Frequently Asked Questions About Morbid Obesity
Our Frequently Asked
Questions section refers to United States-based generally standard and
accepted practices. As always, please check with your healthcare provider to
determine their practices, guidelines and what they recommend for you.
Preparation for Surgery
Insurance Issues
Surgery
The Hospital Stay
Life After Surgery
Diet
General
Preparation for Surgery
What are the routine tests before surgery?
Certain basic tests may be done prior to surgery: a Complete Blood Count
(CUBIC), Urinalysis, and a Chemistry Panel, which gives a readout of about
20 blood chemistry values. Some patients may get a chest X-ray and an electrocardiogram
depending on their medical history. Women are encouraged to undergo breast
exams, mammograms, and PAP smear to screen for abnormalities. A gallbladder ultrasound to look for
gallstones may be performed if chronic symptoms of gallbladder disease are
present. Other tests, such as pulmonary function testing, echocardiogram,
sleep studies, GI evaluation, cardiology evaluation, or psychiatric
evaluation, may be requested when indicated.
What is the purpose
of all these tests?
An accurate assessment of your health is needed before surgery. The best way
to avoid complications is to never have them in the first place. It is
important to know if your thyroid function is adequate since hypothyroidism
can lead to sudden death post-operatively. If you are diabetic, special
steps must be taken to control your blood sugar. Because surgery increases
cardiac stress, your heart may be evaluated if there is significant history
of heart disease.
Why do I have to
have a GI Evaluation?
Patients who have significant gastrointestinal symptoms such as upper
abdominal pain, heartburn, belching sour fluid, etc., may have underlying
problems such as a hiatus hernia, gastroesophageal reflux or peptic ulcer.
For example, many patients have symptoms of reflux. Up to 15% of these
patients may show early changes in the lining of the esophagus, which could
predispose them to cancer of the esophagus. It is important to identify
these changes so a suitable surveillance or treatment program can be
planned.
Why do I have to
have a Sleep Study?
The sleep study detects a tendency for abnormal stopping of breathing,
usually associated with airway blockage when the muscles relax during sleep.
This condition is associated with a high mortality rate. After surgery, you
will be sedated and will receive narcotics for pain, which further depress
normal breathing and reflexes. Airway blockage becomes more dangerous at
this time. It is important to have a clear picture of what to expect and how
to handle it.
Why do I have to
have a Psychiatric Evaluation?
The most common reason a psychiatric evaluation is ordered is that your
insurance company may require it. Most psychiatrists will evaluate your
understanding and knowledge of the risks and complications associated with
weight loss surgery and your ability to follow the basic recovery plan.
What impact do my
medical problems have on the decision for surgery, and how do the medical
problems affect risk?
Medical problems, such as serious heart or lung problems, can increase the
risk of any surgery. On the other hand, if they are problems that are
related to the patient's weight, they also increase the need for surgery.
Severe medical problems may not dissuade the surgeon from recommending
gastric bypass surgery if it is otherwise appropriate, but those conditions
will make a patient's risk higher than average.
What can I do before the appointment to speed up the process of getting ready for surgery?
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Select a primary care physician if you don't already have one, and establish a relationship with him or her. Work with your physician to ensure that your routine health maintenance testing is current. For example, women may have a pap smear, and if over 40 years of age, a breast exam. And for men, this may include a prostate specific antigen test (PSA).
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Make a list of all the diets you have tried (a diet history) and bring it to your doctor.
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Bring any pertinent medical data to your appointment with the surgeon - this would include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital.
-
Bring a list of your medications with dose and schedule.
-
Stop smoking. Surgical patients who use tobacco products are at a higher surgical risk.
Insurance Issues
Why does it take so long to get insurance approval?
After your interview consultation is completed, it usually takes your doctor
several days to send a letter to your insurance carrier to start the
approval process. The time it takes to get an answer can vary from about 3-4
weeks or longer if you are not persistent in your follow-up. It may be
helpful for you to call the claims service of your insurance company about a
week after your letter is submitted and ask about the status of your
request.
