too large).
Any plans for a future pregnancy should be discussed with your Bariatric Specialist at your initial consultation. We advise our POSE® patients to avoid pregnancy for at least 18 months following the procedure, to allow time for your weight and body composition to stabilise.
It is important to note that there is no data on POSE ® and pregnancy as yet, which represents one of the ‘risks of the unknown’.
The follow-up program is critical to your weight loss success as you’ll learn new lifestyle skills. You will meet with your allied health team at least once a month, during the first six months and then monthly to bi-monthly for the remainder of your program. During this time your progress will be evaluated and you will learn valuable principles of health, nutrition and exercise that will provide you with a foundation for long-term success.
When it comes to eating AND drinking post procedure, Dr Sartoretto recommends these three Golden Rules to minimise the risk of symptoms, optimise the chances of weight loss and improve the odds of keeping the weight off
- Small, single portions
- When eating, use a small plate (eg a bread plate or a child’s plate) and serve a portion only the size of the palm of your hand.
- Use a small cup – no large tumblers.
- Do not set your table with food; instead, serve your portion (and anyone else’s) and pack the leftovers away before you eat.
- It is OK to leave some leftover food on your plate – pack it away for lunch tomorrow.
- Go slow!
- Your meal should take no less than 20 minutes to finish – this ensures you chew your food thoroughly and prevents you feeling unwell after you eat.
- Sip on your cup of liquid slowly – drinking too quickly will make you feel bloated and uncomfortable.
- Wait 30 minutes before you go back for seconds
- The brain’s connection with the stomach is delayed – eating too soon after a meal increases the chances of overeating and the chances of developing discomfort.
These rules prevent you from overeating and allow you to get back in touch with your feeling of fullness. If you break them, you are likely to suffer some reflux or cramping, so sooner or later you’ll change your ways!
You will be provided with specific dietary advice, including suitable foods and portion sizes, from our expert team of dietitians who you will meet with regularly across the duration of your program.
You will need to follow a restricted, fluid diet prior to your POSE® procedure, and will be advised to follow a diet progression of various food textures for a period of 5 weeks following your procedure. However, beyond this, you are able to enjoy most foods without concern and within the context of a healthy, balanced diet.
Patients with a BMI greater than 30 are suitable for the POSE® procedure. This procedure is also safe in patients with a risk of gastric cancer, unlike ESG.
Weight loss results of any procedure aftera primary therapy tend to have reduced efficacy. POSE® is able to be done after a gastric balloon or ESG. POSE® may be able to be performed after a gastric sleeve or gastric bypass, but must be discussed with your doctor.
POSE® is much safer than ESG. Complications are very rare and are generally easily managed. They may include:
- Much less than 1% risk of any complication
- Clots in the legs (DVT)
To date, there have been no reported deaths following POSE® procedure.
Yes! Exercise is an important part of losing weight and keeping it off. We encourage exercise as part of your weight loss strategy – all activities are encouraged and safe. Your Bariatric Endoscopist or Surgeon will provide you with specific recommendations for starting exercise at your post-procedure review appointment, and following any adjustments (for patients with a Spatz3 adjustable balloon only).
In order to allow the stitches to mature, it is important that the diet progresses slowly. Thankfully, appetite is strongly suppressed by this therapy and hunger is not an issue. Our patients are required to maintain a liquid only diet for approximately 3 weeks before progressing to a puree diet, then soft diet. Our patients are able to return to a normal diet approximately 5 weeks after the procedure, however portion sizes are much smaller than previous, and will remain so for many months and even years.
The side effects of the POSE® procedure are usually limited to the first 5 days after it is performed, with the first 3 days being most severe. After this period, the symptoms disappear completely and will only recur (and are typically mild) when one of the ‘golden rules’ are broken.
Our doctors have worked tirelessly to optimise the treatment of our patients. You will be provided with our highly advanced, unique and comprehensive treatment program to minimise the occurrence of side effects.
You will also be prescribed medications to assist in controlling symptoms and it is important that you purchase these medications and take them as directed. If symptoms persist or worsen, you should contact the clinic immediately (on our 24/7 patient support number, 1300 376 026).
Most patients of our clinic now typically experience only mild side effects (if any), with the most common being:
- Cramping is common in the first 3-4 days after the procedure and can be treated with medications.
- Overeating or drinking too much at a time can also bring on cramping.
- Reflux (including heartburn and some belching)
- You will be required to take acid medication for the first week following your procedure to manage any reflux. Over the counter antacid medications can also be used.
- Overeating, overdrinking, eating rich (creamy/oily) foods or drinking wine will typically bring on acid reflux symptoms.
- Typically mild to moderate in the initial days after insertion.
- Typically due to the medications used to manage side effects and resolves after 3 days. We recommend resting during this period to hasten your recovery.
Absolutely, we work with patients from all around Australia and currently have many patients located interstate or outside Sydney.
If you are able to travel to Sydney to attend your initial consultation with the doctor in person, Medicare will bulk bill this consultation entirely. If you would rather this initial consultation occur remotely via video conference, you may be eligible for a Medicare bulk billed appointment, pending your residential address.
When it comes to the procedure itself, you will be required to remain in Sydney for 7-10 days post-procedure, as it is during this time that you are most at risk of an uncommon complication. We will also schedule your post-procedure review with your Specialist during this time.
To further support patients who are unable to attend their allied health consultations face-to-face, we offer the option of a video consultation bundle which can be added on to any of our programs. This ensures you are able to access the full support of your care team and get the most out of your included allied health consultations.