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Weight Loss Surgery FAQ

Weight loss surgery is not for everyone. Doctors generally recommend it only for people who:

  • Have a body mass index (BMI) of 40 or more — about 100 pounds’ overweight for men and 80 for women
  • Have a lower BMI (35 to 40), but also have serious health problems related to obesity such as heart disease, type 2 diabetes, high cholesterol, or severe sleep apnea
  • Have tried and failed to lose weight by nonsurgical means such as diet and exercise
  • Fully understand the risks associated with weight loss surgery and are motivated

There are two basic types of weight loss surgery — restrictive surgeries and malabsorptive surgeries. Each helps with weight loss in different ways.

  • Restrictive surgeries (like adjustable gastric banding) work by physically restricting the stomach’s size, limiting the amount of solid food you can eat. A normal stomach can hold about three pints of food. After weight loss surgery, a stomach may only hold one ounce of food, although over time it may be able to hold two or three ounces of food.
  • Malabsorptive surgeries (like gastric bypass) work by changing the way your digestive system absorbs food. This type of weight loss surgery is more complicated. The surgeon removes parts of your intestine, creating a shortcut for the food to be digested. This means that fewer calories get absorbed into the body. The combined malabsorptive/restrictive surgery also creates a smaller stomach pouch, which restricts the amount of food you can eat.

To decide which weight-loss surgery is best for you, start first by considering your current health and weight, your goals, the procedures your physician performs and which are covered by your insurance provider.

There are many different procedures to choose from but they fall into two basic categories:

  • One restricts the size of the stomach to reduce the amount of food you can eat. 
  • The second type restricts the size of the stomach and also bypasses parts of the digestive tract to limit the calories absorbed as food passes through your intestines.

Your physician can help you discuss which approach will help you achieve your individual goals in the safest manner possible.

After surgery, most patients return to work in one or two weeks. You will have low energy for a while after surgery and may need to have some half days, or work every other day for your first week back. Your surgeon will give you clear instructions. Most jobs want you back in the workplace as soon as possible, even if you can’t perform ALL duties right away. Your safety and the safety of others are extremely important – low energy can be dangerous in some jobs.

Many patients are worried about getting hernias at incisions. That is almost never a problem from work or lifting. Hernias are more often the result of infection. You will not feel well if you do too much.

Right away! You will take gentle, short walks even while you are in the hospital. The key is to start slow. Listen to your body and your surgeon. If you lift weights or do sports, stay “low impact” for the first month (avoid competition, think participation). Build slowly over several weeks. If you swim, your wounds need to be healed over before you get back in the water.

It can. Be sure to follow any instructions from your surgeon about managing your diabetes around the time of surgery. Almost everyone with Type 2 Diabetes sees big improvement or even complete remission after surgery. Some studies have even reported improvement of Type 1 Diabetes after bariatric procedures.

Yes, but you may need medical clearance from your cardiologist. Bariatric surgery leads to improvement in most problems related to heart disease including:

  • High Blood Pressure
  • Cholesterol
  • Lipid problems
  • Heart enlargement (dilated heart, or abnormal thickening)
  • Vascular (artery and vein) and coronary (heart artery) disease

During the screening process, be sure to let your surgeon or nurse know about any heart conditions you have. Even those with atrial fibrillation, heart valve replacement, or previous stents or heart bypass surgery usually do very well. If you are on blood thinners of any type, expect special instructions just before and after surgery.

Yes. Most bariatric surgeons put their patients on a special pre-operative diet, usually 2 or 3 weeks just before surgery. The reason for the pre-operative diet is to shrink the liver and reduce fat in the abdomen. This helps during the procedure and makes it safer.
Some insurance companies require a physician-monitored diet three to six months prior to surgery as part of their coverage requirement. These diets are very different from the short term diets, and usually are more about food education and showing a willingness to complete appointments and to learn.

No and Yes.
Most people think of a “diet” as a plan that leaves you hungry. That is not the way people feel after surgery. Eventually, most patients get some form of appetite back 6-18 months after surgery. Your appetite is much weaker, and easier to satisfy than before.
This does not mean that you can eat whatever and whenever you want. Healthier food choices are important to best results, but most patients still enjoy tasty food, and even “treats.”
Most patients also think of exercise as something that must be intense and painful (like “boot camp”). Regular, modest activity is far more useful in the long term. Even elite athletes can’t stay at a “peak” every week of the year. Sometimes exercise is work, but if it becomes a punishing, never-ending battle, you will not keep going. Instead, work with your surgeon’s program to find a variety of activities that can work for you. There is no “one-size-fits-all” plan. Expect to learn and change as you go!
For many patients (and normal weight people, too) exercise is more important for regular stress control, and for appetite control, than simply burning off calories. As we age, inactivity can lead to being frail or fragile, which is quite dangerous to overall health. Healthy bones and avoiding muscle loss partly depends on doing weekly weight bearing (including walking) or muscle resistance (weights or similar) exercise.

Both laparoscopic and open gastric bypass surgeries last about two hours, although it can take longer if a patient has had previous abdominal surgery or if anatomical conditions make the procedure more difficult. Laparoscopic adjustable gastric banding normally takes about 60 to 90 minutes. A laparoscopic sleeve gastrectomy takes about one hour.
If you have the laparoscopic gastric bypass procedure, you can expect to be in the hospital for two days postoperatively. You may be able to return to most of your usual activities in seven to 10 days.
With the adjustable gastric banding procedure, the hospital stay is typically one day, with most patients able to resume normal activities in seven to 10 days.
Sleeve gastrectomy patients also typically stay one day in the hospital, then are able to resume normal activities in seven to 10 days.

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.

Most gastric bypass surgery is laparoscopic, which means the surgeon makes small cuts. That makes for shorter recovery time. Most people stay in the hospital for 2 to 3 days, and get back to normal activities in 3 to 5 weeks.
 
Weight loss is one of the goals of bariatric surgery. The amount of weight loss will depend on the person and the procedure. But it tends to be rapid in the first few months. During the first 30 days after bariatric surgery, the average weight loss is 5 to 15 pounds per week.
Here are eight foods to avoid after bariatric surgery:
  • 1) Food with Empty Calories.
  • 2) Alcohol.
  • 3) Dry Foods.
  • 4) Bread, Rice, and Pasta.
  • 5) Fibrous Fruits and Vegetables.
  • 6) High-Fat Food.
  • 7) Sugary and Highly Caffeinated Drinks.
  • 8) Tough Meats.
Avoid sugar, sugar-containing foods and beverages, concentrated sweets and fruit juices. For the first two months following surgery, your calorie intake should be between 300 and 600 calories a day, with a focus on thin and thicker liquids. Daily caloric intake should not exceed 1,000 calories.
Pre-Op Gastric Sleeve Diet: 3 Weeks Before Surgery
  • Reduce calories – especially carbohydrates. Carbohydrates are a major contributor of calories to most American diets. …
  • Maximize protein intake. Eat 60 or more grams of protein daily. …
  • Focus on healthy fats. It’s a myth that all fats are bad for you. …
  • Don’t dehydrate.
All patients are required to start a Liquid Diet 2 weeks before their surgery date. But, do not forget to ask your surgeon about your diet.
DS patients may also have a problem with foul-smelling flatus, which can be a serious issue. Diet is a major influence on bowel movements after a DS. Reducing the amount of fat will usually have a direct beneficial effect on the number and quality of bowel movements a patient may have

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