How can they deny
insurance payment for a life-threatening disease?
Payment may be denied because there may be a specific exclusion in your
policy for obesity surgery or "treatment of obesity." Such an exclusion can
often be appealed when the surgical treatment is recommended by your surgeon
or referring physician as the best therapy to relieve life-threatening
obesity-related health conditions, which usually are covered.
Insurance payment may also be denied for lack of "medical necessity." A
therapy is deemed to be medically necessary when it is needed to treat a
serious or life-threatening condition. In the case of morbid obesity,
alternative treatments - such as dieting, exercise, behavior modification,
and some medications - are considered to be available. Medical necessity
denials usually hinge on the insurance company's request for some form of
documentation, such as 1 to 5 years of physician-supervised dieting or a
psychiatric evaluation, illustrating that you have tried unsuccessfully to
lose weight by other methods.
What can I do to
help the process?
Gather all the information (diet records, medical records, medical tests)
your insurance company may require. This reduces the likelihood of a denial
for failure to provide "necessary" information. Letters from your personal
physician and consultants attesting to the "medical necessity" of treatment
are particularly valuable. When several physicians report the same findings,
it may confirm a medical necessity for surgery.
When the letter is submitted, call your carrier regularly to ask about the
status of your request. Your employer or human relations/personnel office
may also be able to help you work through unreasonable delays.
Surgery
Does Laparoscopic Surgery decrease the risk?
No. Laparoscopic operations carry the same risk as the procedure performed
as an open operation. The benefits of laparoscopy are typically less
discomfort, shorter hospital stay, earlier return to work and reduced
scarring.
Will I have a lot
of pain?
Every attempt is made to control pain after surgery to make it possible for
you to move about quickly and become active. This helps avoid problems and
speeds recovery. Often several drugs are used together to help manage your
post-surgery pain. While you are still in the hospital, a Patient Controlled
Analgesia (PCA), which allows you to give yourself a dose of pain medicine
on demand, may be used by your physician. Various methods of pain control,
depending on your type of surgical procedure, are available.
How long do I have
to stay in the hospital?
As long as it takes to be self-sufficient. Although it can vary, the
hospital stay (including the day of surgery) can be 2-3 days for a
laparoscopic gastric bypass, and 4-5 days for an open gastric bypass.
Will the doctor
leave a drain in after surgery?
Most patients will have a small tube to allow drainage of any accumulated
fluids from the abdomen. This is a safety measure, and it is usually removed
a week after the surgery. Generally, it produces no more than minor
discomfort.
If I have surgery,
what can I expect when I wake up in the recovery room?
We will provide a Patient Controlled Analgesia (PCA) or a
self-administered pain management system, to help control pain. As with
any major surgery, you are in danger of death from a blood clot or other
surgical side effects. Statistically, the risk of death during these
procedures is less than 1 percent.
All abdominal operations carry the risks of bleeding, infection in the
incision, thrombophlebitis of legs (blood clots), lung problems (pneumonia,
pulmonary embolisms), strokes or heart attacks, anesthetic complications,
and blockage or obstruction of the intestine. These risks are greater in
morbidly obese patients.
How soon will I be
able to walk?
Almost immediately after surgery doctors will require you to get up and move
about. Patients are asked to walk or stand at the bedside on the night of
surgery, take several walks the next day and thereafter. On leaving the
hospital, you may be able to care for all your personal needs, but will need
help with shopping, lifting and with transportation.
How soon can I
drive?
For your own safety, you should not drive until you have stopped taking
narcotic medications and can move quickly and alertly to stop your car,
especially in an emergency. Usually this takes 7-14 days after surgery.
The Hospital Stay
What is done to minimize the risk of deep vein thrombosis/pulmonary
embolism or DVT/PE?
