Bariatric Surgery FAQs
Some of the commonly asked queries related to bariatric surgery by bariatric patients or potential ones are answered as follows:
How will bariatric surgery help me lose weight?
There are two basic types of weight loss surgery—restrictive and malabsorptive surgeries. In restrictive surgery, the surgeon operates to reduce the size of your stomach and decrease the food carrying space. While in malabsorptive surgery, the small intestine, the absorptive site, is operated on. This allows decreased absorption of nutrients. In combined restrictive and malabsorptive surgeries, both stomach and small intestines can be the surgical sites.
Restrictive procedures like sleeve gastrectomy decrease the production of ghrelin, a hunger hormone that usually is produced from the stomach. Malabsorptive procedures cause increased production of appetite-controlling hormone GLP. Changes in hormonal balance allow effective weight loss.
What is the success rate for surgery?
The success rate of bariatric surgery for weight reduction is estimated to be 75-80%. This includes both restrictive gastric procedures: gastric bypass or laparoscopic sleeve gastrectomy.
Is surgery a permanent solution for weight loss?
No, bariatric surgery is not a permanent solution for weight loss. Every surgical procedure requires proper follow-up visits and dietary modifications. This surgery essentially benefits most people. While some may regain weight after a few months of surgery due to a lack of following dietary guidelines.
What are the types of surgery?
There are mainly three different types of surgical procedures:
Sleeve gastrectomy: A surgical technique that involves partitioning the stomach by removing about 85% of the stomach and creating a sleeve shape.
Gastric Bypass Surgery: A surgical technique in which the stomach is unequally divided into upper small and lower larger pouch and small intestine is rearranged to be connected to both. This allows restriction of food intake and eventually its absorption and utilization.
Biliopancreatic diversion: This is similar to gastric bypass surgery. In a biliopancreatic diversion, the distal portion of the stomach is removed, the small portion that remains is connected to the distal part of the small intestine. The bile and pancreatic juices are allowed to mix before entering the colon. This allows weight loss by preventing the absorption of nutrients.
Which one is best for me?
The decision for the best surgical procedure for each individual is based on the clinical condition. This decision is made wisely by the surgeon and discussed with the patient. Every effort is made in favor of the patient.
How long does the surgery take?
Sleeve gastrectomy and gastric banding take around 1-2 hours. Gastric bypass surgical procedure takes longer: around 2-3 hours. Generally, the whole procedures are completed during this period of time if not complications occur.
What preoperative measures should I take?
Necessary pre-operative measures include specific lab tests for evaluation of your general body condition. It is not necessary that you should be in good health. Numerous health conditions require treatment for morbid obesity. These include diabetes, hypertension, sleep apnea, and liver problems, etc. Therefore, your comorbidities need proper assessment to know your health status. A chest X RAY and ECG are essential requirements before surgery and test for specific ulcers- causing bacteria- H pylori.
How long should my stay in the hospital be?
Your hospital stay should generally be 24 hours or less. Occasionally two days.
What are the risks of surgery?
Weight loss surgery has gained popularity because it is a very safe surgery. The risk for complications is 1 to 3 percent, and the risk for death is two in a thousand. However, some complications which may arise during surgery include bleeding, hernia, gallstones, dehydration, hypoglycemia, ulcerations, leak or fistula formation, hair loss, and kidney stones.
When can I return to my job?
You don’t require a long recovery time after surgery, as feared. Most of the patients can return to their jobs within a week’s time.
Are follow-ups necessary to attend after surgery?
Follow-ups are essential after surgery to take you through the different diet stages and keep a close eye on your progress. Your weight loss is dependent on your follow-ups. You will require six weeks of follow-up meetings initially during the first year. These can be scheduled for six to twelve months in the final period. You must be the one to attend those meetings and consult both your operating surgeon and a nutritionist according to need.
How can I achieve the best results after surgery?
You can achieve the best possible results for weight loss by following strict dietary plans and making lifestyle modifications. The surgical procedure reduces the size of your stomach and decreases the amount of food consumption by your body. Consumption of high-calorie and fatty foods after surgery can gradually increase the size of your stomach, and you may end up regaining your weight. Therefore, the surgical procedure is not the only solution. Instead, maintenance of your health after surgery is equally essential.
What should I eat after surgery?
Some essential dietary advice you need to know are as follows:
Life after surgery is a new life that demands some new changes. You may need to modify some of your choices and also limit the size of portions. Follow a diet low in calories, fats, and sweets. Avoid rice, bread, raw vegetables, fresh fruits, and meats like pork and steak that may be difficult to chew. You should eat slowly and chew properly. No need to rush eating. Avoid carbonated drinks as they may cause discomfort by introducing air into your pouch. First two months after surgery, your calorie intake should be between 300 to 600 calories per day. Focus on a thin and thicker liquid diet. After two months, you can eat the same food as everyone while limiting some portions. Always keep a record of calories and protein intake.
Take extra fluids to prevent dehydration and avoid any form of caffeinated drinks. Avoid alcoholic beverages as they may be absorbed more quickly than before. Take multivitamins and calcium, vitamin D, and B12 supplements. Try gradual and supervised progression of diet from liquid to solids to achieve the best results.
What should I do if I want to become pregnant?
As a general rule, pregnancy becomes easier after weight loss surgery because your menstrual cycles are regulated. But it is recommended that you wait at least 15- 18 months for pregnancy, post-surgically. This is important for the maintenance of a healthy pregnancy.
Will my physical appearance change after surgery?
Yes, definitely. Your physical appearance will change within weeks to months following surgery. People around you will notice you. You may have excess skin, for which you may require additional plastic surgery.
Will my social life change after surgery?
With a significant physical change, you will notice people around you, be it your family or your friend’s circle. You will be asked about this new look. You may need to change your priorities for socializing and shift to other exciting activities instead of food and drink parties. After all, you need to maintain your new and bright look for a long time.
Will I feel like myself after surgery?
Initially, a few months after surgery, where you may be thrilled and excited about your new look, at the same time, you may feel difficulty in coping up with new dietary modifications and a significant lifestyle change. You may at times feel distressed by not living up to that change. But it would be best if you went on. You must attend your follow-up visits and consult a good therapist or join a support group that may help you stay focused on your aim.