Bariatric Surgery Frequently Asked Questions
We've included some questions and answers we often hear about bariatric surgery. If you don't find the answer to your questions, we invite you to call our office. We also encourage you to write down questions to discuss with your provider at your next visit. Plus, attending a seminar is another excellent way to get your questions answered.
About bariatric surgery
bariatric surgery, also called bariatric surgery, limits the amount of food the stomach can hold, limits the absorption of nutrients and alters the “hunger” hormones in the gut causing the patient to lose a considerable amount of weight.
Is surgery right for me?
Persons who are extremely obese may want to consider bariatric surgery when traditional attempts at dieting and weight loss programs have failed. bariatric surgery candidates are at least 55 pounds overweight. This means a body mass index (BMI) of 40 or over. Sometimes, patients with a BMI of 30 and over are considered for surgery if they have medical problems that are caused by or associated with obesity, such as diabetes, high blood pressure and heart disease.
Will you lose weight?
About 90 percent of patients typically lose weight successfully after surgery. Of course, results vary by patient. The average long-term weight loss is about two-thirds of excess weight with adherence to lifestyle changes. Some people lose a little more, some a little less.
Is surgery the cure?
No. bariatric surgery is only a tool. Patients must follow dietary and exercise guidelines in order to be successful long-term.
Types of surgical procedures
At WakeMed Bariatric Surgery & Medical Weight Loss, our surgeons offer the latest and most effective surgical procedures including:
- Sleeve Gastrectomy: In the sleeve gastrectomy, 80% of the stomach is removed. This procedure works by 2 mechanisms. First, by removing a large portion of the stomach, it helps to reduce the amount of food that can be eaten. The greater impact seems to be the effect of the surgery on gut hormones that control hunger, fullness, and blood sugar control.
- Gastric Bypass: This procedure involves dividing the top portion of the stomach into a small pouch and connecting it to a loop of the small intestine to bypass another portion of the intestine. This surgery works by several mechanisms. First, the newly created stomach pouch is much smaller (about an ounce) which means less food can be eaten. Also, there is less absorption of nutrients due to the smaller stomach and the bypassing of part of the small intestine. Most importantly, this reroute changes gut hormones that control hunger, fullness, and blood sugar control.
- Single Anastomosis Duodenal Switch: In this procedure the surgeon removes 80% of the stomach, similar to the gastric sleeve. The new smaller stomach is then connected to a loop of the small intestine, bypassing about ½ of the small intestine. The smaller stomach limits food consumption similar to the sleeve. Also, less calories are absorbed in the small intestine. Most importantly, rerouting changes gut hormones that control hunger, fullness, and blood sugar control.
- Duodenal Switch: The duodenal switch has great weight loss potential, and works by creating a sleeve gastrectomy for restriction and hunger control followed by rerouting the intestines similar to a gastric bypass.
What's best for me?
This decision is best made between you and your bariatric surgeon. Your surgeon will discuss the operations and the risks and benefits of each procedure. Whenever possible, your bariatric doctor will conduct laparoscopic surgery, which is less invasive than open surgery, so patients usually have less discomfort, a shorter recovery time and fewer complications. Your surgeon will help you make the best decision after a careful evaluation.
The gastric bypass, sleeve gastrectomy and duodenal switch should not be considered reversible. Rerouted parts of the small intestine could be put together again, but such an operation carries additional risks.
Pre-surgery testing
All patients are required to be seen by a bariatric dietitian and psychologist and will have further workup involving blood work, a chest x-ray and electrocardiogram (EKG). Patients may also need additional medical evaluations or clearances depending on medical conditions.
Time between first appointment and surgery
It can take several months to up to 12 months depending upon the complexity of the case and your insurance requirements.
Recovery time
Expect to stay a minimum of 24 hours in the hospital. Surgical recovery can take from 2 to 6 weeks. Most recovery is done at home.
Follow up care
Generally, patients will be seen four to six times within the first year after their surgery. Visits are then scheduled on an annual basis.
Pregnancy after surgery
As patients lose weight following surgery it can be easier to become pregnant. It’s advisable not to become pregnant during a time of rapid weight loss. The timing of future pregnancies should be discussed with your bariatric provider and your obstetrician.
Many people heavy enough to meet the surgical criteria for bariatric surgery have stretched their skin beyond the point from which it can "snap back." Some patients will choose to have plastic surgery to remove loose or excess skin after they have lost their excess weight. Insurance generally does not pay for this type of surgery. However, some do pay for certain types of surgery to remove excess skin when complications arise from these excess skin folds. Ask your surgeon about your need for a skin removal procedure.
If you do need or want further surgery, Cary Hospital has several experienced plastic surgeons who perform procedures at the hospital.
Just about every type of surgery carries risks and possible complications. Potential risks and complications can be seen here.
You will start taking sips of clear liquids the day of surgery and your diet will progress to regular foods over the next 12 weeks. Learn about nutrition after surgery.
Bariatric surgery can eliminate or improve most obesity-related medical complications, including diabetes, hypertension, high cholesterol, sleep apnea, reflux and osteoarthritis, as well as stress incontinence, dermatitis, muscle and joint pain. Most patients are able to exercise much better, which helps them feel more energetic. Many patients also report feeling better emotionally, with less depression as their health and body image improves. Learn about weight loss benefits.
Your bariatric team will follow you several times in the first year and annually after that. You will need to continue the bariatric surgery, nutrition and fitness guidelines - this is the key to long term success after bariatric surgery.
One way to be successful is by sharing with others who are dealing with the same types of issues as you. Support groups provide a safe, comfortable place to talk, share problems and solutions, and encourage each other. Learn about our support groups.