We understand that weight loss surgery is complex. We want to make sure that we provide you with informed decisions about your weight loss options.
Recent research suggests that surgical intervention provided in a comprehensive surgical weight loss program can save lives. Moreover, 70% to 90% of the issues related to obesity, such as diabetes, coronary artery disease, sleep apnea, hypertension, depression and multiple orthopedic problems are resolved or well controlled after significant weight loss.
Frequently Asked Questions about Weight Loss Surgery
General Surgery Questions
What is the Vertical Sleeve Gastrectomy?
This procedure generates weight loss solely through stomach restriction. The amount of food (or calories) that can be eaten is decreased by removing approximately 80% of the stomach, thus causing weight loss. This is done without bypassing the intestines and causes less gastrointestinal malabsorption.
How do I know if I am a candidate for surgery?
Candidates for surgery are those men and women who have tried unsuccessfully to lose weight with diet and exercise, are about 100 pounds overweight and have deteriorating health due to the excess weight. Also, the National Institutes of Health states the criteria for surgical intervention is a body mass index (BMI) of 40 or higher. Those individuals with a BMI between 35 and 40 with pre-existing medical conditions, such as diabetes or heart disease, are also eligible for surgery.
How big will my stomach be after surgery?
Many surgeons use a tube to guide them when stapling the stomach. In general, approximately 80% of your stomach will be removed.
Is removing a portion of the stomach safe?
This type of stomach removal has been performed since the mid-1980s. It does involve stapling, just like in gastric bypass, and has similar risks.
What is the difference between open surgery and laparoscopic surgery?
The open procedure requires a large incision in the abdomen. This technique allows the surgeon to perform the surgery without the use of video monitors.
The laparoscopic procedure, also known as minimally invasive surgery, allows the surgeon to operate through a number of small incisions rather than one large incision. With the use of video monitors, the surgeon views the internal organs and performs the procedure.
What are the potential risks of surgery?
As with any surgery, risks are involved. These risks are relatively low in most patients. The surgeon will discuss the potential risks with you, and you will be educated in recognizing symptoms of these complications. The complications with vertical sleeve surgery are minimal.
How long will I be in the hospital?
The average length of stay is one night. Allow 2 to 4 weeks for recovery before returning to work.
What can I expect while I'm in the hospital?
Under most circumstances, patients are expected to take deep breaths 10x per hour, use an incentive spirometer and walk every 2 hours – starting in the first hours after surgery. Most patients are admitted for about 24 hours. At home, we expect you to continue with deep breathing and exercise to help prevent blood clots and pneumonia. You can do this by using your incentive spirometer and taking 10 deep breaths every hour while you are awake.
How long before I start losing weight?
Vertical sleeve weight loss is slower than malabsorptive procedures, with an expected weight loss of about 1 to 2 pounds per week. How quickly you lose weight and how much depends on your commitment to your new lifestyle by following the diet and exercise program.
Will my insurance cover my surgery?
Most insurance companies will cover weight loss surgery; however, you must check with your company to determine if you have this benefit in your policy. Most insurance companies have specific guidelines and criteria for your surgery to be approved.
Will I need to lose weight before surgery?
You may be asked to lose weight before surgery. This will aid in shrinking your liver and make the surgery safer. When you meet with the surgeon, if weight loss is recommended or required, you will be informed at that meeting.
How long after surgery is it safe to attempt pregnancy?
Due to your rapid weight loss, we advise that you wait 2 years after surgery before attempting pregnancy. This will be safer for you and your baby.
How will I prevent pregnancy in the first 2 years after surgery?
We do ask that you stop using all estrogen-containing forms of birth control for 30 days before surgery and 30 days after surgery to decrease your risk of blood clots. You will need to use an alternate method of birth control during this time. Please discuss various forms with your gynecologist before and after surgery.
How much weight can I expect to lose?
You can expect to lose 60 to 80% of your excess weight with a gastric bypass and 50 to 70% of your excess weight with a sleeve gastrectomy.
Will I need to take vitamins?
Vitamin deficiencies are less likely with a sleeve gastrectomy because there is no intestinal bypass. Vitamins are recommended after surgery, and you will be provided with a list.
Is it possible to regain weight?
Yes. It is very important that you follow your surgeons and dietitian’s recommendations and guidelines regarding food consumption. The vertical sleeve requires a more stringent diet plan because there is no malabsorptive aspect to the procedure. It is purely restrictive.
Why should I follow a special diet?
It is important to follow the diet to prevent nutritional deficiencies and maximize weight loss in a healthy, appropriate way.
Why should I avoid carbonated beverages?
Carbonated beverages contain carbon dioxide. When carbon dioxide enters the stomach, it warms up, releasing gases. This can cause discomfort and stretching.