Because a DVT originates on the operating table, therapy begins before a
patient goes to the operating room. Generally, patients are treated with
sequential leg compression stockings and given a blood thinner. Both of these therapies continue throughout your hospitalization.
The third major preventive measure involves getting the patient moving and
out of bed as soon as possible after the operation to restore normal blood
flow in the legs.
What should I bring
with me to the hospital?
Basic toiletries (comb, toothbrush, etc.) and clothing may be provided by
the hospital, but most people prefer to bring their own. Choose clothes for
your stay that are easy to put on and take off. Because of your incision,
your clothes may become stained by blood or other body fluids. Other ideas:
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reading and writing materials
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DVD, CD (also available in suites)
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crossword and other puzzles
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personal toiletries
-
bathrobe
Life After Surgery
What do I need to do to be successful after surgery?
The basic rules are simple and easy to follow:
-
No Aspirin: it may lead to bleeding ulcers.
-
Immediately after surgery, most begin with sugar-free liquid diets, moving to gastric bypass semi-solid foods and later, sometimes weeks or months later, solid foods can be tolerated without risk to the surgical procedure performed. Allowing time for proper healing of your new stomach pouch is necessary and important.
-
When able to eat solids, eat 2-3 meals per day, no more. Protein in the form of lean meats (chicken, turkey, fish) and other low-fat sources should be eaten first. These should comprise at least half the volume of the meal eaten. Foods should be cooked without fat and seasoned to taste. Avoid sauces, gravies, butter, margarine, mayonnaise and junk foods.
-
Never eat between meals. Do not drink flavored beverages, even diet soda, between meals.
-
Drink 2-3 quarts or more of water each day. Water must be consumed slowly, 1-2 mouthfuls at a time, due to the restrictive effect of the operation.
-
Exercise aerobically every day for at least 20 minutes (one-mile brisk walk, bike riding, stair climbing, etc.). Weight/resistance exercise can be added 3-4 days per week, as instructed by your doctor.
What's so important
about exercise?
When you have a weight loss surgery procedure, you lose weight because the
amount of food energy (calories) you are able to eat is much less than your
body needs to operate. It has to make up the difference by burning reserves
or unused tissues. Your body will tend to burn any unused muscle before it
begins to burn the fat it has saved up. If you do not exercise daily, your
body will consume your unused muscle, and you will lose muscle mass and
strength. Daily aerobic exercise for 20 minutes will communicate to your
body that you want to use your muscles and force it to burn the fat instead.
What is the right
amount of exercise after weight loss surgery?
Many patients are hesitant about exercising after surgery, but exercise is
an essential component of success after surgery. Exercise actually begins on
the afternoon of surgery - the patient must be out of bed and walking. The
goal is to walk further on the next day, and progressively further every day
after that, including the first few weeks at home. Patients are often
released from medical restrictions and encouraged to begin exercising about
two weeks after surgery, limited only by the level of wound discomfort. The
type of exercise is dictated by the patient's overall condition. Some
patients who have severe knee problems can't walk well, but may be able to
swim or bicycle. Many patients begin with low stress forms of exercise and
are encouraged to progress to more vigorous activity when they are able.
Can I get pregnant
after weight loss surgery?
It is strongly recommended that women wait at least one year, preferably two
years, after the surgery before a pregnancy. Approximately one to two years
post-operatively, your body will be fairly stable (from a weight and
nutrition standpoint) and you should be able to carry a normally nourished
fetus. You should consult your surgeon and obstetrician as you plan for
pregnancy.
What if I have had
a previous weight loss surgical procedure and I'm now having problems?
Contact your original surgeon - he or she is most familiar with your medical
history and can make recommendations based on knowledge of your surgical
procedure and body.
What happens to the
lower part of the stomach that is bypassed?
The stomach is left in place with intact blood supply. In some cases it may
shrink a bit and its lining (the mucosa) may atrophy, but for the most part
it remains unchanged. The lower stomach still contributes to the function of
the intestines even though it does not receive or process food - it makes
intrinsic factor, necessary to absorb Vitamin B12 and contributes to hormone
balance and motility of the intestines in ways that are not entirely known.
