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How does weight-loss surgery help me to lose weight?
How effective is weight-loss surgery?
Are there any risks associated with weight-loss surgery?
How long is the recovery period after weight-loss surgery?
What is considered a successful weight-loss surgery?
Will I have to go on a diet before I have surgery?
Does your diet have to change after surgery?
Do I need to purchase special foods after surgery?
Will I be hungry after surgery?
What foods and drinks should I avoid after surgery?
What is dumping syndrome?
Can I regain weight?
Will I lose my hair after bariatric surgery?
Can I have bariatric surgery if I smoke?
When can I get pregnant after metabolic and bariatric surgery? Will the baby be healthy?
Will my skin sag after and bariatric surgery? Will I need to have plastic surgery? Will my insurance pay for plastic surgery?
Can I have metabolic and bariatric surgery if I have had other abdominal surgery procedures in the past?
Can I have metabolic and bariatric surgery if I have type 2 diabetes?
All types of weight-loss surgery drastically reduce the size of your stomach so that you cannot eat as much as you used to. Also, because your stomach is smaller, you are less hungry which results in eating less. Gastric bypass surgery detours partially digested food around the first 3 to 5 feet of small intestine so that you will not absorb food and nutrients the way you used to.
Research shows that diet and exercise alone do not result in significant weight loss for morbidly obese people. Bariatric surgery procedures have been proven to help obese people lose a large amount of weight, significantly improving their health and drastically reducing their dependence on medications for obesity-related illnesses. Weight-loss surgery success is typically defined by achieving a loss of 50 percent or more of excess body weight and maintaining that loss for at least five years. By substantially reducing weight, this procedure can ease health conditions associated with obesity, such as diabetes, hypertension, cardiac dysfunction, gallbladder disease, arthritis, depression, urinary stress incontinence, menstrual and fertility irregularities, sleep apnea and respiratory dysfunction.
As with any surgery, there are risks associated with bariatric surgery. Though complications are relatively rare you should fully understand and consider them before undergoing surgery. Your surgeon will discuss the potential risks with you while you are making the decision to proceed with surgery.
On average, bariatric patients stay in the hospital two nights. However, your full recovery time can range from two to six weeks, depending on your health and the type of surgery selected.
Bariatric surgery is successful when patients:
- Lose a significant amount (60 to 99%) of their excess weight
- Decrease medication use
- Increase their physical activity levels
- Improve their quality of life
- Increase their ability to work or participate in daily life activities
- Regain a feeling of control over their life
- Feel good about themselves and their commitment to future good health
Yes. Most insurance companies require a physician-monitored diet three to six months prior to surgery as part of their coverage. This is a time to improve food choices, eating habits, and to prepare for life after your surgery. We encourage weight loss prior to surgery. Weight loss makes the surgery technically less difficult and reduces your risk of complications. A pre-operative liver reduction diet may be ordered for 2-3 weeks prior to surgery in order to shrink the liver and reduce fat in the abdomen.
Yes, every patient meets with our dietitian before and after surgery to teach you about the necessary dietary guidelines. The dietitian will assist you in changing your eating behaviors so that you will lose weight and maintain your weight loss. After surgery, you will follow progressive diet, starting with Phase I full liquid diet. Our dietician will educate you on the specific guidelines and provide a bariatric diet booklet to review. It may take you one to four months to move from liquids to regular foods. It is best to eliminate sweets and fatty foods to avoid digestive problems.
Yes, at first you may need to have a protein supplement to help you recover and heal. Adequate protein helps to maintain lean body mass during quick weight loss and helps to prevent hair loss. In addition, vitamin and mineral supplements are necessary in the weight-loss period and certain supplements are needed life-long, depending upon the type of surgery you have. Insurance typically does not pay for vitamin and mineral supplements. However, you can pay for vitamins and minerals out of a flex spending account, which is a pre-tax account from your income that can be used for medical expenses.
People of normal weight whose appetite center works as it is supposed to usually get the “full” sensation after eating the “correct” amount of food. This is often not the case with someone who is morbidly obese. A morbidly obese person may overeat because their appetite center is not signaling correctly, leading to weight gain. After surgery, you should find yourself “full” with smaller amounts of food. Your feeling of hunger should become more specific and you will eat healthy foods when you are hungry and stop when you are full.
After surgery, consume sugar-free, caffeine-free, non-carbonated and non-alcoholic beverages. Processed foods that are high in salt, sugar and fat should be avoided as well. Some foods will not be well tolerated after surgery. Your dietician will discuss specific foods and beverages that will assist with your weight loss. The goal is to move towards a well-balanced diet, including proteins, vegetables, fruits, and healthy fats.
