faq about bariatric surgery
Why should someone consider a Bariatric/Metabolic surgery procedure?
Current research suggests that one in three Americans is obese. Obesity is associated with serious health conditions, including high blood pressure, heart disease, sleep apnea (serious sleep disorder), heartburn or reflux, cerebral artery disease (stroke), diabetes mellitus (sugar diabetes), asthma, osteoarthritis, infertility, or cancer of the breast, colon, prostate or uterus. Usually within the first six months after a Bariatric/Metabolic surgery procedure, patients will no longer need to take medications for these conditions.
What is the recovery time following weight loss surgery?
Most patients recover from a Bariatric/Metabolic surgery procedure without complications. Patients are encouraged to get out of bed and start walking by the next day. The hospital stay for patients who undergo the Roux-en-Y procedure is usually two to four days. Patients who have the LAP-BAND® procedure may stay one to two days. Most individuals return to work in two to three weeks following their Bariatric/Metabolic surgery procedure.
What are the risks?
All surgical procedures carry risks, even more so when a patient is obese. Different procedures involve different risks, and depending upon your individual circumstances, your risks may be higher or lower than average. Keep in mind that the more experience a surgeon has performing Bariatric/Metabolic surgery, the lower the complication and mortality rates will be. Your surgeon will discuss potential risks of surgery with you so you can make an educated and informed decision.
Uncommon Bariatric/Metabolic surgery risks include rare complications of leakage through staples or sutures, ulcers in the stomach or small intestine, blood clots in the lungs or legs, stretching of the pouch or esophagus, persistent vomiting and abdominal pain, inflammation of the gallbladder and failure to lose weight (very rare).
More than one third of obese patients who have weight loss surgery develop gallstones. Gallstones are clumps of cholesterol and other matter that form in the gallbladder. During rapid weight loss, the risk of developing gallstones increases. Gallstone formation can be lessened with medication taken for the first six months after surgery.
Approximately 30% of patients could develop nutritional deficiencies such as anemia, osteoporosis and metabolic bone disease. These deficiencies are avoided by taking vitamin and mineral supplements as prescribed, life-long.
Women of childbearing age should avoid pregnancy for 18 months to two years until the weight stabilizes, since rapid weight loss and nutritional deficiencies can harm a developing fetus.
Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and many arthritis drugs that contain aspirin should not be taken after Bariatric/Metabolic surgery. This is very important to note down as we have seen an increase in this particular non-compliance post-surgery.
Smoking after weight loss surgery may cause ulceration in the pouch, in addition to other health problems.
Which medical conditions are improved after weight loss surgery?
• High blood pressure
At least 70 percent of patients who have high blood pressure, and who are taking medications to control it, are able to stop all medications and have a normal blood pressure, usually within two to three months after surgery. When medications are still required, their dosage can be lowered, with reduction of the annoying side effects.
• High cholesterol
More than 80 percent of patients will develop normal cholesterol levels within two to three months after the operation.
• Heart disease
Although we can't say definitively that heart disease is reduced, the improvement in problems such as high blood pressure, high cholesterol, and diabetes certainly suggests that improvement in risk is very likely. In one recent study, the risk of death from cardiovascular disease was profoundly reduced in diabetic patients who are particularly susceptible to this problem. It may be many years before further proof exists, since there is no easy and safe test for heart disease.
More than 90 percent of Type II diabetics obtain excellent results, usually within a few weeks after surgery: normal blood sugar levels, normal Hemoglobin A1C values, and freedom from all their medications, including insulin injections. Based upon numerous studies of diabetes and the control of its complications, it is likely that the problems associated with diabetes will slow in their progression when blood sugar is maintained at normal values. There is no medical treatment for diabetes that can achieve as complete and profound an effect as surgery - which has led some physicians to suggest that surgery may be the best treatment for diabetes in the seriously obese patient. Abnormal glucose tolerance, or "borderline diabetes," is even more reliably reversed by gastric bypass. Since this condition becomes diabetes in many cases, the operation can frequently prevent diabetes as well.
