Bariatric FAQs
Here are answers to some frequently asked questions (FAQs) about our program. For more information, call our Program Coordinator Catherine Tuppo at (631) 638-3011.
Obesity and Bariatric Surgery
Morbid obesity is generally defined as a Body Mass Index (BMI) of 40 or greater, which is roughly equal to 100 pounds or more over ideal body weight or those with a BMI greater than 35 who have two or more comorbid conditions. The disease of morbid obesity interferes with basic physical functions such as breathing or walking. Long-term effects of morbid obesity include serious health consequences and shorter life expectancy.
The causes of morbid obesity are multiple and complex. Genetic, environmental and social factors may play a role. Studies have demonstrated that once the problem is established, efforts such as dieting and exercise programs have a limited ability to provide effective long-term relief.
A comorbid condition is a health problem that occurs at the same time as another condition. For example, someone with obesity might also have diabetes or high blood pressure. The primary disease of morbid obesity can lead to several comorbid conditions such as diabetes, heart disease, sleep apnea and joint damage.
Bariatric surgery is designed to cause weight loss. It may encompass any one of several procedures that make the stomach smaller so the patient feels satisfied with less food and fewer absorbed calories.
Bariatric surgery includes several procedures that help with weight loss by using one or both of these methods: reducing the size of the stomach or changing how the body absorbs food. It can also improve or resolve health problems like diabetes and high blood pressure.
Talk with your surgeon about the risks and benefits of the various treatments available.
Remember:
- Bariatric surgery is not cosmetic surgery.
- Bariatric surgery does not involve the removal of adipose tissue (fat) by suction or surgical removal.
- The patient must commit to long-term lifestyle changes, including diet and exercise, which are key to the success of bariatric surgery.
- Problems after surgery are uncommon, but if they occur, corrective procedures may be required.
With open or traditional surgery, the surgeon creates a long incision to open the abdomen and operates with a direct view of the internal organs. Laparoscopic, or minimally invasive, surgery allows the surgeon to perform the same procedure using small incisions, a fiber optic camera, video monitor and long-handled instruments. Laparoscopic surgery is not only less invasive, but also permits a faster recovery and minimal scarring.
Because every insurance policy is unique, it's important that you thoroughly understand your Certificate of Coverage to know exactly what is and isn't covered through your plan. Contact your insurer for more information. Many carriers request a weight history and pre-surgery weight loss program. Our center offers a pre-surgical weight loss program as required by insurance.
For many people, bariatric surgery is affordable because it is covered by their health insurance plan. People who do not have insurance coverage for bariatric surgery may pay for it out of pocket. Self-pay may involve alternative financing options such as medical loans or home equity loans.
It varies from person to person. Generally, the hospital stay for weight loss surgery (including the day of surgery) can be one to two days.
Our center offers several options to individuals seeking weight loss interventions prior to the consideration of surgery.
Medical Issues and Bariatric Surgery
Routine tests typically include:
- Complete Blood Count (CBC)
- Urinalysis
- Chemistry screen
- Electrocardiogram
- Psychological evaluation
Other tests that may be requested include:
- Blood glucose test
- Pulmonary function testing
- Sleep study
- GI evaluation
- Cardiology evaluation
Type 2 diabetes is a long-term metabolic disorder where the body produces insulin, but resists it. Insulin is necessary for the body to utilize sugar. Studies have shown that the majority of patients who have gastric bypass surgery experience complete resolution of their diabetes.
Excess body weight is associated with an increased risk of heart disease, elevated cholesterol and high blood pressure. These conditions can lead to heart attacks, strokes, and heart and kidney damage. Bariatric surgery reduces excess body weight over time, which decreases strain on the heart. Studies have shown that the majority of patients who had gastric bypass surgery experienced complete resolution of high blood pressure.
High cholesterol is a disorder of lipids (fat-like substances) in the blood. As these lipids build up inside the arteries, harmful scar tissue and other debris begin thickening and hardening the artery walls. Long-term, this can lead to heart disease and high blood pressure. Most patients who have bariatric surgery experience improved cholesterol health.
Obstructive sleep apnea occurs when breathing suddenly stops because soft tissue in the back of the throat collapses and closes during sleep. Morbid obesity can cause sleep apnea and other respiratory problems that may result in chronic fatigue. The vast majority of patients who have bariatric surgery are cured of their sleep apnea.
