1. What is Bariatric Surgery?
Bariatric surgery is an operation that changes the way the body absorbs food.
Individuals who undergo bariatric surgery typically lose a large amount of weight (between 40 – 75% of excess body weight depending upon the procedure) in the two to three years after surgery.
2. Am I a Candidate?
Bariatric surgery may be an option if at least one of the following conditions applies to you:
- Your body mass index (BMI) is over 40. Calculate your BMI.
- You have a BMI of 35 or more plus medical problems such as high blood pressure, diabetes, hypertension, sleep apnea, arthritis or heart disease.
- You have obesity-related problems that interfere with work, family life or basic walking.
- You are unable to lose weight or maintain weight loss through traditional methods such as diet and exercise.
3. What is Gastric Banding?
Gastric banding is a minimally invasive procedure that involves permanently placing an adjustable silicone band around the upper portion of the stomach, making a narrow opening through which food travels. The band restricts the amount of food one can comfortably consume. Gastric banding is most suitable for patients with a BMI up to 50 who are physically active.
4. What is Gastric Bypass?
Gastric bypass is a permanent surgical weight loss procedure that is typically done laparoscopically. During gastric bypass, the patient’s stomach is divided into two sections, the small upper gastric pouch (which becomes the “new” stomach) and the larger bottom half of the stomach which will no longer be used.
When a gastric bypass patient eats a meal, food is swallowed into the small gastric pouch and then empties slowly into a limb of the small bowel, permanently bypassing the rest of the stomach and the first part of the small intestine.
By shrinking the size of the stomach and redirecting the digestive path, the surgeon limits the amount of food that the patient can consume at one time and reduces the number of calories his or her body can absorb.
5. Will My Insurance Cover Bariatric Surgery?
Coverage of bariatric surgery varies from provider to provider so it’s important that you check with your insurance company before seeking treatment.
6. How Do I Know Which Hospital to Choose?
When deciding upon a bariatric surgery program it is important that you select one that has a demonstrated track record of favorable outcomes and has completed a high number of surgeries. Typically these programs have been accredited by the American Society for Metabolic & Bariatric Surgery (www.asmbs.org) as a Center of Excellence or the American College of Surgeons (www.facs.org) as a member of its Bariatric Surgery Center Network.
It’s important to note that some insurance providers won’t pay for bariatric surgery unless it is done at a hospital that possesses one of these two distinctions.
Some insurance providers have even assigned their own distinctions to preferred bariatric surgery programs. An example would be the Blue Cross “Blue Center of Distinction.” Distinction such as this help consumers make more informed health care decisions, while improving overall quality outcomes and affordability.
7. What Should You Expect Before Surgery?
In advance of surgery, patients will typically undergo a number of tests and physical exams to rule out any underlying problems that would compromise their recovery.
In addition to blood tests, a patient may have to see a pulmonologist or a cardiologist. Some patients may also need to have an examination of their legs to rule out any blood clots.
Patients also see a bariatric psychologist and bariatric dietitian. The psychologist works with the patient to make sure he or she is ready and can adapt to the psychological changes that come with bariatric surgery. A patient will work with the dietitian to develop a healthy eating pattern that he or she can sustain after surgery.
A responsible surgical team will also expect patients to get in shape prior to surgery by improving their diet, increasing their physical activity and shedding any unhealthy behaviors such as smoking. Many programs will also expect the patient to attend a preoperative
seminar where they learn what they should expect with gastric bypass both pre- to postsurgery.
8. What Happens After Surgery?
- Discharge for gastric bypass is within a day or two of surgery. Adjustable gastric band patients are usually ready to go home within a day.
- Returning to work should be evaluated according to job requirements. Most patients are able to go back to desk-type work a week or so after banding and two to three weeks after bypass.
Time and patience are essential to a full recovery. Weight loss surgery requires a lifelong commitment to follow dietary guidelines, vitamin and mineral supplement regimes and lifestyle changes to maintain weight loss. Additionally, patients must follow up with their surgical team frequently the first year and at least once a year thereafter to check blood work and other health parameters.
9. What are the Risks of Bariatric Surgery?
Some of the risks of bariatric surgery include:
- Nutritional deficiencies
- Leaks, infections
- Mortality associated with breathing failure, blood clots or problems with the bypass procedure
- Band prolapse or intolerance
- Pulmonary embolism
In addition to the surgical procedure itself, your physical and medical condition influences your risk. Approximately 10 to 20 percent of patients who have weight loss operations may require re-operations. Discuss potential risks of surgery with your surgeon.
10. What are the Benefits of Bariatric Surgery?
- Most obesity-related conditions, such as diabetes and high blood pressure, asthma, sleep apnea, joint and back pain, stress urinary incontinence, hormonal abnormalities, reflux and heartburn often improve.
- Many patients maintain long-term weight loss if they are able to make the necessary lifestyle changes and are committed to following their nutrition plan and activity routine.
- Gastric bypass provides a quicker weight loss and a higher degree of resolution of weight related health problems.
- Adjustable gastric band provides a slower, more controlled weight loss over longer period of time, and is adjustable to accommodate each patient’s desired rate of weight loss.
- Many patients report a substantial improvement in their quality of life after significant weight loss. They become part of the mainstream of society and no longer suffer the embarrassment and stigma of obesity discrimination.