May I continue to drink caffeinated beverages?
Caffeine can increase blood pressure and heart rate. It is also a stimulant and can increase hunger, while also acting as a diuretic. As a result, caffeine can leave you feeling thirsty if used as your main source of fluid intake. It is recommended that you do not drink caffeinated beverages after surgery.
Why do I have to separate liquids and solids?
Your stomach is too small to allow both liquids and solids. If you drink with your meals, you are at risk for nausea and vomiting because the liquid fills the stomach up too fast. Also, if you drink with your meals or too soon after eating, you will flush the food from your pouch faster, which may cause you to be hungry sooner. This may cause you to snack more between meals, resulting in an intake of more calories.
Can I drink alcohol?
Alcoholic beverages should be avoided for the first year. After the first year, alcohol should be limited for the following reasons:
- Alcohol is high in calories. Excess calories can easily be consumed when drinking them without thinking.
- Many alcoholic beverages are carbonated, and carbonation should be avoided.
- Alcohol is irritating to the stomach and can increase your risk of ulcers.
- Alcohol can be absorbed more quickly, resulting in an increased risk of abuse.
Why do I have to drink so much clear liquid?
When losing weight, there is a heavy load of waste products to eliminate, mostly in the urine. These waste products can cause formation of kidney stones. Drinking water helps the body efficiently remove these waste products. Also, dehydration can occur rapidly with insufficient water intake.
How soon after surgery can I exercise?
This depends on how you define exercise. Walking begins almost immediately after surgery. We want you to walk in and out of the house, up and down the stairs and do any activity you did before, with the exception of driving, lifting more than 10 pounds or straining by holding your breath. After you are seen for your 1-week visit and as you heal, you can progressively increase the intensity and frequency of your exercise. You are encouraged to increase your walking distance (this can be done on a treadmill or an elliptical machine). Your goal is 60 minutes per day of walking while recovering. Your surgeon will see you about 4 weeks after surgery (sometimes this is a nurse practitioner). It is likely that your surgeon will release you back to unrestricted activity at this visit. This will be determined based on your progress. Most patients return to work in 4 weeks.
How should I exercise?
Generally, we suggest that you exercise 2.5 to 3 hours per week. This should include at least 30 minutes five times a week of aerobic activity. Aerobic activity means getting your heart rate up and getting sweaty. Your exercise should include aerobic, anaerobic (resistance) and stretching exercises. Aerobic exercise results in improvement of cardiovascular health. Anaerobic exercise improves muscle tone and strength. It also results in the most calories burned. Flexibility is important to prevent injury.
Please be careful not to injure yourself by progressing too quickly. At the same time, keep in mind that what we are recommending is the minimum. More exercise is always better if it is done safely. Learn what is available in your community, and discuss it with your surgeon.
Will I get a hernia from exercise?
Most of the procedures are done laparoscopically. With this approach, hernias are much less common than with conventional open surgery. In fact, most of the time, you can go back to normal activity in 2 weeks. However, to be safe and accommodate all types of activity and work, we suggest that you can go back to normal strenuous activity in 4 weeks. This does not mean that you may not feel some discomfort at your incision sites. This can occur for up to 3 months. However, what you are feeling is not a hernia. It is your abdominal wall muscle healing. The general rule is to increase your activity progressively. You will feel discomfort with twisting and sudden movement. Therefore, you should stretch and increase your activity as you can tolerate it. If your surgery was done in an open approach, then the waiting period is longer before unrestricted activity. Most surgeons will tell you at least 6 weeks for heavy lifting. If you have other conditions like pre-existing hernias, then your surgeon will give you specific instructions.
Is everyday walking like what I do at work or walking my dog considered exercise?
Not really! You should take time out for yourself that is specifically for exercise. Everyone has 30 minutes a day for their health. You are worth it.
Will I lose muscle mass?
Part of losing weight includes losing some muscle mass. However, starting a progressive exercise program early will minimize this problem and can actually result in gaining muscle mass.
Will exercise help get rid of extra skin?
Yes and no. The extra skin that results from weight loss occurs no matter how you lose weight. The amount of extra skin is directly proportional to the amount of weight you lose and your genetics. If the weight is located centrally (the fat is around organs), you will have less skin than someone with weight that is located peripherally (the weight is carried on the hips and extremities). An example of a central adipose distribution is the apple shape. An example of the peripheral adipose distribution is the pear shape. The time will come when you have lost most of the fat between your muscle and your skin. What remains results in skin that sags. Unfortunately, there is no amount of exercise that can take away that extra skin. You may want to consider plastic surgery. For the best results, you should be out of surgery at least a year and have lost 60% of your excess body weight before you consider plastic surgery.
To schedule an appointment with the Blessing Weight Loss Center or refer a patient, please call (217) 214-5800.