Acid reflux, also known as GERD, causes injury to the esophagus through chronic exposure to stomach acid. It is a serious disease that can cause esophagitis, Barrett’s esophagus and esophageal cancer. Studies show that nearly all patients who had gastric bypass surgery experienced complete resolution of acid reflux/GERD.
Research on cancer prevalence found consistent evidence that higher amounts of body fat is associated with an increased risk of a number of cancers. A nationwide cross-sectional study using BMI and cancer incidence data from the US Cancer Statistics database estimated that each year from 2011 to 2015, among people ages 30 and older, about 37,670 new cancer cases in men (4.7%) and 74,690 new cancer cases in women (9.6%) were due to excess body weight.
Depression is an illness that involves the body, mood and thoughts. It affects the way a person eats, sleeps, thinks and feels. There are many reasons people with morbid obesity experience depression. Emotional health goes hand in hand with physical health. Lifestyle improvements and renewed health can help resolve depression. Weight loss, combined with counseling, can be very helpful in improving mental health.
Osteoarthritis is one of the most common forms of arthritis. Known as the wear-and-tear kind of arthritis, osteoarthritis is a chronic condition in which there is a breakdown of joint cartilage. For anyone who is living with morbid obesity, the excess body weight placed on joints, particularly knees and hips, results in rapid wear and tear, and pain caused by inflammation. Bariatric surgery can reduce much of this weight over a long period of time and can be very effective in treating osteoarthritis.
Among women, morbid obesity is a risk factor for stress urinary incontinence, or uncontrollable urine loss. This occurs when the valve on the urinary bladder weakens, leading to leakage of urine with coughing, sneezing or laughing. Bariatric surgery has been found to improve stress urinary incontinence. Less weight is placed on the bladder, and other physical changes take place to improve this condition.
Reproductive health can be a concern for women struggling with morbid obesity. Issues such as infertility (the inability or reduced ability to produce children) and menstrual irregularities may occur due to morbid obesity. Fertility issues include possible miscarriage, reduced success with fertility treatments, polycystic ovarian syndrome (PCOS) and a risk of birth defects.
Life After Bariatric Surgery
Bariatric surgery is not a quick fix. It’s part of an ongoing journey toward transforming your health through lifestyle changes. After surgery, you will feel satisfied and fuller with less food. Positive changes in your body, your weight and your health will occur, if you maintain the diet and exercise routines recommended by your bariatric program.
Our comprehensive, multidisciplinary bariatric program uses a team approach involving a program coordinator, psychologist, nutritionist and other healthcare professionals. Each expert is dedicated to providing support for bariatric patients both before and after surgery. Our psychology team runs a 6-week pre-surgical group and a 10-week postsurgical group to help patients to foster effective behavioral coping strategies.
Most doctors recommend that women wait at least one year after the surgery before a pregnancy. Consult your surgeon as you plan for pregnancy.
Most patients report some discomfort and soreness rather than pain.
It depends on the procedure but generally ranges between two and three weeks.
After the initial recovery period, most patients are instructed to eat 1/4 cup, or 2 ounces, of food per meal. As time goes on, you can eat more (as instructed by your medical team). Most people can eat approximately 1 cup of food per meal (with 4 ounces of protein) a year or more post surgery.
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 weeks of surgery.
Exercise is an important part of success after surgery. You will be encouraged to begin walking soon after surgery. After your follow-up visit with your surgeon, your exercise program will be progressed. The type of exercise depends on your overall condition, but the long-term goal after weight loss surgery is to get 30 minutes of cardio exercise three or more days each week, in addition to strength training two to three times per week.
Eating simple sugars (such as sugar, honey and corn syrup) or high-fat foods can cause dumping syndrome in patients who have had gastric bypass surgery. This occurs when these products, which have a small particle size, are “dumped” from the stomach into the intestine at a rapid rate. Water is pulled into the intestine from the bloodstream to dilute the sugar load. This flush of water causes symptoms that can include diarrhea, rapid heart rate, hot flashes or sweating and clammy skin, and dizziness.
Patients who undergo weight loss surgery typically see their surgeons and members of the bariatric team for three to five follow-up appointments the first year, then once or twice per year thereafter. Over time, patients who had gastric bypass or duodenal switch will need checks for anemia (low red blood cell count), vitamin B12, folate, iron and other nutrient levels.
Support groups give patients an excellent opportunity to talk about concerns and share ideas. Patients help keep each other motivated, celebrate small victories together, and provide perspective on everyday successes and challenges. Our monthly support groups will offer this assistance, in addition we can direct you to online support groups.
