If you are considering weight-loss surgery, you probably have a lot of questions. Be sure to attend one of our free informational seminars to learn more about the Temple Bariatric Surgery Program. Before you do, write down a list of questions and bring them with you. The following is a list of common questions and concerns about bariatric and metabolic surgery.
Frequently Asked Questions About Bariatric & Metabolic Surgery
You may be a candidate for weight-loss surgery if you meet the following criteria:
Your BMI (body mass index) is over 40. Calculate your BMI.
Your BMI is 35 or above, and you have two or more medical problems, such as diabetes, high blood pressure, sleep apnea or arthritis.
Because everyone is different, many factors go into deciding if you are a candidate for weight-loss surgery. To be considered, schedule an appointment with one of our bariatric surgeons or register for a free informational seminar.
Depending on which procedure you have, you may lose 59 to 72 percent of excess weight in the first 12 to 14 months after surgery.
You will go through an assessment with a bariatric surgeon. This includes tests to evaluate your blood, gastrointestinal (GI) system, heart and lungs. Your surgeon will decide which tests you need. If you need help scheduling your tests, our bariatric surgery team is here to help.
The time from initial consultation to surgery is different for everyone. Your compliance with your necessary appointments and behavioral changes assist in determining your readiness for surgery. Your insurance may also have a predetermined number of mandatory supervised medical weight-loss months. Your procedure will be scheduled within three to several months. In the meantime, there are a number of steps you can take:
Attend one of our free informational seminars.
Check with your insurance company to ask what they require to cover your bariatric procedure.
Work with your primary care doctor to gather the required documentation for your insurance company.
Complete your evaluation and tests with a bariatric surgeon and members of our weight-loss team.
The Temple Bariatric team will do everything we can to help you through the process, and ensure you have everything you need for a safe and successful procedure.
Most bariatric surgery procedures are minimally invasive, including laparoscopic and robotic procedures. For some patients, an open procedure may actually be safer. Your bariatric surgery team will talk to you about their recommendations, including the risks and benefits of your procedure.
If you do not have gallstones, your gallbladder will most likely not be removed. If you do have gallstones, you will work with your surgeon to discuss options.
As part of the assessment process, you will meet with a dietitian, who will talk to you about your weight history and food intake. Your weight will be taken. Based on this information, you will receive customized diet recommendations. We recommend you start following your dietitian’s recommendations prior to surgery. Losing weight before your surgery will help your surgical team perform the procedure as safely as possible.
Some insurance providers require evidence of weight loss prior to surgery. In addition, the dietitian will need to provide a statement to the insurance provider that you are “low-risk” for bariatric surgery because you have demonstrated that you can make the necessary changes in your diet and physical activity level, which you will need to continue after your surgery. The preparation period before surgery provides time for you to practice healthier eating habits and mentally adjust to a different lifestyle. Bariatric surgery involves physical, mental, and emotional changes to be successful in the long term.
Two weeks before your surgery, you are required to follow a liquid meal replacement diet. The purpose of this diet is to reduce the size of the liver to make surgery safer. This diet includes protein shakes, several “approved” snacks (e.g., sugar-free pudding, yogurt, and sugar-free gelatin), and plenty of clear liquids (water, broth, sugar-free jello and popsicles, etc.). Your Registered Dietitian will go over the details of this diet once your surgery is scheduled.
*Note for patients with diabetes: You will be asked to talk to your primary care doctor or endocrinologist about adjusting your diabetes medications while following the pre-op liquid diet.
During your hospital stay, your Temple dietitian will again review your diet. Please be sure to bring the handbook you received at the informational seminar with you when you check in.
Immediately after surgery, you will follow a liquid diet. Liquids containing sugar, carbonation (soda) and caffeine must be avoided. You will first add protein-based liquids to your diet, followed by pureed foods, and finally foods with texture. The post-operative diet is a progressive diet and you will be back to eating a regular healthy diet by week 9.
It is important to eat nutritious foods following surgery to help heal your incision and for your overall health. Your dietitian will recommend vitamin and mineral supplements, and guide you on protein intake.
Weight-loss surgery is just one part of your weight-loss plan. The path to success depends on you. Even before surgery, begin to adjust your eating patterns and lifestyle:
Drink calorie-free beverages. Avoid soda altogether, including diet soda.
