Commonly asked questions about weight loss surgery

Bariatric surgery, also called weight loss surgery, is a highly effective, long-term weight loss solution for people who struggle with obesity and are unsuccessful at losing weight through diet and exercise. Since obesity has been linked with serious medical problems, including type 2 diabetes, heart disease, stroke, sleep apnea, and cancer, losing weight can prevent or reverse many of these health risks, and can actually add years to your life. Patients who are interested in bariatric treatment must be committed to making lifelong changes in their approach to eating, nutrition, exercise, and other lifestyle behaviors.

What is obesity defined as?

Obesity is having a body mass index (BMI) of 35 or more. The disease of obesity interferes with basic physical functions, such as breathing or walking and also has social impact on your life. The long-term effects of obesity include shorter life expectancy, serious health consequences in the form of weight-related health problems (comorbid conditions) such as type 2 diabetes and heart disease, and a lower quality of life with fewer economic and social opportunities.

What are the main causes of obesity?

The major causes of obesity are multiple and complex. Despite conventional wisdom, it is not simply a result of overeating. Research has shown that, in many cases, significant, underlying causes of obesity are genetic, environmental and social. Studies have demonstrated that, once the problem is established, efforts such as dieting and exercise have a limited ability to provide effective long-term relief.

What is BMI based on?

BMI stands for body mass index. It is a measurement of your height and weight. BMI allows health care professionals and patients to better understand health issues associated with a specific weight classification (classifications such as obesity and morbid obesity). You can use a BMI calculator to easily determine your BMI.

What is bariatric surgery for obesity?

Bariatric surgery, also called weight loss surgery, refers to a minimally invasive procedure designed to help you lose weight and resolve your health issues. At Main Line Health we offer four different bariatric surgery procedures.

Weight loss surgery or diet: What difference does it make?

With typical weight loss dieting and exercise programs, 90 percent of people regain the weight they have lost. Many diet pills have been taken off the market due to safety issues and the fact that they simply don’t work. Bariatric surgery is different because it focuses on three areas diets can’t touch:

  1. Restriction (restrictive bariatric surgery) – reduces stomach size
  2. Malabsorption (malabsorptive bariatric surgery) – reduces calorie absorption
  3. Hormones – alters gut hormones that control hunger and fullness

How do I know if I am a candidate for bariatric surgery?

Qualifications for weight loss surgery include:

  1. Be age 18 years or older
  2. Have a BMI of:
    1. 40 or greater without other risk factors OR
    2. 35 or greater with weight-related risk factors, such as:
      1. Diabetes
      2. Cholesterol
      3. High blood pressure
      4. Sleep apnea
  3. Experiencing diminished quality of life because of your weight
  4. Be willing to participate in long-term follow-up care
  5. Be willing to take prescribed vitamins and minerals as needed

Other common guidelines include:

  • Having failed at previous attempts to lose weight
  • Understanding the risks of bariatric surgery
  • Committing to dietary and lifestyle changes recommended by your surgeon
  • Undergoing a complete examination, including medical tests and a psychological evaluation

Is bariatric surgery right for me?

Talk with your surgeon about the different obesity treatment options and weight loss surgery risks and benefits.

Remember:

  • Bariatric surgery is not cosmetic surgery.
  • Bariatric surgery does not involve the removal of adipose tissue (fat) by suction or surgical removal.
  • You must commit to long-term lifestyle changes, including diet and exercise, which are key to your success with bariatric surgery.
  • Complications after bariatric surgery are rare, but you may need corrective procedures. Some patients also choose to have post-bariatric surgery plastic surgery .

If surgery is not right for you, our medically managed weight loss program can help you meet your goals.

What about bariatric surgery insurance coverage?

Because every insurance policy is unique, it is important that you thoroughly understand your Certificate of Coverage to know exactly what is and is not covered through your plan. Get in touch with your provider to get the details of your plan. If your insurance plan does not cover bariatric surgery and associated fees, a separate, comprehensive, self-pay package is available.

What are the steps to weight loss surgery?

Bariatric surgery is like any other major abdominal surgery. You can best prepare by knowing the benefits and risks of weight loss surgery and by closely following your doctor's instructions. Here are some additional ways to prepare yourself:

  • Learn about bariatric treatments through our free bariatric informational webinar, in-person seminar, or online video.
  • Talk to people who have had bariatric surgery.
  • Write down your reasons for having bariatric surgery and outline your plans to maintain your weight loss after bariatric surgery.
  • Start a journal in which you record how you feel now, the challenges you currently face, and the things you hope to be able to do after bariatric surgery.
  • Attend bariatric support groups.
  • Ask your family and friends for their support. Talk to them about why you want to have bariatric surgery. It helps to have people behind you, waiting to help.

What should I expect post-bariatric surgery?

Bariatric surgery is not a quick fix. It’s an ongoing journey toward transforming your health through lifestyle changes. After surgery:

  • You will feel satisfied and fuller with less food.
  • You will experience positive changes in your body, your weight and your health if you maintain the diet and exercise routines recommended by your bariatric program.
  • You may experience unexpected responses to alcohol after bariatric surgery and should avoid it, if possible.

Through our bariatric program, we offer psychological services for bariatric patients who have concerns regarding alcohol intake and other addictive or impulsive behaviors before or after surgery. Bariatric counseling services are also helpful as you navigate relationships, work and lifestyle while transitioning to a new way of life.

How often will I be able to eat?

After the initial recovery period, most patients are instructed to eat one-quarter cup, or two ounces, of food per meal. As time goes on, you can eat more (as instructed by your medical team). A year or more postsurgery, most people can eat approximately one cup of food per meal (with four ounces of protein). Please review the Bryn Mawr Bariatric Handbook (PDF) for more healthy diet information.

When can I go back to my normal activity level?

Your ability to resume presurgery levels of activity depends on your physical condition, the nature of the activity, and the type of bariatric surgery you had. Many patients return to normal levels of activity within three to six weeks of surgery.

What are the bariatric surgery exercise guidelines?

Exercise is an important part of bariatric surgery success. We encourage you to begin exercising about two weeks after surgery at whatever level is recommended for you (as long as it doesn’t cause discomfort). The type of exercise depends on your overall condition, but the long-term goal is to work up to 30 minutes of exercise, three or more days each week.

Is there any difficulty in taking medications after bariatric surgery?

Most pills or capsules are small enough to pass through the new stomach pouch. At first your doctor may suggest that medications be taken in crushed or liquid form. As a general rule, ask your bariatric surgeon before taking any medication.

What is the follow-up after bariatric surgery?

Gastric bypass patients typically see the surgeon for three to five follow-up appointments in the first year, then once per year after that. Over time, gastric bypass and duodenal patients will need regular checks for anemia (low red blood cell count) and vitamin B12, folate and iron levels.

How can I find a bariatric support group?

Most bariatric surgeons will tell you that ongoing support after surgery helps their patients achieve the greatest level of success. Patients help keep each other motivated, celebrate small victories together, and provide perspective on the everyday successes and challenges of life after bariatric surgery. Bariatric support groups also give patients an excellent opportunity to talk about personal issues. (Patients often learn, for example, that getting bariatric surgery will not resolve existing relationship issues.)

Learn more about our bariatric surgery support group

Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.