Read through a list of our frequently asked questions concerning bariatric surgery and the surgery process options we provide.
If you are between the ages of 18 and 70 and have a Body Mass Index (BMI) of 40 or greater, or a BMI between 35-39 with co-morbidities such as diabetes, high blood pressure, obstructive sleep apnea, or congestive heart failure, you may be a candidate.
Each person’s case is different. But depending on the operation it usually lasts about 1 to 1 1/2 hours. After surgery you will remain in the recovery room until your anesthesiologist clears you to be moved to your hospital room, usually about 1 hour after surgery.
Most people can expect to lose between 60% and 70% of their excess body weight. Most of this is lost within the first 18 months following surgery.
Due to the tremendous weight loss as a result of the Roux-En-Y gastric bypass, you may have some loose or sagging skin. You may also develop skin breakdown due to excess moisture problems underneath the skin along with chronic infection. There may be less excess skin with the sleeve gastrectomy because the weight loss is more gradual, and the skin has time to recoil and adjust. If you are left with excess skin and loose tissue around your abdomen, you may be a candidate for a panniculectomy. A panniculectomy is a procedure to remove the “apron” of fat and skin that hangs from the front of your abdomen. If Dr. Fernandez deems you to be a candidate, we can submit for approval to your insurance company.
With any weight loss surgery, your body has to adjust to a smaller capacity for food. Although it is common for some post-operative stretching to occur, if you follow your post-operative eating guidelines you should be able to maintain a healthy weight. There is no reliable way to predict the amount of excess skin you may have. Younger patients will have fewer problems with excess skin after weight loss but most patients will have excess skin that may require surgery for removal.
Aside from the initial bariatric diet which consists of a 1 to 1.5-month transition to solid food, you should be able to eat whatever you want - just not the quantity you could tolerate before.
In most cases, yes. With a reduction of weight on the joints, many people experience less joint pain and increased mobility. However, if there is already permanent damage to your joints, weight loss may not resolve all your joint pain.
We frequently hear from our patients that their cravings have significantly diminished, and they don’t feel compelled to eat all of the time. Much of this is due to reducing the amount of the hunger hormone (known as ghrelin) that is released into the system from the native stomach. Because the stomach is smaller, less ghrelin is produced.
Due to the post-operative diet, many patients suffer from a temporary thinning of the hair. To alleviate this problem, I recommend increasing protein intake and using hair-thickening shampoos. Thinning hair is a normal response to the initial rapid weight loss that occurs from both the Roux-en-Y gastric bypass and sleeve gastrectomy. Once you’re back on a normal diet with adequate protein levels, the hair loss stabilizes, and you start to regain your hair. For most people, it goes back to normal.
Typically, patients spend the first night postoperatively in the hospital. Many patients do not require any pain medicine. I encourage patients to get up and walk around immediately during their post-operative stay in the hospital. Most people get back into the swing of things after a week or two following their procedure. For example, typically my patients go back to light aerobics and brisk walking after two weeks.
As with most operations, initially patients will feel fatigued. Once your metabolism changes for the better, your energy level will increase. This is because the quantity of food that is taken in is adequate enough to sustain good health. For other required energy, your body metabolizes the storage areas including the fatty deposits and therefore you should have an abundance of energy.
The surgeon may decide to take out your gallbladder if it is causing you significant problems. If you still have your gallbladder and it is causing you symptoms, the surgeon may request an ultrasound of your gallbladder to examine it better before to your surgery, to determine whether removing it is necessary.
Your surgeon will be in the room and is the person performing the entire operation. Your surgeon may use a specialized team that is specifically trained to assist with robotic procedures and may be present as well.
The Roux-en-Y gastric bypass changes your gastrointestinal tract. Because nothing is removed during this bypass, it can be reversed. However, this operation should be viewed as a permanent change. If you are not ready for that type of commitment, this type of procedure may not be the best option for you at this point.
It is not recommended to drink carbonated beverages.
First and foremost, educate yourself. Read all materials available from our website. Check out other reputable online resources like www.obesityhelp.com, www.ASMBS.org, and www.obesityaction.org/weightlossoptions/bariatricsurgery. Attend our informational seminar, and/or one of our support group sessions. Listen to the stories of other weight loss surgery patients, which you can also find online or in print, but be aware of the individual differences in surgical experience and compliance. Begin to put in place the recommended healthy lifestyle behaviors that go hand-in-hand with weight loss success, such as weaning carbonated/caffeinated beverages, building in healthy protein sources to each meal, increasing physical activity as able, and cutting out simple and starchy carbohydrates. You will find that the sooner you “surrender” to these recommendations, the easier it will be to adopt and maintain this healthy lifestyle after surgery, and you will be more successful long-term in keeping off excess weight.
Pregnancy after Weight Loss Surgery is very possible. In fact, women who have suffered from infertility in the past will often regain their fertility as they lose weight. However, we recommend that our female patients avoid pregnancy for ideally at least 18 months to two years after Weight Loss Surgery – specifically with Gastric Bypass and Gastric Sleeve. The reasoning behind this is that periods of rapid weight loss are not the ideal situation for nourishing a growing fetus.
However, after you’ve gotten past your first two years, have lost the bulk of your excess weight and are successfully maintaining, pregnancy is much safer for both you and the baby, as you will be lighter, more active and healthier all around. In addition, you will have a lower risk of weight-related pregnancy and delivery complications, and the baby, if born at a healthy weight, will have a lower risk of later health problems as well. If you become pregnant, please let us know as soon as possible because we’ll work closely with you and your OB-GYN to make sure you don’t become vitamin or mineral deficient during the pregnancy.
There is no right or wrong surgery, but the choice is usually largely up to the patient, with input by the providers. The decision should be based first on a clear understanding of the basics of each surgery, including risks and benefits; health conditions which may favor the benefits of one surgery vs. another, or conversely, increase the risks; an acknowledgement of current eating style as to which procedure is truly “best fit”; and personal preference. Our goal is to help you make the best informed decision possible for your circumstances and health challenges.