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Common Questions and Answers About Weight Loss Surgery

Who is a candidate for weight loss surgery?

Weight loss surgery is not right for everyone. You should take in consideration of all the hard work, lifestyle change and motivation it will take after surgery. Obesity surgery is an effective treatment for morbid obesity, although the pounds do not come off by themselves. The surgery is an aid to help achieve lasting results by limiting your food intake.

Additionally, patients with complex medical conditions and limited mobility increase the surgical risks; patients are thoroughly evaluated and considered on a patient-by-patient basis. Individuals may be candidates if they meet the NIH Guidelines for morbid obesity surgery.

Click here for more information on the NIH Guidelines.
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How much weight can I expect to lose after surgery?

The amount and rate at which you lose excess body weight varies depending on the type of surgery, the starting weight, and compliance with dieting, exercise, and vitamin intake.

How much weight can I expect to loose after surgery?

How soon should I see weight loss after surgery?

You can lose as much as 10-20 pounds in the first 2 weeks after surgery and as much as 30-45 pounds in the first month, again depending on the factors above.

Will I need plastic surgery to eliminate excess skin?

The amount of excess skin especially in the abdominal area depends on the amount of weight lost after bariatric surgery (the more weight lost, the more excess skin), age (younger patients may have better elasticity in their skin than older patients), exercise (some patients notice less excess skin if they've adhered to aggressive abdominal exercise regimens while losing weight to help tone those areas), and genetics (some patients notice that their parents have less loose skin than others). Loose skin in the face, neck, arms and legs are very likely to occur regardless of these factors mentioned.

Can I drink alcohol after undergoing surgery?

No, We encourage you not to drink alcohol after surgery.

What are the dietary guidelines after weight loss surgery?

Liquids for the first 3 weeks after surgery, then pureed foods for another week, followed by soft foods for a week and then regular, high protein foods afterwards. Lifelong vitamins and even protein drink supplements are required.

Is exercise an important factor after weight loss surgery?

Exercise is critical to successful weight loss as well as long-term cardiovascular health. Remember weight loss surgery only minimized calorie intake. Daily exercise allows for the excess fat in your body to be burned off.

What happens if I do not obey my dietary guidelines after surgery?

If you do not follow the guidelines after having bariatric surgery, you can still be obese and malnourished at the same time.

Can I get pregnant after weight loss surgery?

Women are advised not to become pregnant and thus use reliable forms of birth control for the first 1 1/5-2 years after surgery. Nutritional issues are already of the utmost concern for the patient, and would be putting a growing fetus at high risk during this time. Some patients may even need to wait longer depending if they have reached their goal weight or if there are nutritional problems occurring after surgery.

What are the surgery options?

How do I qualify for surgery?

Indications/qualifications (Click here to calculate your BMI)

You must be at least 18 years of age and under 62 years of age.
Your body mass index (BMI) is greater than 40 kg/m². Or you are about 100 pounds overweight for men or 80 pounds overweight for women?
Your BMI is between 35-39.9 and you have a serious obesity-related health problem, such as diabetes, high blood pressure, heart disease, sleep apnea or degenerative joint disease
Overweight for more than 5 years
You have taken serious attempts to lose weight and only had short term effect
You do not drink alcohol in excess
You do not smoke
You are not diagnosed with Prader Willi Syndrome
You have no serious disease that may have caused your obesity, such as steroid-secreting tumors
Have no serious untreated, underlying psychiatric disorders, or current issues with substance abuse, or narcotic dependency
You are willing to be monitored by a specialist who is treating you
An understanding of the operation and the lifestyle changes you will have to make
Be medically healthy enough to tolerate major surgery
You are not medically disabled nor extremely limited in activity

Why weight loss surgery?

Weight loss surgery can offer successful long-term improvement in medical conditions such as improved cholesterol, diabetes, high blood pressure, joint disease and sleep apnea. The National Institute of Health has endorsed surgical weight loss an effective method for the treatment of morbid obesity.

What are the risks of weight loss surgery?

Serious complications can occur with any surgery; fortunately complications at Crystal Spring Associates remain extremely low. Specific and proper patient preparation, selection along with Dr. Feng’s experience markedly reduces the risk and complications of weight loss surgery.

What are the benefits of weight loss surgery?

Click here to see the benefits to weight loss surgery
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Does Laparoscopic Surgery decrease the risk?

No. Laparoscopic operations carry the same risk as the procedure performed as an open operation. The benefits of laparoscopy are typically less discomfort, shorter hospital stay, earlier return to work and reduced scarring.

Will I have a lot of pain?

