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Bariatric surgery is a treatment option available for adults ages 18 to 60 years who have a BMI over 40 (or for those who have a BMI between 35 and 40 and obesity-related medical complications, such as: diabetes, significant cardiovascular disease, or sleep apnea). You can calculate your BMI by clicking here.
The laparoscopic surgery often requires a hospital stay of only 1-2 days.
If the work you perform is sedentary, you can probably return to work in 2 weeks and up to 3-6weeks if physical labor is involved. You should be able to return to normal activities between one and two weeks, compared with four to six weeks for traditional surgery.
You may experience hair loss or hair thinning within 3-5 months after the surgery. However, this is usually a temporary condition.
Your gallbladder will not be removed unless there are signs or symptoms of a diseased gallbladder. However, our patients will be treated post-operatively for six months with medication to decrease the risk of developing gallstones, which can occur from rapid weight loss.
The amount of food you will be able to eat will change significantly. Just after surgery, food intake is limited to one to two fluid ounces per meal so that the stomach can heal properly. Later, the quantity of food increases, and other foods will be added as you can tolerate them. At maximum capacity, about 12-18months after surgery, the pouch can hold between 4 to 6 ounces of food.
You may be unable to tolerate certain foods, especially those containing sugar and fat. You will be required to meet with a nutritionist and will be provided with a comprehensive diet. A balanced diet of 1,000-1,200 calories a day is recommended.
Yes, you will need to take vitamins for the rest of your life. Immediately after surgery you will begin taking a chewable multi-vitamin daily, as well as vitamin B-12 and calcium citrate.
Weight loss results vary with each individual. The average patient will lose about 75 to 80% of their excess body weight by the end of the first year following surgery.
Depending upon your type of insurance plan there may be an exclusion for weight loss treatments, including surgery. Other plans will have certain requirements before agreeing to pay for the surgery, such as a medically supervised diet history and the need for psychological evaluation. Not all plans have the same requirements. You should call your insurance company to find out if it covers the Bariatric Roux-en-Y surgery. Obtain a printed copy of the insurance company’s requirements, and document all contacts you have with the insurance company.
Yes. Bariatric surgery often increases fertility in those who have had difficulty conceiving in the past. However, pregnancy must be avoided for 18-24 months post operatively, until your weight has stabilized.
Medical conditions, such as serious heart or lung problems, can increase the risk of any major surgery. If they are problems that are related to the patient’s weight they also increase the need for surgery. In other words, severe medical problems will usually not dissuade the surgeon from recommending the gastric bypass surgery if it is otherwise appropriate. However, he will estimate your risk as higher than average upon initial consultation.
The national mortality rate is low -- 0.5%, or 1 out of very 200 patients.
The stomach pouch is designed to hold approximately one ounce. In the first few months it is rather stiff due to natural surgical inflammation. From about 12-18 months after surgery, the stomach pouch expands a bit as the inflammation subsides. Most patients end up with a meal capacity of about 4-6 fluid ounces.
The amount of excess skin depends on the total weight loss, age, and how much the skin was stretched. Unfortunately it cannot usually be prevented -- the majority of people who have gotten heavy enough to merit gastric bypass surgery have stretched their skin beyond a point from which it can “snap back.”
It’s hard to say because every person is different. Factors like age and skin elasticity will play a big part in determining if surgery will be needed. Usually this is considered cosmetic surgery which often is not covered by insurance, though some non-cosmetic cases will be covered. If you desire this service, we have experienced plastic surgeons who are available for consultation.
Most patients say no. For the first 6 months many patients have almost no appetite. Over the next several months the appetite returns but it tends not to be a ravenous type of hunger.
Usually this is caused by the types of food you are consuming, especially starches (rice, pasta, potatoes). Increasing protein intake is helpful for many patients. There may also be a psychological problem with the lack of food in your life (“head hunger”).
Many medications (for blood pressure, diabetes, etc.) may be stopped at some point after gastric bypass. For medications that need to be continued, most can be swallowed, absorbed and work the same as before gastric bypass. Usually no change in dose is required.
We can schedule your surgery shortly after you receive authorization from your insurance company..
From the time you decide to move forward with the surgery a lot happens. If you are trying to have your insurance pay for the surgery, authorization should be requested at this time.
Once authorization is obtained we give you a surgical date; but we have to allow enough time to get any additional medical clearances that are needed. There is also a mandatory pre-operative education class that you must attend or your surgery will be cancelled until after you attend the class.
Establish a relationship with your primary physician, if you don’t already have one. Work with that physician to get “caught up” on your routine health maintenance testing: for woman this is a biannual exam and Pap smear and (if over 40) a mammogram. For men this might include a PSA.
Fill our the Patient Information Form and mail it to our office or bring it to the educational seminar. Bring any pertinent medical data to your appointment. This will include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital. It should also include all progress notes related to your medically supervised weight loss attempts. Most insurance policies require 6-12 months of consecutive, medically supervised weight loss attempts within the prior 24 months as criteria for approving the surgery.
Generally not, as most patients lose very small amounts of blood during the surgery. Even those who have unexpected bleeding during surgery do not usually lose enough blood to warrant transfusion. The main downside to giving your own blood is that you would need to wait several weeks for your blood to build back up after being donated.