Frequently Asked Questions About Bariatric Surgery

How much weight will I lose and how fast?

The expectation for most patients is that they will lose up to 50% of their excess weight in the first year. That means that if you are 100 pounds over your ideal weight, you will lose 50 pounds within a year of the surgery. If you are 200 pounds overweight, we expect you will lose 100 pounds the first year. You will continue to lose weight after the first year, but at a slower rate.

Which surgery is better?

Each surgery has its own risks and benefits. Your doctor will discuss your individual circumstances with you, and together you will decide which procedure is best for you based on how much you need to lose along with any other health issues you have.

Vertical Sleeve Gastrectomy is increasing in popularity because it does not reroute the digestive tract and has a slightly lower risk of complication than the Roux-en-Y Gastric Bypass procedure.

The Bypass surgery has the extra benefit of bypassing a portion of the small intestines, which further limits calorie absorption and speeds weight loss. It does, however, involve slightly more risk than Sleeve surgery. Bypass surgery is often recommended for patients with type 2 Diabetes because it has been shown to improve diabetes even without significant weight loss.

How long will it be before I can schedule my surgery?

The average time from initial consultation to the actual surgical procedure is about four to six months. This is because you need to undergo a thorough evaluation of your health and a supervised weight loss program before we can schedule the surgery. Not everyone who starts the process will have the surgery because they may not qualify or they may be so successful in their supervised weight loss program that they no longer need the surgery.

Will my insurance cover bariatric surgery?

In most cases, the patient's insurance does cover bariatric surgery. We conduct a rigorous review and evaluation process prior to performing surgery to ensure you meet the criteria required by your insurance company, including a medically supervised weight loss program and health and psychological evaluations.

When can I eat normally again?

When you say "normal diet," it all depends on what you consider "normal." Do you consider "normal" sitting down and devouring a plate of spaghetti or a 10-ounce steak? If so, your new eating regimen will be considerably different, for if you resume those kinds of eating habits, you will, at a minimum, be uncomfortable and possibly feel quite ill. Worst-case scenario, you will re-stretch your stomach and gain the weight back.

With any bariatric procedure, it is important make significant lifestyle changes that include limiting portion sizes and calorie consumption as well as regular exercise. Permanent weight loss requires a permanent lifestyle change. If you cannot commit to making that lifestyle change, you might want to consider more traditional weight loss methods rather than surgery.

I've been trying to lose weight for years and but have been unsuccessful. Why do I have to lose weight before I can have surgery?

We want you to lose weight prior to undergoing surgery for a number of reasons. First, we want you to survive the procedure; being overweight has compromised your health long enough. Losing weight before surgery will help your body withstand the procedure. It will also reduce the size of your liver, which will help give the surgeon a clear field of vision while performing the surgery. Finally, by following a restricted diet before the surgery, you will be more acclimated to the new diet and lifestyle you will have to adhere to after your surgery.

We will support you in your pre-surgery weight loss by having you work with a dietitian who will give a specific diet and exercise regimen as well as track your progress.

How long will I be unable to work after the surgery?

Most people are able to go back to work within 14 days. Work situations can sometimes create stress that may make you overeat, so we want you to be fully adjusted to your new diet and exercise regimen before returning to work.

When can I stop taking my blood pressure pills and diabetes medication?

Many patients can begin to reduce the amount of medication they take for conditions like high blood pressure and diabetes as they lose weight. Some are able to stop taking them altogether, but it is important to work with your primary care provider or endocrinologist regularly to monitor your bloodwork.

I really want to have a baby, but my OB says I can't because I am obese. Will bariatric surgery allow me to try to get pregnant? If so, how soon after surgery can I try?

Getting pregnant while obese is often very difficult and can be dangerous for both the mother and the baby. Bariatric surgery can help you lose enough weight to minimize the risks associated with pregnancy. We recommend you wait at least 12 months following surgery before attempting to get pregnant so that you can lose enough weight to mitigate the potential risks. It is important to note, however, that weight loss surgery has an immediate effect on your hormones, meaning many women can become very fertile as soon after surgery. Because of the increased fertility, you should take precautions so you do not become pregnant too quickly; while your fertility may be higher, your risk will remain high until you lose a significant amount of weight.

Can I still eat pizza?

