Why surgery?

Most morbidly obese individuals have tried numerous weight loss methods and have failed. Also, most morbidly obese individuals are at high risk or suffer from diabetes, high blood pressure and sleep apnea and obesity surgery will alleviate and may eliminate such problems. Surgery is the only effective treatment of severe obesity.

What are the surgical procedures performed by the surgeon?

The Laparoscopic Roux-en-Y gastric bypass and the Lap-Band are the most common procedures. However, I also perform the Sleeve Gastrectomy, Biliopancreatic Diversion with Duodenal Switch (BP-DS), and revisions of previous bariatric surgeries, which is of special interest to me. All surgeries are done laparoscopically.

How long does the surgery take?

It depends on the procedure and the weight of the patient. The heavier the patient, the longer the procedure. In average the laparoscopic Roux-en-Y takes between 70 and 90 minutes, and the Lap Band takes between 45 to 60 minutes.

Are these procedures reversible?

Roux-en-Y Gastric Bypass is reversible, but you must understand that it will take very complex, serious and major surgical procedures to take it down. Lap Band is easily reversible, but it will require a surgery with hospital admission post-op recovery.

I heard that bariatric surgery is dangerous. How safe is it?

ALL surgeries involve a certain amount of risk, and this surgery is no exception. Also, obese patients have more risks and complications than non-obese patients do. The surgeon will go over the complications with you, but it is important to realize that the risks of obesity surgery are outweighed by the risks of leaving morbid obesity untreated. Also, not all patients have the same surgical risk. The heavier the patient the bigger the risk. The higher risks are for:

patients older than 55
patients with BMI higher than 55
patients with sleep apnea
patients with previous surgery
patients with a history of hypertension, diabetes, embolism, heart disease, asthma, etc
patients who had previous bariatric surgery are the ones with higher risk and complications.

I heard that bariatric patients are susceptible to frequent vomiting. Is this true?

Vomiting is more frequent in banding procedures patients because of the band placed around the stomach pouch. It can occur in some gastric bypass patients, but it is much less common.

How long will I stay in the hospital, and when will I be allowed to return to work?

Normally, patients are in the hospital overnight and patients usually return to work 2 weeks after surgery. Lap Band and Lap Band Takedowns are outpatient surgeries and you will go home the same day. Recovery is typically one week.

How will I lose weight with this procedure?

Most procedures are restrictive surgical procedures designed to reduce the amount of food you consume in other words, you will feel satisfied more quickly and will eat smaller amounts of food. The Sleeve Gastrectomy, Roux en Y Gastric Bypass, and the Duodenal Switch also have metabolic component that also assist in weight loss. The DS also has a malabsorptive component that does not allow fat to be absorbed.

How fast will I lose weight?

Patients will begin to lose weight in the first week after surgery, but how much weight will you lose will depend on how overweight you are. Patients should have a realistic expectation about the results and benefits of this surgery. The better quality of food and THE MORE ACTIVE YOU ARE, the more WEIGHT YOU will LOSE. There is clear scientific evidence that the quality of food, emphasizing natural, non-processed and nutrient rich foods is important in long term weight loss maintenance

How successful is bariatric surgery with weight loss?

In general, all surgeries are very effective as far as weight loss is concerned. The success of surgery depends largely on several factor. First, the procedure itself. Procedures with metabolic component have more weight loss than non-metabolic procedures. Second, the patients commitment to lifestyle change. If patients become active and eat healthy natural diets restricting high sugar and excessive fatty food results will be better. The goal of surgery is not only weight loss but to improve health and quality of life.

Will I starve?

No. Your metabolism will eventually adjust to the smaller amounts of food and the calories you intake. This is why it is important for you to follow instructions given to you by your doctor – take vitamin and nutrient supplements, make sure to get enough protein, and eat small meals every 3 hours.

Will I ever have to diet again?

It is important for you to realize that surgery is just the beginning. Obesity surgery provides you with the mechanical means to help you lose and manage your weight. You will have to adopt a healthy way of life: eating right and making certain that you get the vitamins and nutrients your body needs. The decision to have this surgery is a COMMITMENT to changing your life. After surgery, your eating habits will change: you must eat every 2 to 3 hours, small amounts of food. Most people are able to eat most foods, but it will take time, and it is important to remember that everybody is different. It is also possible to sabotage the surgery. One way to do this is to eat large amounts of food at one sitting. By doing this, the small pouch will STRETCH. Eating large amounts of food like ice cream will also sabotage the surgery. Because it is in liquid form, a patient will not feel full very quickly. It is high in fat and calories and has no nutritional value. Once again, it will be very important for you to strictly follow all the instructions given to you by the doctor during your pre-op and post-op visits. Keep those eating guidelines always with you. If you are having problems read them again to see if you are really following these directions.

How important is a support group or after care program?

Patients who attend support programs have a better success rate than those who do not. Education and support is key in long term success for weight loss. Support groups offer excellent resources for patients who have had surgery or patients who are considering surgery.