Bariatric FAQ

Here are answers to some frequently asked questions (FAQs) about our program. For more information, call our Program Coordinator Catherine Tuppo at (631) 444-2619

FAQ Obesity and Bariatric Surgery

What is morbid obesity?
What causes morbid obesity?
What is a co-morbid condition?
What is bariatric surgery?
How does bariatric surgery work?
What is Body Mass Index (BMI)?
How do I determine if bariatric surgery is right for me?
What is the difference between laparoscopic and open surgery?
Do I qualify for insurance coverage for the surgery?
How do I pay for bariatric surgery?
How long do I have to stay in the hospital?
Is there help available so I can start learning how to lose weight successfully before surgery?

FAQ Medical Issues and Bariatric Surgery

What tests are required before bariatric surgery?
What is type 2 diabetes and how is it be affected by bariatric surgery?
What is high blood pressure (hypertension) and how is it affected by bariatric surgery?
What is high cholesterol and how is it affected by bariatric surgery?
What is sleep apnea and how is it affected by bariatric surgery?
What is acid reflux or gastroesophageal reflux disease (GERD) and how is it affected by bariatric surgery? 
What is the relationship between morbid obesity and cancer?
What is depression and how is it affected by bariatric surgery?
What is osteoarthritis and how is it affected by bariatric surgery?
What is stress urinary incontinence and how is it affected by bariatric surgery?
How is reproductive health affected by bariatric surgery? 

FAQ Life After Bariatric Surgery

What will my life be like after the surgery?
What support will I receive in adjusting to new daily habits?
Can I get pregnant after bariatric surgery?
What about postoperative pain and discomfort?
How long is recovery?
When can I go back to my normal activity level?
How often will I be able to eat?
How much exercise is needed after bariatric surgery?
What is “dumping syndrome?”
What is the long-term follow-up schedule?
Should I participate in a support group?

FAQ Obesity and Bariatric Surgery

What is morbid obesity?
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 co-morbid 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. Back to Top

What causes morbid obesity?
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. Back to Top

What is a co-morbid condition?
It is the presence of one or more disorders or diseases in addition to a primary disorder or disease; or, the presence of a disorder or disease that is caused by or otherwise related to another condition in the same patient. The primary disease of morbid obesity can lead to several co-morbid conditions such as diabetes, heart disease, sleep apnea and joint damage. Back to Top

What is bariatric surgery?
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 calories are absorbed. It is intended for people who are 100 pounds or more overweight (with a BMI of 40 or greater) or those with a BMI of greater than 35 and two or more co-morbid conditions. For gastric banding procedures, the criteria are a BMI greater than 35, or a BMI greater than 30 plus two significant medical problems. Back to Top

How does bariatric surgery work?
Bariatric surgery is the clinical term for several different procedures. The procedures use one or both of two approaches to help patients lose weight and improve or resolve co-morbid conditions such as diabetes and high blood pressure.

Gastric Restrictive Procedures. During these procedures, the surgeon creates a small stomach pouch that limits the amount of food patients can eat. The smaller stomach pouch fills quickly, which helps patients feel satisfied with less food.

Examples of restrictive procedures:

– Adjustable Gastric Band
– Band with Plication
– Sleeve Gastrectomy

Combined Mode of Action Procedures. Some bariatric procedures use malabsorption as well as restriction. Malabsorption occurs when the surgeon reroutes the small intestine so that food skips a portion of it. Because the small intestine absorbs calories and nutrients from food, avoiding part of it means that fewer calories and nutrients are absorbed.

For example, Roux-en-Y gastric bypass surgery uses both restriction and malabsorption. During the procedure, the surgeon creates a small pouch. The surgeon then attaches a Y-shaped section of the small intestine directly to the stomach pouch. This allows food to bypass a large portion of the small intestine, which absorbs calories and nutrients. The smaller stomach pouch causes patients to feel fuller sooner and eat less food; bypassing a portion of the small intestine means the patient’s body absorbs fewer calories.

The Roux-en-Y Gastric Bypass is an example of a procedure using a combined mode of action. Back to Top

What is Body Mass Index (BMI)?
BMI is a measure used to index a person’s height and weight. Calculate your BMI. Back to Top

How do I determine if bariatric surgery is right for me?
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. Back to Top

What is the difference between laparoscopic and open sugery?
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. Back to Top

Do I qualify for insurance coverage for the surgery?
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. Back to Top

How do I pay for bariatric surgery?
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 pocketbook. Self-pay may involve alternative financing options such as medical loans or home equity loans. Back to Top

How long do I have to stay in the hospital?
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 for a gastric band and two to three days. Back to Top

Is there help available so I can start learning how to lose weight successfully before surgery?
Our center offers several options to individuals seeking weight loss interventions prior to the consideration of surgery. Back to Top

FAQ Medical Issues and Bariatric Surgery

What tests are required before 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 Back to Top

What is type 2 diabetes and how is it affected by bariatric surgery?
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. Results also have been good for gastric banding. In addition, patients who had bariatric surgery experienced lower insulin resistance, and their risk for metabolic syndrome, high blood pressure and high cholesterol also decreased. Back to Top

What is high blood pressure (hypertension) and how is it affected by bariatric surgery?
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. Results also have been good for gastric banding. Back to Top

What is high cholesterol and how is it affected by bariatric surgery?
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. Back to Top

What is sleep apnea and how is it affected by bariatric surgery?
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. Back to Top

What is acid reflux or gastroesophageal reflux disease (GERD) and how is it affected by bariatric surgery?
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. Back to Top

What is the relationship between morbid obesity and cancer?
Morbid obesity may put you at a higher risk for several types of cancer, such as colon, breast and kidney cancer. In 2003, an article in the New England Journal of Medicine estimated that obesity could account for:

  • 14% of all deaths from cancer in men
  • 20% of all deaths from cancer in women

Back to Top

What is depression and how is it affected by bariatric surgery?
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. Back to Top

What is osteoarthritis and how is it affected by bariatric surgery?
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. Back to Top

What is stress urinary incontinence and how is it affected by bariatric surgery?
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. Back to Top

How is reproductive health affected by bariatric surgery?
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. A recent study of women following gastric bypass surgery showed improvement of multiple clinical problems related to infertility and PCOS. In addition, 100% of patients who had gastric bypass surgery experienced complete resolution of menstrual dysfunction due to PCOS. Back to Top

FAQ Life After Bariatric Surgery

What will my life be like after the 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. Back to Top

What support will I receive in adjusting to new daily habits?
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 six-week presurgical group and a 10-week postsurgical group to help patients to foster effective behavioral coping strategies. Back to Top

Can I get pregnant after bariatric surgery?
Most doctors recommend that women wait at least one year after the surgery before a pregnancy. Consult your surgeon as you plan for pregnancy. Back to Top

What about postoperative pain and discomfort?
Most patients report some discomfort and soreness rather than pain. Back to Top

How long is recovery?
It depends on the procedure but generally ranges between two and three weeks. Back to Top

How often will I be able to eat?
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 postsurgery. Back to Top

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. Back to Top

How much exercise is needed after bariatric 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. Back to Top

What is “dumping syndrome?”
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. Back to Top

What is the long-term follow-up schedule?
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, gastric bypass patients will need checks for anemia (low red blood cell count) and vitamin B12, folate and iron levels. Gastric band patients need to work with their surgeons to have their band adjusted several times during the first 12 to 18 months after surgery. Back to Top

Should I participate in a support group?
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. Back to Top