The best diet with which to lose weight and maintain weight loss is one high in protein and low in simple complex carbohydrates. Does that mean you can never have a treat ever again? Of course not. However, high-carb foods such as pizza, pasta and cake should only be consumed only occasionally and in very small quantities. Your diet will be more focused on proteins and vegetables with minimal grains. Your dietitian will help you learn what you should and should not eat to lose and keep off weight. The good news is that once you stop eating carbs and sugar, your body will stop craving them and you will naturally come to prefer proteins and vegetables and not feel deprived.

Will I be able to drink alcohol after surgery?

We recommend that you not drink alcohol following surgery for two reasons:

1. Alcohol has empty calories that offer no nutritional benefit. Since losing weight entails limiting calorie consumption, it is better to get your calories from nutritious food.
2. Your stomach will be significantly smaller after surgery, thus it will have a much smaller surface area for digesting alcohol. This means that any alcohol you drink will enter your blood system much faster and at a much higher concentration, resulting in you becoming intoxicated very quickly, even after just a few sips.

I'm a smoker. I think I can handle not smoking for the six months before the surgery, but why do I have to commit to never smoking again?

When you decide to have bariatric surgery, you are taking the first step toward a healthier lifestyle. Smoking is the leading cause of a number of life-threatening diseases, including heart disease and a large number of cancers. If you continue to smoke after your surgery, you are continuing to put your health at risk.

I can barely walk now. How am I supposed to exercise?

The expectation before or even after your surgery won't be that you will be ready to run a marathon. You will simply need to become more active and mobile. Perhaps that will mean just walking to mailbox every day to start. As you lose weight and start to move more, moving will become easier. Most exercise programs start with easy walking and then gradually increase the distance and amount of time you walk. Adding exercise bands and light hand weights can help you add muscle mass, which in turn will help you burn more calories and increase your muscle tone.

Do some patient eventually run marathons? Yes, and that's an admirable goal. However, even a marathon starts with a single step.

If bariatric surgery is just making my stomach smaller so I can't eat as much and am forced to restrict calories, isn't that the same as the calorie restricting diets that haven't worked? What's makes surgery different?

A number of things happen as part of weight loss surgery. Yes, your stomach is physically reduced in size so you will feel fuller faster. In removing a portion of your stomach, we also remove some of the parts that produce the hormones that affect hunger, satiety and metabolism. The diet will also focus on protein and 'good' carbs like vegetables, which helps to reduce (or eliminate) cravings for high-carbohydrate, high-calorie foods like bread and pasta. Your diet will also include protein shakes and small snacks throughout the day, which also helps prevent hunger. With a smaller stomach and fewer hormones in your system, you won't be as hungry and you will be satisfied with smaller amounts of food.

What happens if I regain weight?

The possibility of regaining weight is a concern for any patient undergoing bariatric surgery, particularly those who find changes to their diet and their exercise regimen too difficult to maintain. We often see that some patients have a harder time remaining disciplined in their diet when they begin to socialize more, especially when socialize taking part in social activities that involve food.

We will work with you to help keep you on track and motivated to maintain your newfound lifestyle. You will see your doctor at least once a year. A dietitian will also be available to you as you need. We also offer support groups in which you can talk with others who are dealing with the same feelings, emotions and challenges as you, providing a safe space to share experiences and success tips.

How long will I be in the hospital?

You should plan to be in the hospital at least one night—possibly two, depending on the procedure and your overall health. We perform weight loss procedures using minimally invasive laparoscopic techniques, which generally means a faster recovery time and less scarring. In some rare cases, we may have to convert to an "open" procedure that requires larger incisions, in which case you may be in the hospital longer.

I hear stories about people having surgery and then gaining back all the weight they had lost. How is that possible if you're taking out most of my stomach?

Committing to changes to your diet and increased activity levels is key to not regaining weight. Some people revert back to their old eating habits after they reach their weight loss goal, falsely thinking they have done all the necessary work. Others think they are adhering to their new diet if they drink smoothies or other high-calorie 'health drinks' rather than eat healthy food. Unfortunately, those approaches do not work. Weight loss is a lifestyle change, not a quick fix. If you resume your old eating habits, you could stretch your stomach over time, negating the benefits of the surgery. If you replace solid food calories with high-calorie smoothies and liquid meal replacements, you will consume more calories than your body needs, which also results in weight gain.

Successful, long-term weight loss requires a lifelong commitment to changing how you eat, what you eat and why you eat.

Contact Us

For more information about the support group or to schedule an appointment, please call 301-609-5006.