In the BPD procedures, some portion of the stomach is completely removed.
How big will my
stomach pouch really be in the long run?
This can vary by surgical procedure and surgeon. In the Roux-en-Y gastric
bypass, the stomach pouch is created at one ounce or less in size (15-20cc).
In the first few months it is rather stiff due to natural surgical
inflammation. About 6-12 months after surgery, the stomach pouch can expand
and will become more expandable as swelling subsides. Many patients end up
with a meal capacity of 3-7 ounces.
What will the
staples do inside my abdomen? Is it okay in the future to have an MRI test?
Will I set off metal detectors in airports?
The staples used on the stomach and the intestines are very tiny in
comparison to the staples you will have in your skin or staples you use in
the office. Each staple is a tiny piece of stainless steel or titanium so
small it is hard to see other than as a tiny bright spot. Because the metals
used (titanium or stainless steel) are inert in the body, most people are
not allergic to staples and they usually do not cause any problems in the
long run. The staple materials are also non-magnetic, which means that they
will not be affected by MRI. The staples will not set off airport metal
detectors.
What if I'm not
hungry after surgery?
It's normal not to have an appetite for the first month or two after weight
loss surgery. If you are able to consume liquids reasonably well, there is a
level of confidence that your appetite will increase with time.
Is there any
difficulty in taking medications?
Most pills or capsules are small enough to pass through the new stomach
pouch. Initially, your doctor may suggest that medications be taken in
liquid form or crushed.
Will I be able to
take oral contraception after surgery?
Most patients have no difficulty in swallowing these pills.
Is sexual activity
restricted?
Patients can return to normal sexual intimacy when wound healing and
discomfort permit. Many patients experience a drop in desire for about 6
weeks.
Is there a
difference in the outcome of surgery between men and women?
Both men and women generally respond well to this surgery. In general, men
lose weight slightly faster than women do.
Will I be asked to
stop smoking?
Patients are encouraged to stop smoking at least one month before surgery.
If I continue to
smoke, what happens?
Smoking increases the risk of lung problems after surgery, can reduce the
rate of healing, increases the rates of infection, and interferes with blood
supply to the healing tissues.
How can I know that
I won't just keep losing weight until I waste away to nothing?
Patients may begin to wonder about this early after the surgery when they
are losing 20-40 pounds per month, or maybe when they've lost more than 100
pounds and they're still losing weight. Two things happen to allow weight to
stabilize. First, a patient's ongoing metabolic needs (calories burned)
decrease as the body sheds excess pounds. Second, there is a natural
progressive increase in calorie and nutrient intake over the months
following weight loss surgery. The stomach pouch and attached small
intestine learn to work together better, and there is some expansion in
pouch size over a period of months. The bottom line is that, in the absence
of a surgical complication, patients are very unlikely to lose weight to the
point of malnutrition.
What can I do to
prevent lots of excess hanging skin?
Many people heavy enough to meet the surgical criteria for weight loss
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 (often seen as elective surgery).
However, some do pay for certain types of surgery to remove excess skin when
complications arise from these excess skin folds.
Will exercise help
with excess hanging skin?
Exercise is good in so many other ways that a regular exercise program is
recommended. Unfortunately, most patients may still be left with large flaps
of loose skin.
Will I be miserably
hungry after weight loss surgery since I'm not eating much?
Most patients say no. In fact, for the first 4-6 weeks patients have almost
no appetite. Over the next several months the appetite returns, but it tends
not to be a ravenous "eat everything in the cupboard" type of hunger.
What if I am really
hungry?
This is usually caused by the types of food you may be consuming, especially
starches (rice, pasta, potatoes). Be absolutely sure not to drink liquid
with food since liquid washes food out of the pouch.
Will I have to
change my medications?
