What can I expect when I first visit the office?
You will meet with the surgeon, or with our nurse practitioner who will initiate the process to become a new healthier you. You will have a thorough history taken at the time of your visit, and as a candidate for weight loss surgery you can expect to go through a series of consultations. Please make sure to bring any pertinent medical information and tests results from other physicians as well as the names and addresses of your primary care physician. Your nurse practitioner may recommend further testing to evaluate any potential obesity-related problems, such as sleep apnea and gastroesophageal reflux disease (GERD). Once you complete your visit with the nurse practitioner, you will then meet with the registered dietician who will evaluate your dietary habits, and discuss healthy lifestyle changes before and after surgery. For this meeting with the dietician, it is a good idea to bring a list of everything you have eaten and their amounts in the two days prior to your appointment. Once the nurse practitioner receives the results of the tests that he/she has recommended that you do, it is then that our office will schedule an appointment to meet with the surgeon again. You are not expected to decide which surgical procedure you would like on the day you first meet with the surgeon or nurse practitioner. It may be beneficial to you to contact some past patients to learn about their experiences with the program. This information can be provided during your first seminar.
What can I expect when I first visit the surgeon?
By the time that you meet with the surgeon, you may have already completed any preliminary testing that the nurse practitioner felt you needed in order to evaluate any potential obesity-related problems. Your tests results, as well as your medical and dietary history, will be reviewed by the surgeon and any potential concerns will be discussed. The surgeon will then review with you the various surgical procedures and potential risks of surgery as they pertain to your individual case. Most patients then decide which weight loss surgery is best for them. If you are still undecided, you do not need to make that decision just then. However, when you do decide which procedure you would like to have after meeting with the surgeon, it is then that your date for surgery will be given. If at any time you feel the need to have further clarification on any step of this journey, please feel free to contact any member of our staff.
When is surgery for weight loss considered successful?
Weight loss surgery is considered successful when 50% of excess weight is lost and the loss is sustained up to five years. For example, a patient who is 100 pounds overweight should lose at least 50 pounds; a patient who is 200 pounds overweight should lose at least 100 pounds. And they should be able to maintain loss successfully for the following five years. Ninety-five percent of patients reach that goal after gastric bypass surgery, and 85% of patients go on to lose 2/3 or more of their excess weight.
Are there any restrictions after the surgery like lifting and driving?
Yes. In the post operative period, especially while using any pain medication, we recommend that you do not drive. Depending on how well you are recovering from your surgery, lifting, pulling, or pushing may or may not be restricted. Certainly for the first two weeks most patients are not comfortable enough to do any heavy lifting. After that, if all is going well, you can lift as tolerated.
Do insurance companies cover surgery for obesity?
Most insurance companies will cover this surgery. Some will fight coverage, but we have had great success in getting insurers to realize that this is necessary. We give the insurance providers the information they need to understand why the surgery is necessary and what it involves. These operations are not being done for cosmetic purposes; they are being done to improve overall health and take the morbidity out of morbid obesity. Since bariatric surgery can actually reverse the risk of death, it is medically necessary.
Can I eat whatever I wish, or must I control my portion, intake of fats and sugars?
Weight loss surgery, no matter which type, is only a tool to help you lose weight and keep it off, if used effectively. After weight loss surgery, almost any type of food is tolerated if chewed well enough, and eaten slowly. There are many exceptions to this:
- The Gastric Band can provide constant restriction on your stomach; however, it can affect your eating habits. Weight loss is dependent on the quality of food you eat. Eating soft sweets, such as chocolates, ice creams, or drinks/liquids high in calories can cause poor weight loss or weight gain.
- The Gastric Bypass provides significant weight loss for one to two years, then plateaus. Gastric bypass requires that you greatly reduce your intake of sweets and fats. You will experience physical symptoms such as abdominal cramping, sweating and general weakness when you consume too much fatty food or too many sweets.
- The Sleeve Gastrectomy results in a banana shaped, or sleeve-like stomach. Similar to the Gastric Band, eating, soft foods, sweets and drinks/ liquid high in calories will cause weight regain, or poor weight loss.
What is "dumping syndrome?"
This term refers to the emptying of concentrated food directly into the small intestine. Gastric Bypass surgery empties food from the small stomach pouch directly into the small intestine without first being diluted with fluids in the rest of the stomach. Therefore, whatever you eat empties directly into the small intestine. Sweets and fatty foods irritate the small intestine and causes discomfort. Eating and drinking fluids simultaneously will also cause this dumping syndrome. This is why we recommend waiting half an hour between eating and drinking.
What about exercise after bariatric surgery?
You should get out of bed and start walking as soon as possible after surgery. We recommend that you exercise every day. Whether you have surgery or not, exercise is important to overall health. The more you exercise the healthier you will be and the more weight you will lose. Since walking greatly accelerates weight loss, specifically fat loss, we suggest you walk every day. We recommend walking 30 minutes per day to start, and increasing the amount of time to 45 minutes to one hour to maintain lost weight.
After the surgery how often do I see the doctor?
While you are healing you will be seen on a regular basis, usually once after two weeks, and again six weeks after surgery. You return for follow-up visits after three, six, nine, and 12 months to make sure you are adjusting well, and then once a year after that. It is important for us to follow your vitamin and mineral levels (particularly after gastric bypass and sleeve gastrectomy) as well as your protein intake.
Can bariatric surgery be reversed?
Surgery for weight loss can be reversed, but reversal procedures are usually more dangerous than the original ones. We would only consider reversing these operations in patients who have significant long term problems from the surgery. It is important to note that anyone who has the operation reversed will regain the weight they lost after the first surgery.
Is there anyone who should not have bariatric surgery?
Weight loss surgery is a serious step. Patients with psychiatric conditions such as depression, bipolar disease, and/or schizophrenia should be under the care of a psychiatrist before they consider surgery. These conditions can become exaggerated by the body changes that are associated with weight loss. There are some medical conditions which make the surgery too risky to perform. These occur rarely but must be taken into account. If patients meet the eligibility guidelines that are outlined above, they will be candidates for success with this surgery.
How long will I be in the hospital?
Gastric Band patients go home the same day as their surgery. Most patients stay one or two nights in the hospital after surgery unless a complication develops.
When can I return to normal activity?
You can resume normal activity within 3 to 4 weeks after your surgery. Any pain related to the surgery should go away after 7-10 days or so.