Dumping syndrome can occur when consuming foods or beverages that are high in sugar or fat. Symptoms include cramps, nausea, sweats, chest pain, lightheadedness, vomiting and diarrhea. This is your body’s way of rejecting foods that are not well tolerated.
Yes, you can regain the weight you lost by consuming unhealthy foods, snacking too often, eating high-calorie foods, or drinking high-calorie beverages often. Bariatric surgery is a tool to help you change your eating style and begin healthy habits. Exercise is very helpful in preventing weight gain as well.
Some temporary hair loss is common following surgery and typically occurs between the third and sixth month following surgery. Hair loss is usually minimal and will regrow after the rapid weight loss phase has ended. Hair loss is a result of several factors including physiologic, emotional and nutritional stress following surgery. Hair loss is temporary; adequate intake of protein, vitamins and minerals will help to ensure hair re-growth.
Any use of tobacco products should be discontinued prior to surgery. Smoking disrupts normal lung functioning and can increase the possibility of anesthesia complications. Smoking can lead to blood clots, decreased circulation to the skin, and delayed healing. You can decrease the risk of these surgical complications by stopping smoking altogether and at least 8 weeks prior to surgery. After surgery, continued smoking will stimulate excessive stomach acid production and reduce blood flow to your constructed stomach which increases the risk of gastric ulcer formation and stomach pain.
Bariatric surgeons generally recommend waiting approximately 18 months after surgery to become pregnant due to the possibility of nutrient deficiencies during the weight-loss period. Obesity is a major cause of infertility and with weight-loss fertility levels may increase. It is important to practice effective contraception other than birth control pills during this 18 month period to avoid getting pregnant. Bariatric surgery does not cause growth or development problems for offspring if appropriate nutrition and vitamin/mineral supplementation recommendations are followed.
In fact, studies find that women who had bariatric surgery have improved pregnancy and offspring outcomes than those who are affected by severe obesity and have not had bariatric surgery. These improvements include a reduced rate of preeclampsia (an increase in blood pressure leading to chronic high blood pressure) and gestational diabetes, a lower incidence of stillbirths, and fewer miscarriages. The offspring of bariatric surgery patients are also less likely to be underweight or overweight at the time of birth.
Whether or not your skin will sag after surgery depends upon several factors including how much weight you lose, your age, your genetics and whether or not you exercise. Generally, loose skin is well hidden by clothing. Many post-operative patients utilize compression garments to help with the appearance of excess skin. Many different types of compression garments can be found online. Some patients will choose to have plastic surgery, which is the only solution for removing the excess skin. Plastic surgery for removal of excess skin is rarely covered by insurance because it is generally considered cosmetic and should be considered 18 months after bariatric surgery. Consult your surgeon when considering plastic surgery.
In some instances, removal of excess skin is necessary for medical reasons, i.e. skin irritation, ulceration or infection, pain, sexual function problems or hygiene issues. Although it is more likely insurance will pay for the plastic surgery in these cases, it is best to call and ask.
The general answer is yes. Most of the commonly performed abdominal operations such as C-section, gall bladder surgery, appendectomy, tubal ligation, hysterectomy and minor hernia repair of the belly button rarely impact the ability to have bariatric surgery. However, if you have had prior surgery for hiatal hernia or reflux, intestinal surgery involving removal of a portion of the small intestine or colon, or have had a major hernia repair with a large mesh, it could impact the type of surgery you can have or the ability to do it laparoscopically through small incisions. It is important to recall all prior surgeries and let your surgeon know during the evaluation process. If you have had a major abdominal surgery, it is very helpful to obtain the operative reports as well.
Yes, bariatric surgery has been shown to improve or cause remission of type 2 diabetes. There is evidence that procedures such as gastric bypass and sleeve gastrectomy improve gut hormone responses along with weight loss produce improvement or remission of Type 2 diabetes. Studies find a greater than 95 percent of patients have improvement of type 2 diabetes with bariatric procedures and up to 85 percent have remission of their diabetes with these surgeries. Some studies have even reported improvement of type 1 diabetes mellitus following bariatric procedures. The adjustable gastric band can result in improvement or remission of diabetes; however, this is solely from the weight-loss alone. Therefore, the improvement or remission of type 2 diabetes seen with the band tends to be slower and occurs in a smaller percentage of patients compared to the other surgeries.