Your family doctor will determine whether medications for blood pressure,
diabetes, etc., can be stopped when the conditions for which they are taken
improve or resolve after weight loss surgery. For meds that need to be
continued, the vast majority can be swallowed, absorbed and work the same as
before weight loss surgery. Usually no change in dose is required. Two
classes of medications that should be used only in consultation with your
surgeon are diuretics (fluid pills) and NSAIDs (most over-the-counter pain
medicines). NSAIDs (ibuprofen, naproxen, etc.) may create ulcers in the
small pouch or the attached bowel. Most diuretic medicines make the kidneys
lose potassium. With the dramatically reduced intake experienced by most
weight loss surgery patients, they are not able to take in enough potassium
from food to compensate. When potassium levels get too low, it can lead to
fatal heart problems. Please avoid taking Aspirin. Aspirin is a
blood thinner that may lead to bleeding after surgery.
What is a hernia
and what is the probability of an abdominal hernia after surgery?
A hernia is a weakness in the muscle wall through which an organ (usually
small bowel) can advance. Approximately 20% of patients develop a hernia.
Most of these patients require a repair of the herniated tissue. The use of
a reinforcing mesh to support the repair is common.
Is blood
transfusion required?
Very rarely: If needed, it is given after a thorough screening from a blood
bank.
What is phlebitis
and is it preventable?
Undesired blood clotting in veins, especially of the calf and pelvis. It is
not completely preventable, but preventive measures will be taken,
including:
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Early ambulation
-
Special stockings
-
Blood thinners
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Pulsatile boots
Will I lose hair
after surgery? How can I prevent it?
Many patients experience some hair loss or thinning after surgery. This
usually occurs between the fourth and the eighth month after surgery.
Consistent intake of protein at mealtime is the most important prevention
method. Also recommended are a daily zinc supplement and a good daily volume
of fluid intake.
Does hair growth
recover?
Most patients experience natural hair regrowth after the initial period of
loss.
What are adhesions
and do they form after this surgery?
Adhesions are scar tissues formed inside the abdomen after surgery or
injury. Adhesions can form with any surgery in the abdomen. For most
patients, these are not extensive enough to cause problems.
What is the
"Candida Syndrome?"
Some patients have a type of yeast present on the surface of their skin,
intestine or vagina at the time of surgery. This leads to overgrowth in
certain circumstances. A whitish coating may occur on the tongue or throat.
This syndrome is associated with a frothy mucous, nausea, difficulty
swallowing, sore throat, loss of taste and appetite, and occasionally
abdominal bloating and diarrhea.
What causes it to
appear?
It is promoted by the use of most antibiotics and some other medications, by
stress, by reduced immune response, and by diabetes.
Can it be cured?
There are several effective medications now available for treating the
overgrowth of Candida.
What is sleep apnea
(SA)?
It is the interruption of the normal sleep pattern associated with repeated
delays in breathing. Sleep apnea often shows rapid improvement after
surgery. In most patients, there is a complete resolution of symptoms by six
months following surgery.
Diet
How long will I be off of solid foods after surgery?
We recommend a period of four weeks or more without solid foods after
surgery. A liquid diet, followed by semi-solid foods or pureed foods, may be
recommended for a period of time until adequate healing has occurred. Our
dietician will provide you with specific dietary guidelines for the best
post-surgical outcome.
What do I eat once I get home from the hospital?
Refer to your book from the gastric bypass education class, the section titled Diet Advancement. You should be on the liquid diet until somewhere between 10 and 14 days past the date of your surgery. This includes strained clear soups (liquid part), tomato soup made with milk, soy milk, or Isopure Zero Carb 20 oz. Liquid drink or EAS Carb Sense (both available at GNC). You can have sugar free popsicles, broth, sugar free Jello, water, or and other sugar free beverages discussed in class.
How many ounces of water should I be consuming per day?
