Frequently Asked Questions

Many people who suffer from obesity find it very difficult to lose weight and maintain it through diet and exercise alone, or even through medication. This is due to multiple causes, not just the person's willpower. It is in these cases that weight loss surgery is the best therapeutic alternative.

No. Weight-loss surgery is very safe and significantly reduces the chance of dying from obesity. In fact, weight-loss surgery is safer than removing your gallbladder or undergoing knee replacement.

Yes. Most bariatric surgeons put their patients on a special preoperative diet, usually 2 to 3 weeks before surgery. The reason for the preoperative diet is to reduce the size of the liver and reduce fat in the abdomen. This helps during the procedure and makes it safer.

The general answer to this is yes. Make sure to tell your surgeon and anesthesiologist about all previous operations, especially those on your abdomen and pelvis. Many of us forget childhood operations. It is best to avoid surprises! Sometimes your surgeon may request to see the surgical report for unusual or complicated procedures, especially those in the esophagus, stomach, or intestines.

Yes, but you may need medical clearance from your cardiologist. Bariatric/metabolic surgery leads to improvement in most problems related to heart disease, including: High blood pressure Lipid problems Enlarged heart (enlarged heart or abnormal thickening) Vascular (artery and vein) and coronary (heart artery) disease During the screening process, be sure to tell your surgeon about any heart conditions you have, as well as their treatment.

May be. Be sure to follow your surgeon's instructions on managing your diabetes at the time of surgery. Almost all people with type 2 diabetes see great improvement or even complete remission after surgery. Some studies have reported improvement in type 1 diabetes after bariatric procedures.

No and yes. Most people think of a "diet" as an eating plan that leaves you feeling hungry. That is not the way people feel after surgery. Eventually, most patients regain their appetite 6 to 18 months after surgery. Your appetite is much weaker and easier to satisfy than before. Most patients also think of exercise as something that must be intense and painful (like "boot camp"). Regular, modest activity is much more helpful in the long run. There is no one-size-fits-all plan. Expect to learn and change as you go!

Immediately! You will take gentle, short walks even while in the hospital. The key is to start slowly. Listen to your body and your surgeon. If you lift weights or play sports, keep it "low impact" for the first month (avoid competition, think about participation). Work slowly over several weeks. If you swim, you must allow your wounds to heal before returning to the water.

After surgery, most patients return to work in one to two weeks. You will be low on energy for a time after surgery. Your surgeon will give you clear instructions. Your safety and the safety of others are extremely important (low energy can be dangerous in some jobs).

As you lose weight, you may be able to reduce or eliminate the need for many of the medications you take for high blood pressure, heart disease, arthritis, cholesterol, and diabetes. If you have a gastric bypass, sleeve gastrectomy, or duodenal "switch," you may even be able to lower your dose or discontinue use of your diabetes medications shortly after the procedure.

Depending on the type of surgery, you may need to take a multivitamin for life. You may need higher doses of certain vitamins or minerals, especially iron, calcium, and vitamin D. You will also need to have at least one annual lab check.

As long as patients take the appropriate vitamin supplements, health problems due to vitamin deficiencies are very rare.

Some hair loss is common 3 to 6 months after surgery. The reasons for this are not fully understood. Even if you take all the recommended supplements, the hair loss will be noticeable until the follicles return. Hair loss is almost always temporary. Adequate protein, vitamin and mineral intake will help ensure hair growth and prevent thinning in the longer term.

Most women are more fertile after surgery, even with moderate weight loss before surgery. Birth control pills do NOT work as well for obese patients. Birth control pills are not very reliable during weight loss. For this reason, it is necessary to have an IUD or use condoms and spermicides in ALL sexual intercourse. Menstrual periods can be very irregular and you can get pregnant when you least expect it! Most groups recommend waiting 12 to 18 months after surgery before considering pregnancy.

Most patients have some loose or sagging skin, but it is often more temporary than expected. You will have many changes between 6 and 18 months after surgery. Your individual appearance depends on several things, including how much weight you lose, your age, your genetics, and whether or not you exercise or smoke. In general, loose skin is well hidden by clothing. Many patients wear compression garments, to help with appearance. Some patients will opt for plastic surgery to remove excess skin. Most surgeons recommend waiting at least 18 months, but you can get an evaluation before that.

Almost everyone can find an activity that "counts" as moderate exercise, even those who are partially paralyzed, or who have arthritis or joint replacement or pain in the spine. Special therapists may be needed to help you find what works for you.

No. A small number of patients may regain their weight, but the vast majority lose a lot of weight and keep it off.

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