Bariatric Surgery for
Obesity - FAQ’s
do I know if I am eligible for weight loss surgery?
surgery or Bariatric surgery is not for everyone. Certain criteria were laid
out by Bariatric associations across world. At present, patients with BMI (Body
Mass Index) >32.5 Kg/cm2 associated with metabolic disorders like
Diabetes, High blood pressure or any other diseases related to obesity etc.,
and anyone with a BMI >40Kg/cm2 are eligible. But before opting
for Bariatric surgery, I strongly recommend the patients to meet a Bariatric
surgeon and discuss in detail about the pros and cons of surgery. They need
long counseling sessions and motivation even after surgery. So, it’s very
important that both patient and doctor committed.
are the risks of weight loss surgery?
Weight loss surgery as such is a safe
procudure when done by a trained team. Considering the weight and associated
comorbidities, majority of the complications occur during induction and
reversal of anesthesia as medications alter the physiology of the patient. This
brief period of risk if well tolerated and well managed will give a very
fruitful life to the patient in the coming years to come. Surgical risks are
mainly staple site leakage and bleed. Pulmonary embolism, Deep venous
Thrombosis and others complications associated with obesity are always there
and are kept in check with medications. Some
hair loss is common between 3 and 6 months following surgery. Hair loss is
almost always temporary. Adequate intake of protein, vitamins and minerals will
help to ensure hair re-growth, and avoid longer term thinning. Vomiting,
constipation, anemia, osteoporosis, Hernia, Gallstones, Ulcerations, Gastric prolapse, Severe scarring of the new
stomach pouch, Dehydration, Kidney stones, are some other side effects we see in these
much weight will I lose? Will the weight loss be quick?
Amount of weight loss depends on the type of
procedure chosen and needed for the patient. A quick changes in body weight is
detrimental to health. All bariatric procedure aim at a gradual loss of weight
for the patient.
I become pregnant after weight loss surgery?
Birth pill usually are no effective in obese
patients. Also, peripheral fat results in high estrogen levels which makes it
difficult to conceive and maintain the fetus. All weight loss surgeries are
associated with nutritional deficiencies and patients are bound to gain weight
after conceiving. So, it is not advisable to conceive at least for 1 year when
the patient loses maximum weight and is nutritionally balanced. A weight gain
after that can be managed with diet and exercise after delivery.
my insurance cover the procedure?
Most of the insurances policies do not cover
bariatric procedure. We advice the patients to check with their policy advisors
before planning any procedure.
I am interested in weight loss surgery, what is my first step? Where
is my first appointment?
First step will always be consulting a
Surgical Gastroenterologist who is having special interest in Bariatric
happens during the first appointment? After
the first appointment, how long will it take before I have surgery?
During your first visit, you will be assessed
regarding the need for Bariatric procedure and counseled about the same.
Usually we take about 3-4 sessions before we plan surgery for the patient. This
will ensure that the patient understands the implications and intensity of he
long will I have to stay in the hospital after surgery?
Usually 2-3 days
long will I be off of work after surgery?
Depends on how well the patient is able to
take care of himself. Usually they are off from work for 1 week.
if I have excess skin?
This definitely has some aesthetic issues to
some patients, but
it is often more temporary than expected. Plastic surgeons usually rim the sagging
extra skin and give them a shape. We tied up with the best plastic surgeons who
do that work for us. Generally,
loose skin is well-hidden by clothing. Many patients wear compression garments.
I have to take vitamins?
When we do resection or diversion procedure,
acid production is decrease and most of the food will not come in contact with
the intestines. This causes nutritional and vitamin deficiencies. We supplement
these nutrients for long time correcting them after occasional laboratory
I have to go on a diet before I have surgery?
A pre-operative diet, usually 2 or 3 weeks just before surgery helps to shrink
the liver and reduce fat in the abdomen making it safer during surgery.
I have to diet or exercise after the procedure?
and Yes. Most patients get some form of appetite back 6-18 months after
surgery. It is much weaker, and easier to satisfy than before. Healthier food
choices inducted into diet plans, but most patients still enjoy tasty food, and
even “treats.” Regular, modest activity is far more useful in the long term
than intense and painful ones. There is no “one-size-fits-all” plan. Expect to
learn and change as you go! Healthy bones and avoiding muscle loss partly
depends on doing weekly weight bearing (including walking) or muscle resistance
(weights or similar) exercise. We prefer in finding workouts in our day today
I go off some of my medications after surgery?
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 Excess skin that may need to be removed in an additional surgery
How Does Weight Loss Surgery Affect Overall
Obesity-related medical problems will
generally improve after weight loss surgery. These include:
- Type 2 diabetes
- Gastroesophageal reflux disease (GERD)
- High cholesterol
- Degenerative joint disease or orthopedic problems
- High blood pressure
What Lifestyle Changes Are Necessary After Weight
People eating high-calorie or high-fat foods instead of
healthy foods, eating too often, relying on "soft meals" such as ice
cream and milk shakes regain weight despite bariatric surgery. The body itself
may change over time, too, leading to weight gain. The digestive tract adapts
and begin absorbing more calories. Even the size of your surgical stomach can
expand gradually over time.
Many patients (up to 50%) may regain a small amount of weight (approximately 5
percent) two years or more following their surgery. However, longitudinal
studies find that most bariatric surgery patients maintain successful
To keep the weight off,
you need to work at it. Here are some tips:
- Eat very small meals. Adapting
to small meals is challenging but necessary. Eat small amounts of food
slowly, chew well, and eat lots of protein.
- Make nutrition a priority. You must make the foods you eat count. A
dietitian can create a diet and nutrition plan designed to meet your
- Exercise regularly. Many obese people aren't used to exercise, but it's
very important to prevent weight regain. The good news: Once you start
losing weight, exercise will get easier
Will bariatric surgery
patients (up to 50%) may regain a small amount of weight (approximately 5
percent) two years or more following their surgery. The average excess weight
loss was 66.5%, and there was no significant association between excess weight
loss and length of follow-up. Now we have data to support the durability
of gastric bypass surgery up to 15 years. Studies also have shown that
sleeve gastrectomy patients were able to maintain its well-documented weight
loss outcome at 5 or more years after surgery, with the overall mean excess
weight loss at 5 or more years still remaining>50%. Such
significant and sustained weight loss after surgery is in sharp contrast to
Surgical Gastroenterology (Apollo Hospital, Chennai)
Sanjeevani PEBLS Advanced Gastro Center