You should be consuming at least 32 ounces of fluids per day. If you can drink more, then you can have more! The minimum is 32 ounces. Remember, all fluids count towards 32 ounces. Remember to pace yourself; 2 ounces every 15 minutes; this helps you keep your intake slow and steady and avoids discomfort.
What vitamins should I be taking and when do I start them?
Start taking them when you get home from the hospital. You can choose a chewable Flintstones, Bugs Bunny type or Bariatric Advantage chewable multiformula, chewable calcium, chewable iron and sublingual B12. The Bariatric Advantage option is slightly more costly, but is more convenient as it is delivered to your door and you can start all the vitamins you need as chewable and stay on the chewable vitamins indefinitely if you wish.
What happens if I feel hungry?
You may or may not feel hungry a few days out from surgery. Some people are hungry on the liquids, others are not. Feel free to have the liquids as often as you need to. For example, if you want milk or the Isopure or EAS supplement 4 or 5 times throughout the day instead of just three times (breakfast, lunch, and dinner), you may do so.
Do I need to sign up or register to attend a support group session?
No, you can just show up, but please note that at the Littleton Hospital and Swedish Hospital groups we share problems, concerns, tips, etc. in small break out groups or with the group as a whole. At the St. Joseph’s “downtown” group we may have a guest speaker or special party or event planned that you may or may not be interested in attending. Once you attend on a fairly routine basis, you can request to be called or e-mailed an announcement on the speakers and events at the downtown location. You can attend any location you choose at any time or visit them all!
Can I have carbonation or caffeine?
No! Carbonation is forbidden as the pressure from the CO2 can be painful or at least very uncomfortable and some believe it may likely stretch out your pouch/outlet. As for caffeine, it is a diuretic and it can cause dehydration in those who struggle to get in adequate fluids as it pulls them out of the body. Caffeine should not be consumed until at least 64 ounces of water can be consumed in a 24 hour period.
Do I need protein supplements?
No. There is no clinically based evidence that supports the need for protein supplements. There is no evidence that supports the claim that they help you maintain muscle mass. There is no set grams of protein that one should consume per day. On the other hand, it is crucial to eat protein foods first in your meal (meat, milk, yogurt, cheese, beans, peanut butter, and soy). Many people feel more energy if they achieve around 30 grams of protein per day. The EAS Carb Sense, Isopure Zero Carb, (both at GNC) and milk can provide this level of protein intake with ease.
What are the best
choices of protein?
Eggs, low-fat cheese, low-fat cottage cheese, tofu, fish, other seafood,
chicken (dark meat), turkey (dark meat).
Why drink so much
water?
When you are losing weight, there are many waste products to eliminate,
mostly in the urine. Some of these substances tend to form crystals, which
can cause kidney stones. A high water intake protects you and helps your
body to rid itself of waste products efficiently, promoting better weight
loss. Water also fills your stomach and helps to prolong and intensify your
sense of satisfaction with food. If you feel a desire to eat between meals,
it may be because you did not drink enough water in the hour before.
What is Dumping
Syndrome?
Eating sugars or other foods containing many small particles when you have
an empty stomach can cause dumping syndrome in patients who have had a
gastric bypass or BPD where the stomach pylorus is removed. Your body
handles these small particles by diluting them with water, which reduces
blood volume and causes a shock-like state. Sugar may also induce insulin
shock due to the altered physiology of your intestinal tract. The result is
a very unpleasant feeling: you break out in a cold clammy sweat, turn pale,
feel "butterflies" in your stomach, and have a pounding pulse. Cramps and
diarrhea may follow. This state can last for 30-60 minutes and can be quite
uncomfortable - you may have to lie down until it goes away. This syndrome
can be avoided by not eating the foods that cause it, especially on an empty
stomach. A small amount of sweets, such as fruit, can sometimes be well
tolerated at the end of a meal.
Is there a problem
with consuming milk products?
