We want your learning experience about weight-loss surgery to be as easy, yet as comprehensive, as possible. The following are some of the most frequently asked questions and answers.

General

Taking vitamins is essential.
Support Group Meetings are offered to all patients on a monthly basis. We recommend attending these support group meetings and most surgeons require you to attend at least two meetings prior to surgery. We also encourage you to bring any interested family and/or friends. Individuals who are important to you need to understand the change you will undergo as well as your new diet and new lifestyle. Post-operatively, we have found that most successful patients are those that attend a support group and/or follow up with their psychologist.
If you are considering Weight Loss Surgery, we recommend that one of the first things you do is to contact your insurance company and speak to a customer service agent. Ask if you have benefits for WLS. If you do not, an available option is self-pay. If you do have coverage, some insurance companies are requesting evidence of a medically-supervised weight loss attempt. These weight loss attempts do not have to involve medication; they can include exercise, a low-calorie diet and behavior modification. The important aspect is that this is documented in the doctor's progress notes at regular intervals (every month) for a period of time. A letter from your Primary Care Physician indicating that you have been on such a plan without documentation in his/her notes usually will not meet the criteria and result in a denial.
Bariatric surgery is considered a “tool” and all individuals are at risk for regaining weight. Those individuals who adopt good lifestyle changes such as good dietary and exercise habits are most successful in maintaining their weight loss.
Each doctor will have his own protocol but generally speaking, a few weeks prior to surgery, you will be placed on a liver reducing diet. Most all obese patients have what is known as a fatty liver. A fatty liver alone is bad for you as it can cause poor digestion, contribute to high triglyceride levels, and may eventually lead to cirrhosis of the liver. A fatty liver becomes even more troublesome when you undergo weight loss surgery. This is due to the fact that the liver lies directly on top of the stomach. When your surgeon performs weight loss surgery, he/she has to use a special instrument to lift up your liver and hold it away from the stomach so they can get a clear view of the area that they are operating on. If your liver is too big, the operation becomes riskier and potentially more complicated. This may result in surgery being cancelled.
The weight loss surgery patient is at increased risk for nutrient deficiencies. However the risk is easily avoided by taking all of your recommended vitamins/minerals on a regular basis. Vitamin/Mineral deficiencies can lead to a host of health problems and significantly impact your weight loss. Needs differ between the procedures and your surgical team will advise you on their protocol.

Adjustable Gastric Band

The Adjustable Gastric Band reduces the capacity of your stomach and increases the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived. Remember that the Adjustable Gastric Band is a tool to help you change your eating habits.
Patients typically spend less than 24 hours in the hospital. It takes most patients a few days to a week to return to work. However, each individual is different.
Weight-loss results vary from patient to patient, and the amount of weight you may lose depends on several things. The band needs to be in the right position, and you need to be committed to your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won't come off by themselves.
Although the two current bands are not meant to be removed, they can be. The stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight or even gain more.
Adjustments are often carried out in the doctor's office, however sometimes they need to be performed under fluoroscopy so the access port can be clearly seen. After the area is numbed with some local spray, a fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes. Most patients say it is nearly painless.
There are no restrictions based on the access port. It is placed under the skin in the abdominal wall, and once you have healed it should not cause discomfort or limit your movements or any physical exercise. The only sensation you may have from the port is when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.
Although the Adjustable Gastric Band System is not meant to be removed, it can be. The stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight or even gain more.
This is a fairly common feeling, especially for people with bands that are tight or just after an adjustment. During the day the water content in the body changes and this may cause the band to feel "tighter" some of the time. Some women have also noticed that the Adjustable Gastric Band feels tighter during menstruation.
One of the major advantages of the Adjustable Gastric Band System is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline. If the band cannot be loosened enough, it may have to be removed.
Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After the pregnancy, the band may be made tighter again, and you can resume losing weight.
Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions.
Alcohol has a high number of calories. It also breaks down vitamins.

Gastric Bypass

The obese individual's normal stomach has the ability to hold a large quantity of food. This equates to a higher caloric intake. These extra calories become stored fat. Roux-En-Y Gastric Bypass surgery converts the large stomach into a very small stomach that can only hold a couple of ounces. This limits the quantity of food that can be consumed and leaves the patient feeling full and satisfied. Consequently, one starts burning fat from the stored portion and experiences weight loss.
After surgery, you will soon learn how much you can take in and what foods you can tolerate. It is difficult to say what foods will agree with you and which ones won't since everyone is different but fried foods, sweet food and drinks, and food with tough fiber such as orange pulp should be avoided. You will have the ability to eat a meal much like a child's portion. This will be the amount you eat indefinitely, unless your stomach is stretched by not following post-operative guidelines. So, eat slowly and allow at least a half an hour for each meal. If you feel full, stop eating. Drink liquids between meals but not with meals. And, remember NO snacks.
No, patients don't fade away; they seem to reach a plateau and level off after losing about one-third of their preoperative weight. As reported by the American Society for Metabolic and Bariatric Surgery (ASMBS), the ultimate window of opportunity for weight loss is about 18 months. Typically patients lose 70% of their weight in the first year, provided they follow the recommendations on diet and behavior modification.
The stomach pouch stretches a little as time goes on, but not to any great degree. Weight loss is usually maintained except in those few patients who take in large quantities of high caloric foods and fluids. Remember, this is not a cure-all operation, the surgery will do a great deal toward the goal of weight loss, but ONLY you can make it work.

Sleeve Gastrectomy

The size of your stomach will vary depending on the surgeon and your individual needs. More times than not, the bariatric surgeon is removing approximately 80% of the stomach, leaving a stomach shaped like a thin banana or sleeve.
No the procedure is not reversible. Your surgeon will remove a portion of your stomach.
The procedure is a type of restrictive weight loss surgery. The procedure generates weight loss by restricting the amount of food that can be consumed at one setting before feeling full. It is also felt that the hormones that control the appetite are created in a portion of the stomach that is removed, and by taking out that portion of the stomach, the patient’s appetite is reduced.