Coronavirus (COVID-19) - Latest Information for Patients and Visitors

(La más reciente información para pacientes y visitantes)

 

Read Now (Lea ahora)
SEARCH TEMPLE HEALTH
Bariatric Program

Bariatric and Metabolic Surgery Frequently Asked Questions

If you are considering bariatric surgery, you probably have a lot of questions. We offer free informational seminars (via Facebook Live and online) so that you can learn more about the Temple Bariatric Program. 

The following is a list of common questions and concerns about bariatric and metabolic surgery.

General Questions

Am I a Candidate for Weight-Loss Surgery?

You may be a candidate for weight-loss surgery if you meet the following criteria:

  • Your BMI (body mass index) is over 40.

  • Your BMI is 35 or above, and you have two or more medical problems, such as diabetes, high blood pressure, sleep apnea or arthritis.

To find out your BMI, use our BMI Calculator >

Am I a high-risk bariatric surgery candidate?

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.

How do I schedule an appointment to see a bariatric surgeon?

All new bariatric surgery patients must first attend an informational seminar. You may click on the Schedule an Appointment button on this page, or you may call 800-TEMPLE-MED (800-836-7536). Tell the Temple Health Access Center Representative that you would like to attend a bariatric seminar.

What Is Laparoscopic Surgery?

Laparoscopic bariatric surgery is a minimally invasive procedure. A surgeon makes tiny incisions in your belly, then inserts a laparoscope (small camera) and surgical instruments to perform the surgery. 

The camera is connected to a video monitor in the operating room, where the surgeon can view the inside of your belly to perform the procedure. Gastric sleeve surgery is performed laparoscopically.

Your bariatric surgery team will talk with you about their recommendations, including the risks and benefits of your procedure.

What Will This Surgery Cost? Will My Insurance Cover It?

Most insurance providers cover the cost of Roux-en-Y gastric bypass and gastric sleeve if you meet certain criteria. Before your procedure, be sure to call your insurance company to discuss your coverage, including any exemptions, co-pays, deductibles or out-of-network expenses. 

Your Temple weight-loss team will provide any pre-authorization paperwork needed to help your insurance company set up your claim.

Read more about insurance coverage >

What Are the Benefits of Bariatric Surgery?

Bariatric surgeries, such as gastric sleeve and Roux-en-Y gastric bypass, are effective treatments for significant weight loss. You can expect to lose 60-80% of your excess body weight within the first 2 years following your surgery. 

You may also experience health benefits such as reversal of Type 2 diabetes and a decrease in chronic conditions such as high blood pressure and sleep apnea. 

You may also start to feel significantly more energy with improved heart health.

What Are the Risks of Bariatric Surgery?

No surgery is without risks. Although Roux-en-Y gastric bypass and gastric sleeve are common bariatric procedures, you may experience some side effects or complications during or after your surgery. 

Depending on the procedure, you may have bleeding or develop a leak at the staple line, wound infection, Dumping syndrome or GERD (gastroesophageal reflux disease). You can reduce your risk of bariatric surgery complications by following your pre-operative instructions, including good nutrition, diet, exercise, vitamins and supplements, and avoiding the use of all tobacco products.

Can the Treatment Be Reversed?

Gastric sleeve cannot be reversed because a portion of the stomach is removed. Roux-en-Y gastric bypass can be reversed or converted to gastric sleeve if the need arises due to complications.

Before Surgery

Will I Need to Have Tests Before 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.

How Long Does the Surgery Take?

Gastric sleeve, also known as sleeve gastrectomy, takes approximately 1-2 hours to complete in the operating room. Roux-en-Y gastric bypass takes a little longer. 

What Is Pre-Operative Nutrition?

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.

Why Do I Need to Make Changes in My Diet and Lose Some Weight Before Surgery?

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.

What Is the Pre-Op Liquid Diet?

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.

Will You Remove My Gallbladder During the 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.

After Surgery

How Long Will I Have to Stay in the Hospital After Surgery?

If you have laparoscopic surgery, you will go home the day after surgery.

How Much Weight Will I Lose After Surgery?

Depending on which procedure you have, you may lose 59 to 72% of excess weight in the first 12 to 14 months after surgery.

Is There Pain Associated with the Procedure?

Following bariatric surgery, you may experience pain in the incision site. This should resolve over time. Your bariatric surgeon will examine you or prescribe a limited amount of pain medications.

How Long Will I Be Out of Work?

If you have minimally invasive gastric sleeve or laparoscopic Roux-en-Y gastric bypass, you can expect to return to work in about 1-2 weeks. If you have a physically strenuous job, you may talk with your employer about working half-days or taking on some lighter work until you recover. 

You may have low energy for a while.

Will I Need to Take Medicine After Bariatric Surgery?

After surgery, you will take a bariatric complete multivitamin with iron and calcium every day.

What Is Post-Operative Nutrition?

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.

Is There Anything I Can’t Eat After Surgery?

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.

Why Do I Need to Take Vitamin/Mineral Supplements After Surgery?

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.

When Can I Stop Taking My Vitamin/Mineral Supplements?

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.

What Is Dumping Syndrome?

Dumping syndrome is an unpleasant side effect where food passes rapidly into the small intestine. Symptoms include:

  • Cramping

  • Sweating

  • Flushed appearance

  • Dizziness

  • Weakness

  • Headache

  • Diarrhea

To prevent dumping syndrome, follow your dietitian’s recommended dietary guidelines and avoid the following:

  • Sweets

  • Fried, fatty or greasy food

  • Eating too much at one sitting

  • Drinking fluids with your meals

What Will My Diet Be Like After I Have Healed from Surgery?

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.

Can I Drink Alcohol After Weight-Loss Surgery?

It is not recommended to drink alcohol following bariatric surgery.

Can I Smoke or Use Tobacco After 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.

Do I Need to Exercise After Surgery?

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.

Can I Try For Pregnancy After Bariatric Surgery?

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.

Will I Lose My Hair After 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.

Will I Need Plastic Surgery After My Weight Loss?

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.

Can I Regain the Weight I Lost After Bariatric Surgery?

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.

I Had Bariatric Surgery, But Regained the Weight. Can I Have Another Procedure?

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.


 

Page medically reviewed by:
Eric J. Velazquez, MD, FACS, FASMBS
November 25, 2019