Frequently
Asked Questions |
Q: How much must
I weigh to qualify for surgery?
A: To qualify for surgery patients must weigh 100
pounds more than their ideal body weight, or have a Body
Mass Index greater than 40. However, patients who weigh
less than this may be considered if they suffer from other
illnesses that are related to their weight such as diabetes,
high blood pressure, or sleep apnea.
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Q: How long
is the hospitalization and recovery?
A: The hospitalization is typically three days. The recovery
period varies but many patients have returned to work in
a few weeks after the operation. Their only restriction
is no heavy lifting for six weeks after the operation.
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Q: Can I still
take all my medications after the bypass?
A: Food passing out of your new stomach pouch must sqeeze
through a new small opening before it gets into the normal
digestive tract. This hole, or stoma, will dictate
what size medications can pass through to your digestive
system. Pills or capsules that are small enough will pass
through the stoma without a problem. But to be safe, you
may want to crush all your medications or find liquid substitutes
for them. Not all pills can be crushed (e.g., time release
) and some taste too awful to be tolerated in a crushed
form. Speak to your doctor about which of your medications
can be taken in liquid form and which can be crushed.
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Q: Will I have a
lot of excess skin and is there anything I can do about
preventing it or removing it?
A: Many people heavy enough to meet the surgical criteria
for weight loss surgery have stretched their skin beyond
the point from which it can re-tone itself. While a regular
exercise program is recommended for many reasons, tightening
the skin is not one of them. The skin is not a muscle and
does not respond to toning exercises. Unfortunately, most
patients will be left with large flaps of loose skin after
the surgery. The skin flap covering the abdominal area is
called the abdominal panniculus and it’s removal is
known as a "panniculectomy".
Some may choose to have plastic surgery to remove loose
or excess skin after they have lost their excess weight.
This surgery is not cosmetic, but rather a reconstruction
procedure
Insurance generally does not pay for this type of surgery
(often seen as elective surgery). However, some do pay for
certain types of surgery to remove excess skin when complications
arise from these excess skin folds. Ask your surgeon about
your need for a skin removal procedure.
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Q: Is there
hair loss following the bypass?
A: While not all patients lose some hair after the bypass,
many do. The reason has to do with weight loss and not surgery.
Anyone who experiences a rapid, sustained weight loss will
frequently also experience some temporary hair loss as well.
This usually occurs between the fourth and the eighth month
after surgery. Consistent intake of protein at mealtime
is the most important prevention method. Also recommended
are a daily zinc supplement and a good daily volume of fluid
intake. Almost all patients will experience natural hair
re-growth after the initial period of loss.
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Q: Will my diet
be radically altered after surgery?
A: Yes and No. After a five-week transition period,
patients will be eating essentially "regular food."
The greatest difference will be the marked change in meal
size. After eating only a few ounces of food, patients will
feel very full and therefore not mind the small meal size.
Although gastric bypass surgery patients must avoid sugars
and limit fats in their diet, they otherwise can eat a wide
range of their favorite foods and even dine out.
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Q: Can I get
pregnant after I’ve had the bypass?
A: If you are a woman of childbearing age and in otherwise
good health, you should be able to have a baby after this
surgery - but not right away. If you were to become pregnant
in the first 12 months following this surgery, it could
harm your health and that of a developing fetus. It is strongly
recommended that women wait at least one year after the
surgery before a pregnancy. Approximately one year post-operatively,
your body will be fairly stable (from a weight and nutrition
standpoint) and you should be able to carry a normally nourished
fetus. You should consult your surgeon as you plan for pregnancy.
Women who need to take precautions are all women who have
not yet gone through menopause, as well as women who have
completed menopause within the last two years. This applies
even if you have not had regular periods, or if you believe
that you are not capable of becoming pregnant.
Unfortunately, you must not take birth control pills during
the month before surgery, and for at least two months after
surgery because they increase the risk of blood clots. Please
be sure to talk with your primary care doctor or gynecologist
about a birth control method that will be best for you.
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Q. What
will my diet be like after surgery?
A: Immediately post - op you will be on sugar-fee
non-fat liquids. Within 2-3 weeks you will be advanced
to soft/pureed foods and by week five/six you will begin
on regular foods.
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Q. Why
do I have to avoid sugar and fats after gastric bypass?
A. After surgery your new
stomach cannot tolerate foods high in fat and sugar.
If you eat these foods you may experience dumping syndrome.
Dumping syndrome causes dizziness, sweating, diarrhea, nausea,
and/or cramps.
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Q. How much
will I be able to eat?
A. Remember your new stomach pouch is 1-2 oz.
Imagine the size of a baby's stomach. You will be
able to eat regular foods however you will be eating a lot
less than you did before.
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Q. How will
I get all the nutrition that I need if my portions are smaller
than before?
A. You will need to take a mulitvitamin and a calcium
supplement daily. You will also have your vitamin levels
checked periodically.
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Q: Will there be changes
in my medications as my health improves?
A: Weight loss often leads to an improved medical status
which in turn often leads to reductions in medication dosages
and even elimination of some medications altogether. Many
medications specifically designed to treat the illnesses
brought about by obesity, such as blood pressure, diabetes,
etc., can be stopped when the conditions for which they are
taken improve or resolve after weight loss surgery. For meds
that need to be continued, the vast majority can be swallowed,
absorbed and work the same as before weight loss surgery.
Usually no change in dose is required. Always check with
your doctor to determine what medication changes are needed.
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Q: What is the
success rate for gastric bypass surgery?
A: Nation-wide 75-80% of patients having surgery will lose
more than half of their excess weight. The success rate
for the Obesity Consult Center is somewhat higher - -85-90%.
Failures are usually due to patients not returning for their
follow-up. The Obesity Consult Center has a comprehensive
aftercare program to monitor long-term weight loss, and
correct any potential problems before they become serious.
This program includes formal clinic appointments and several
types of patient support group meetings.
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Q: Does the surgery
ever fail? Is there a possibility that I won’t lose
weight or that I will gain it all back?
A: Most patients will lose weight with this operation. There
is no guarantee, however, that your weight loss will be
significant or permanent. In the years following surgery,
some weight regain is common and expected. Your pouch and
stoma will stretch over time and allow you to eat more food.
This is how your weight loss eventually stops and this is
one reason weight may be regained to some degree. We here
at the Obesity Consult Center do expect, however, that if
you follow our program, you should enjoy a significant and
long-term, weight loss with all the quality of life and
health benefits that this brings.
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