Most asthmatics find that they have fewer and less severe attacks, or sometimes none at all. When asthma is associated with gastroesophageal reflux disease, it is particularly benefited by gastric bypass.
• Respiratory insufficiency
Improvement of exercise tolerance and breathing ability usually occurs within the first few months after surgery. Often, patients who have barely been able to walk find that they are able to participate in family activities, and even sports.
• Sleep apnea syndrome
Dramatic relief of sleep apnea occurs as our patients lose weight. Many report that within a year of surgery, their symptoms were completely gone, and they had even stopped snoring completely—and their spouses agree. Many patients who require an accessory breathing apparatus to treat sleep apnea no longer need it after surgically induced weight loss.
• Gastroesophageal reflux disease
Relief of all symptoms of reflux usually occurs within a few days of surgery for nearly all patients. We are now beginning a study to determine if the changes in the esophageal lining membrane, called Barrett's esophagus, may be reversed by the surgery as well—thereby reducing the risk of esophageal cancer.
• Gallbladder disease
When gallbladder disease is present at the time of the surgery, it is "cured" by removing the gallbladder during the operation. If the gallbladder is not removed, there is some increase in risk of developing gallstones after the surgery, and occasionally, removal of the gallbladder may be necessary at a later time.
• Stress urinary incontinence
This condition responds dramatically to weight loss and usually becomes completely controlled. A person who is still troubled by incontinence can choose to have specific corrective surgery later, with much greater chance of a successful outcome with a reduced body weight.
• Lower back pain, degenerative disk disease, and degenerative joint disease
Patients usually experience considerable relief of pain and disability from degenerative arthritis and disk disease and from pain in the weight-bearing joints. This tends to occur early, with the first 25 to 30 pounds lost, usually within a month after surgery. If there is nerve irritation or structural damage already present, it may not be reversed by weight loss, and some pain may persist.
When is weight loss surgery considered successful?
Weight loss surgery is considered successful when a person loses 50 percent of his or her excess weight. Although few people lose all of their excess weight, they do gain numerous health benefits, which may be lifesaving. It’s important to remember that there are no guarantees with any method of weight loss, even surgical procedures. Success hinges on your ability to become part of the plan to support the surgical tool you’ve chosen and make lifestyle changes with exercise and dietary adjustments.
Are there any activity restrictions following a Bariatric/Metabolic surgery procedure?
Yes, strenuous activity after a Bariatric/Metabolic surgery procedure should be avoided until you are healed. Walking, however, is a required activity at this stage of recovery. You are advised not to drive if you are taking pain medication other than Stopayne. At your first follow-up visit, your doctor will determine when you can return to work, but most people return to work three to six weeks after the initial Bariatric/Metabolic surgery procedure.
How long will it take to lose excess weight after weight loss surgery?
Excess weight loss begins right after surgery and continues for 18-24 months after surgery.
Is it possible to gain the weight back after a Bariatric/Metabolic surgery procedure?
Bariatric/Metabolic surgery has an excellent long-term track record for helping morbidly obese individuals maintain weight loss. If you are committed to making permanent dietary and lifestyle changes, your chance of weight re-gain is minimized.
Can weight loss surgery be reversed?
Both weight loss procedures are considered permanent weight loss measures. However, the LAP-BAND® is removable via laparoscopic surgery. Gastric bypass surgery is potentially reversible. Reversal requires another operation of the same, or greater, magnitude with the same, or greater, risks. Reversal of this operation is very uncommon and the procedure rarely occurs beyond six weeks from the time of surgery.
is it possible to lose hair because of the surgery?
Patients may experience some hair loss post surgery. This is due to the rapid weight loss post surgery. There are no shampoos or supplements to prevent this. The hair will grow back over time.