Frequently asked questions about bariatric surgery

The idea of having surgery can be scary but making changes to take control of your health is important. Our dedicated team is here to help you determine the best approach to your surgery and create a personalized plan for weight loss. Below are some frequently asked questions and answers.

Many things can cause obesity. It’s not simply a result of overeating. Research has shown that, in many cases:

  • A significant underlying cause of morbid obesity is genetic—including hereditary factors such as metabolism and efficient fat storage
  • Environmental factors such as fast food, long days sitting at a desk, and living in an area that requires you to drive everywhere rather than walk can magnify hereditary factors
  • Once the problem is established, dieting and exercise programs have a limited ability to take control of excess weight

Morbid obesity increases your risk of developing other health conditions. Some conditions include heart disease, high blood pressure (also called hypertension), high blood cholesterol, sleep apnea, respiratory issues, degenerative arthritis, heartburn, diabetes, gallbladder disease, and others. Being morbidly obese can also impact you emotionally and can lead to depression.

Doctors use these 3 criteria to determine whether you are morbidly obese:

  • If you are more than 100 pounds over your ideal body weight
  • If you have a body mass index (BMI) of greater than 40
  • If your BMI is more than 35 and you also have serious obesity-related conditions

The main goal in managing and treating obesity is to lower your medical risk and improve your quality of life. A weight management program will combine many components to help you reach your weight loss goals:

  • Physical activity
  • Diet
  • Behavior modification
  • Psychological counseling
  • Medications (sometimes)

Surgery is usually reserved as a last resort. It may be an option for you if you have repeatedly failed to lose weight by all other means, including diet and exercise, behavioral therapy, and medications. Surgical treatment is medically necessary because it is the only proven method of achieving long-term weight control for people who are morbidly obese.

At Phelps Hospital, Northwell Health, we use the American Society for Metabolic and Bariatric Surgery (ASMBS) patient-qualification guidelines to make sure you’re an ideal candidate for weight loss surgery. We know that bariatric surgery is a major procedure and it may not be right for every candidate. Discuss all of your options with your doctor or surgeon.

Most candidates meet the following criteria:

  • Are 100 pounds or more over their ideal body weight or have a BMI of 35 or greater
  • Have weight-related health problems, such as high blood pressure, diabetes, sleep apnea, or heart disease
  • Have tried unsuccessfully to lose weight with supervised diets, exercise programs, and medications

Here are some questions to ask yourself if you’re considering bariatric surgery:

  • Have I tried every nonsurgical measure (diet, exercise, counseling, medications)?
  • Am I well informed about the available surgical procedures and the effects of treatment?
  • Am I determined to lose weight and improve my health?
  • Can I maintain a lifelong commitment to medical follow-up and vitamin/mineral supplements?

Keep in mind that weight loss surgery is major surgery. Most patients enjoy an improvement in obesity-related issues such as mobility and self-esteem after weight loss surgery, but this should not be your only motivation. The goal is to live better, healthier and longer. You should make the decision to have weight loss surgery only after careful consideration and consultation with an experienced bariatric surgeon or a knowledgeable family physician.

Your surgeon should answer your questions clearly and explain the exact details of the procedure, the length of the recovery period and the reality of the follow-up care that will be required. As part of routine evaluation for weight loss surgery, your doctor may require that you consult with a dietitian/nutritionist and a psychiatrist/therapist. This is to help establish a clear understanding of the changes in behavior that are essential for long-term success after surgery.

It is important to remember that there are no guarantees in any kind of medicine or surgery. Weight loss surgery will succeed only when you make a lifelong commitment. Surgery is only a tool. Your ultimate success depends on strict adherence to the recommended dietary, exercise and lifestyle changes.

Like any surgery, weight loss surgery has risks. That’s why our highly skilled surgeons carefully assess whether you are a good candidate for bariatric surgery. We also use state-of-the-art equipment and procedures for the best possible results. Some of the possible risks of bariatric surgery include:

  • Anastomotic leak—a leak from the staple line around new connections between your stomach and intestine
  • Dehiscence—an opening or splitting of the surgical suture line (where you have stitches)
  • Gastric fistula—an abnormal opening at the connection with the stomach
  • Pulmonary embolism—a blockage of an artery in the lung. A blood clot can start in your legs and then travel to your lungs. After surgery your doctor will give you anti-clotting medicines to help avoid this
  • Wound infection at the site of the surgical incision
  • Wound seroma—a mass at the site of the surgical incision caused by fluid within the tissue

Bariatric surgery is typically extremely successful. However, there are rare instances (about 3% of cases) where a patient will experience problems like too much or too little weight loss. To correct these types of issues, follow-up bariatric surgery (or revision surgery) might be performed.

To try to reduce some risk and to help your recovery, you can do the following at least 2 months before your surgery:

  • Increase your physical activity
  • Lose 10% of your body weight
  • Quit smoking
  • Stop drinking alcohol

Everybody’s recovery journey is different, and it will vary depending on the type of procedure you have. The Lap-Band recovery is typically a week. Most patients completely recover in 6 weeks to 3 months. Recovery includes 6 weeks with no strenuous activities. How quickly you return to work will depend on your physical condition and the type of work you do. For some people, office and routine work can be resumed within 3 weeks. Most patients are able to go back to work within 6 weeks of their procedure.

Weight loss will vary depending on your weight before surgery. After your surgery, your choice of foods and level of activity will change. The majority of patients lose one-third of their original body weight within 2 years of surgery.

Any time you experience rapid weight loss, you can expect some hair loss. This is a temporary problem. It usually occurs during the third through eleventh month after surgery.

Yes, as long as you have no other outstanding fertility problems. It is recommended that you wait at least 2 years after gastric bypass surgery before you get pregnant.

Exercise is recommended to help tone your muscles and your skin. Some patients may want plastic surgery to help the problem areas. We suggest you wait for 2 years after your weight loss surgery, because there will be less skin to remove, and plastic surgery may not be necessary.

Weight loss surgery is only a tool that may be used to help control your weight. If you don’t use the tool properly, you will regain some of the weight. Weight loss surgery gives you an opportunity to change your lifestyle and eating habits, which can make weight control easier in the long run.

Joining a support group can provide an excellent opportunity to discuss your personal and professional issues and experiences. Many patients learn in support groups, for instance, that weight loss surgery will not immediately resolve existing emotional issues. Most bariatric surgeons will tell you that ongoing post-surgical support helps produce the greatest level of success for their patients.