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Bariatric surgery for Obesity - FAQ's

Bariatric Surgery for Obesity - FAQ’s

· How do I know if I am eligible for weight loss surgery?

· Obesity 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.

· What 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 patients.

· How 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.

· Can 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.

· Will 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.

· If 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 Surgery.

· What 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 procedure.

· How long will I have to stay in the hospital after surgery?

· Usually 2-3 days

· How 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.

· What 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.

· Will 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 tests.

· Will I have to go on a diet before I have surgery?

· Yes. 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.

· Will I have to diet or exercise after the procedure?

· No 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 activities.

· Can I go off some of my medications after surgery?

· 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 Excess skin that may need to be removed in an additional surgery

· How Does Weight Loss Surgery Affect Overall Health?

· Obesity-related medical problems will generally improve after weight loss surgery. These include:

  • Obstructive sleep apnea
  • Type 2 diabetes
  • Gastroesophageal reflux disease (GERD)
  • High cholesterol
  • Degenerative joint disease or orthopedic problems
  • High blood pressure
  • Asthma
  • Urinary incontinence

· What Lifestyle Changes Are Necessary After Weight Loss Surgery?

· 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 weight-loss long-term.

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 needs.
  • 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 last?

· Many 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 medical management.


Dr Pavan Addala

M.B.B.S, M.S (Manipal)

D.N.B Surgical Gastroenterology (Apollo Hospital, Chennai)

Consultant Surgical Gastroenterologist,

Sanjeevani PEBLS Advanced Gastro Center

Contact: 9494110638



  • 2017-10-01T05:18:53
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