Milk contains lactose (milk sugar), which is not well digested. This sugar
passes through undigested until bacteria in the lower bowel act on it,
producing irritating byproducts as well as gas. Depending on individual
tolerance, some persons find even the smallest amount of milk can cause
cramps, gas and diarrhea.
Why can't I snack
between meals?
Snacking, nibbling or grazing on foods, usually high-calorie and high-fat
foods, can add hundreds of calories a day to your intake, defeating the
restrictive effect of your operation. Snacking will slow down your weight
loss and can lead to regain of weight.
Why can't I eat red
meat after surgery?
You can, but you will need to be very careful, and we recommend that you
avoid it for the first several months. Red meats contain a high level of
meat fibers (gristle) which hold the piece of meat together, preventing you
from separating it into small parts when you chew. The gristle can plug the
outlet of your stomach pouch and prevent anything from passing through, a
condition that is very uncomfortable.
How can I be sure I
am eating enough protein?
40 to 65 grams a day are generally sufficient. Check with your surgeon to
determine the right amount for your type of surgery.
Is there any
restriction of salt intake?
No, your salt intake will be unchanged unless otherwise instructed by your
primary care physician.
Will I be able to
eat "spicy" foods or seasoned foods?
Most patients are able to enjoy spices after the initial 6 months following
surgery.
Will I be allowed
to drink alcohol?
You will find that even small amounts of alcohol will affect you quickly. It
is suggested that you drink no alcohol for the first year. Thereafter, with
your physician's approval, you may have a glass of wine or a small cocktail.
Will I need
supplemental vitamins?
B12 injections are sometimes suggested once a month for the first year and
every six months thereafter. B12 may also be taken orally or sublingually
(under the tongue) by many patients.
What vitamins will
I need to take after surgery?
We recommend a daily multivitamin for the rest of your life.
Is it important to
take calcium, iron, trace elements or female hormone replacements?
Some patients require these supplements, but your need for these can be
determined by your surgeon.
Do I meet with a
nutritionist/dietician before and after surgery?
We require patients to consult with our dietician before surgery. Counseling
after surgery is available on an individual basis as needed.
Will I get a copy
of suggested eating patterns and food choices after surgery?
We provide patients with materials that clearly outline their expectations
regarding diet and compliance to guidelines for the best outcome based on
your surgical procedure. After surgery, health and weight loss are highly
dependent on patient compliance with these guidelines. You must do your part
by restricting high-calorie foods, by avoiding sugar, snacks and fats, and
by strictly following the guidelines set by your surgeon.
General
What is the youngest age for which weight loss surgery is
recommended?
Generally accepted guidelines from the American Society for Bariatric
Surgery and the National Institutes of Health indicate surgery only for
those 17-18 years of age and older. Surgery has been performed on patients 16
and younger. There is a real concern that young patients may not have
reached full developmental or emotional maturity to make this type of
decision. It is important that young weight loss surgery patients have a
full understanding of the lifelong commitment to the altered eating and
lifestyle changes necessary for success.
What is the oldest
patient for whom weight loss surgery is recommended?
Patients over 65 require very strong indications for surgery. The risk of surgery in this age group is
increased, and the benefits, in terms of reduced risk of mortality, are
reduced. However, we do recognize that there are those who are in
their late 60's who may benefit from weight loss surgery.
Can Weight Loss
Surgery prolong my life?
There is good evidence from scientific research that if you have Type 2
diabetes (or other serious obesity-related health conditions), are at least
100 lbs. over ideal body weight, and are able to comply with lifestyle
changes (daily exercise and low-fat diet), then weight loss surgery may
significantly prolong your life.
Can weight loss
surgery help other physical conditions?
According to current research, weight loss surgery can improve or resolve
associated health conditions.
Condition |
Percentage found in preoperative individuals |
Percentage cured 2 years after surgery |
Diabetes or insulin resistance |
34% |
85% |
High blood pressure |
26% |
66% |
High triglycerides |
40% |
85% |
Sleep apnea |
22% in males, 1% in females |
40% |