Every attempt is made to control pain after surgery to make it possible for you to move about quickly and become active. This helps avoid problems and speeds recovery. Often several drugs are used together to help manage your post-surgery pain. While you are still in the hospital, a Patient Controlled Analgesia (PCA), which allows you to give yourself a dose of pain medicine on demand, may be used by your physician. Various methods of pain control, depending on your type of surgical procedure, are available. Ask your surgeon about other pain management options.

How long do I have to stay in the hospital?

As long as it takes to be self-sufficient. Although it can vary, the hospital stay (including the day of surgery) can be 1-2 days for a laparoscopic band, 2-3 days for a laparoscopic gastric bypass, and 5-7 days for an open gastric bypass.

Will the doctor leave a drain in after surgery?

Most patients will have a small tube to allow drainage of any accumulated fluids from the abdomen. This is a safety measure, and it is usually removed a few days after the surgery. Generally, it produces no more than minor discomfort.

If I have surgery, what can I expect when I wake up in the recovery room?

Some doctors will provide a Patient Controlled Analgesia (PCA) or a self-administered pain management system, to help control pain. Others prefer to use an infusion pump that provides a local anesthetic in the surgical site to control pain without the side effects of narcotics. As with any major surgery, you are in danger of death from a blood clot or other surgical side effects. Statistically, the risk of death during these procedures is less than 1 percent. Your doctors will have assessed you for risks and prepared accordingly.

All abdominal operations carry the risks of bleeding, infection in the incision, thrombophlebitis of legs (blood clots), lung problems (pneumonia, pulmonary embolisms), strokes or heart attacks, anesthetic complications, and blockage or obstruction of the intestine. These risks are greater in morbidly obese patients.

How soon will I be able to walk?

Almost immediately after surgery doctors will require you to get up and move about. Patients are asked to walk or stand at the bedside on the night of surgery, take several walks the next day and thereafter. On leaving the hospital, you may be able to care for all your personal needs, but will need help with shopping, lifting and with transportation.

How soon can I drive?

For your own safety, you should not drive until you have stopped taking narcotic medications and can move quickly and alertly to stop your car, especially in an emergency. Usually this takes 7-14 days after surgery.

Will I be able to continue smoking after weight loss surgery?

No. We do not recommend smoking and will encourage you to stop smoking.

I heard that you can loose hair after weight loss surgery; is this true?

Yes. Hair loss is usually related to hormonal changes due to rapid weight loss. Of course, if there are problems with inadequate nutrition, hair loss may also be related to malnutrition that needs to be checked and corrected.

How can I prevent hair loss after my surgery?

Most patients experience some hair loss after surgery that cannot be prevented. Some patients have found success in taking "hair and nail supplements" found at most vitamin stores. These vitamin formulations contain extra B vitamins, flax seed oil, coenzyme Q and other supplements that may help. Results are not guaranteed.

What is Dumping Syndrome?

Eating sugars or other foods containing many small particles when you have an empty stomach can cause dumping syndrome in patients who have had a gastric bypass or BPD where the stomach pylorus is removed. Your body handles these small particles by diluting them with water, which reduces blood volume and causes a shock-like state. Sugar may also induce insulin shock due to the altered physiology of your intestinal tract. The result is a very unpleasant feeling: you break out in a cold clammy sweat, turn pale, feel "butterflies" in your stomach, and have a pounding pulse. Cramps and diarrhea may follow. This state can last for 30-60 minutes and can be quite uncomfortable - you may have to lie down until it goes away. This syndrome can be avoided by not eating the foods that cause it, especially on an empty stomach. A small amount of sweets, such as fruit, can sometimes be well tolerated at the end of a meal.

What are some recommended readings after weight loss surgery?

A Complete Guide to Obesity Surgery: Everything you need to know about weight loss surgery and how to succeed by Bryan G. Woodward
Weight Loss Surgery: Understanding and Overcoming Morbid Obesity by Michelle Boasten
Weight Loss Surgery: Finding the thin person hiding inside you by Barbara Thompson
Eating Well after Weight Loss Surgery by Patt Levine and Michele Bontempo-Saray

What are the differences between traditional and minimally invasive approaches for surgery?

Minimally invasive approaches for surgery has been shown in studies to have less pain, smaller scars, earlier discharge from the hospital and earlier return to routine activities and work when compared to traditional, open, larger-incision surgery for weight loss surgery patients.

Does insurance pay for weight loss surgery?

Most insurance plans cover surgery, especially the hospitalization portion but may not cover any or all the surgeon's fees. Patients should be aware that there are out-of-pocket expenses, and insurance policies may cover one type of weight loss surgery and not another type of surgery. The patient expenses can vary; patients should contact their insurance company to confirm their policy benefits for weight loss surgery.

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