Commonly Asked Questions & Concerns

Q: Why should someone consider having bariatric surgery?
A: Current research suggests that one in three Americans is obese. In this country alone, about 300,000 deaths per year can linked to obesity. Obesity is associated with serious health conditions including high blood pressure, heart disease, sleep apnea (serious sleep disorder), heartburn or reflux, cerebral artery disease (stroke), diabetes mellitus (sugar diabetes), asthma, osteoarthritis, infertility, or cancer of the breast, colon, prostate or uterus. Usually within the first six months of having surgery, patients will no longer need to take medications for these conditions.

Q: Who is eligible for bariatric surgery?
A: A person may be a candidate for bariatric surgery if he or she is about 100 pounds overweight (or has a BMI of more than 35) and traditional weight loss methods have failed.

Q. What is BMI?

A. Your BMI, or body mass index, is a calculated measure of your body fat based on your height and weight. BMI = mass (kg)/ height (m) 2. Based on this calculation, the BMI categories are described below:

  • Underweight <18.5
  • Normal weight= 18.5-24.9
  • Overweight=25-29.9
  • Obese >30
  • Morbidly obese >35

Q: What does bariatric surgery involve?
A:  The most commonly performed bariatric procedure is called the Roux-en-Y gastric bypass. This method makes the stomach smaller and alters digestion. It is referred to as a combine restrictive and malabsorptive procedure because less food can be eaten and fewer calories can be absorbed.  The laparoscopic adjustable band, or LAP-BAND is a restrictive procedure.  This device works by limiting the amount of food that can be eaten. A more recent addition to surgical options to treat morbid obesity is a sleeve gastrectomy. All surgical options will be discussed individually with each patient in order to assist  patients in their decision making as to what surgical option may be a best fit for individual patient.

Q: What is the recovery time following surgery?
A: Most patients recover from surgery without complications. Patients are encouraged to get out of bed and start walking by the next day. The hospital stay for patients who undergo the Roux-en-Y procedure is usually two to four days. Patients who have the LAP-BAND procedure usually go home on the same day.  Most individuals return to work in two to three weeks.

Q. When is surgery for weight loss considered successful?
A.  Traditionally, weight loss surgery is considered successful when a person loses 50% of his/her excess weight. Although few people lose all of their excess weight, they do gain numerous health benefits, which may be lifesaving. It’s important to remember that there are no guarantees with any method of weight loss, even surgery. Success hinges on your ability to become part of the plan to support the surgical tool you’ve chosen and make lifestyle changes with exercise and dietary adjustments.

Q. Are there activity restrictions following surgery?
A.  Yes, strenuous activity should be avoided until you are healed. Walking, however, is a required activity at this stage of recovery. You are advised not to drive, if you are taking pain medication other than Tylenol. At your first follow-up visit, your doctor will determine when you can return to work, but most people return to work 2-4 weeks after surgery.

Q. Do insurance companies cover bariatric surgery?
A.  Almost all insurance companies now recognize obesity as a substantial health risk and are paying for bariatric surgery as a medical necessity.

Q: What are the dietary restrictions following surgery?
A: Following surgery, you will need to follow specific eating guidelines. Registered dietitians at our hospital work directly with bariatric surgery patients to provide dietary education before and after surgery.

Q. What about exercise after surgery?
A.  Light exercise, such as walking, should begin immediately after surgery.  Vigorous exercise will be gradually introduced in 6-8 weeks. Exercise will not only keep you feeling well and energized, but it also helps burn fat and calories. For many people, returning to physical exercise is an important step toward feeling better.

Q: How long will it take to lose excess weight?
A: Weight loss begins right after surgery and usually continues for 18-24 months after surgery.

Q: Is it possible to gain the weight back after surgery?
A: Bariatric surgery has an excellent long-term track record for helping morbidly obese individuals maintain weight loss.  If you are committed to making permanent dietary and lifestyle changes, your chance of weight re-gain is minimized.

Q: What are the risks of bariatric surgery?
A: All surgical procedures have risks, particularly when the patient is morbidly obese. Different procedures involve different risks, and depending upon your individual circumstances, your risks may be higher or lower than average. It’s also important to know that surgeons with more experience performing bariatric surgery techniques have fewer complications. Potential risks of surgery should be discussed with your surgeon so you can make an informed choice.

Q. Can bariatric surgery be reversed?
A.  All procedures are considered permanent and for life weight loss measures.  However, the LAP-BAND is removable via laparoscopic surgery. Gastric bypass surgery is potentially reversible. Reversal requires another operation of the same, or greater, magnitude with the same, or greater, risks. Reversal of this operation is very uncommon and rarely occurs beyond six weeks from the time of surgery. Sleeve gastrectomy permanently removes a portion of the stomach.

Q. How long is the process from my initial visit to the date of surgery?

A. The process from your initial visit to the operation date takes usually about six months. During this time you will need to see your primary care provider for six continuous months for weight and health monitoring, while simultaneously making several appointments to see health care providers such as the nutritionist and psychologist. During this time we also encourage you to lose weight to prepare for your surgery.

Q. Why must I lose weight before surgery?

A. Losing weight will prepare your body for the weight loss you will be enduring after the surgery. As you lose weight, you will become healthier, resulting in lower complications and better outcomes after the operation.

Q. Do I need to stop smoking before my surgery?

A. Yes! Smoking is a harmful habit that can lead to lung and heart disease, and increased complications during and after surgery. We encourage patients to quit smoking for better health, but we especially require them to quit smoking before the procedure to ensure decreased infection rates and better oxygenation.

  P Gorecki , Oct 2011