Eat fewer fried foods, added fats like butter, and high-fat foods.
Incorporate fruits and vegetables.
Pay attention to your eating habits and patterns. If you eat in response to boredom, find another activity to divert your attention.
Chew food completely, and eat meals slowly.
Dumping syndrome is an unpleasant side effect where food passes rapidly into the small intestine. Symptoms include:
To prevent dumping syndrome, follow your dietitian’s recommended dietary guidelines and avoid the following:
Fried, fatty or greasy food
Eating too much at one sitting
Drinking fluids with your meals
If you have laparoscopic surgery, you will go home the day after surgery.
After surgery, you will take a bariatric complete multivitamin with iron and calcium every day.
Research has shown that nutrient deficiencies are common after bariatric surgery. You may not be absorbing or utilizing nutrients in the same way and your food intake is restricted. Therefore, your requirements for vitamins and minerals are higher than they were before surgery. Once you have surgery, you are committing to taking the necessary supplements permanently. If vitamin and mineral deficiencies become severe, you can have very serious and permanent complications.
During your preparation for surgery, you will receive education about the recommended products to purchase before your surgery. We regularly review the current ASMBS (American Society for Metabolic and Bariatric Surgery) recommendations and adjust our educational materials according to the most current research.
We recommend that you take your vitamin and mineral supplements for the rest of your life. You will need to get your blood checked several times within the first year after surgery, and once a year thereafter. This is done to ensure you are absorbing your vitamins and minerals adequately.
You will eat in a regular pattern of three meals per day, with snacks in-between meals that are low in calories. Since you will have a small stomach pouch, you should eat about four ounces (half a cup) of food at each meal. Focus on proteins first, followed by vegetables and fruits. Water and non-calorie-containing liquids are the beverages of choice. Avoid carbonated beverages altogether. Do not drink liquid with your meals. This can make your pouch empty more quickly and make you feel hungry too soon.
Yes, regular exercise after surgery has many benefits, including:
Achieving optimal body weight
Improving body composition
Improving weight-loss maintenance
Reducing risk of weight gain
Finding and maintaining long-term success
Once cleared by your bariatric team, start a maintenance exercise regimen with the long-term goal of 30 minutes of moderate aerobic exercise each day. In addition, it is recommended to add strength training at least 2 days per week to complement aerobic exercise.
We strongly caution against becoming pregnant for 12 to 18 months after surgery. You may become more fertile as you lose weight, so a reliable birth control method should be used during this time. If you do become pregnant after bariatric surgery, partner with your bariatric team and with your obstetrician (OB-GYN). It’s important that you monitor your pregnancy throughout, and take the proper amount of vitamins and minerals.
It is not recommended to drink alcohol following bariatric surgery.
We strongly recommend you quit smoking before your procedure, and do not start again after your procedure. Smoking is contraindicated (meaning we advise against it) to weight-loss surgery.
Temporary hair thinning can occur in the months after Roux-en-Y gastric bypass surgery, as you rapidly lose weight. If you do lose hair, it should re-grow when your weight stabilizes. Avoid hair treatments and maintain recommended protein intake during this time. Biotin and zinc supplements may also help. Your dietitian can provide you with recommendations.
Your bariatric surgery team will talk to you prior to your procedure about the likelihood of needing plastic surgery. If you do have plastic surgery, it’s best to wait until your weight has stabilized.
It’s possible. Weight-loss surgery is a tool designed to help you lose weight, but it’s just one part of your larger program. Following your dietary recommendations and exercising regularly are also important to your overall result. Be sure to take advantage of the resources the Temple Bariatric Program has available to you, including diet and lifestyle counseling, education and support.
Revisional surgery may be an option if it is medically advisable, but not recommended for everyone. The risks are greater than the first time the procedure was performed. Schedule an appointment with your bariatric surgeon to discuss options.
Our objective is to help you achieve your weight-loss goals in the healthiest way possible. Bariatric surgery requires a lifelong commitment to following dietary guidelines, a vitamin and mineral supplement regime and lifestyle changes. Additionally, you must follow-up with the bariatric team at Temple at least once a year to check your health.