10 Important Questions to Ask about Weight Loss Surgery

Obesity is at epidemic proportions in the United States. More than 50 percent of the adult population is overweight and over five percent of the population is severely overweight. Nearly 300,000 Americans die prematurely each year as a result of obesity-related complications, also known as co-morbidities, such as diabetes, high blood pressure, sleep apnea.

For the majority of those that have clinically severe obesity --100 pounds over their ideal body weight for their height--medical therapies such as dieting, behavior modification or drugs have not had a long-term effect. Weight loss surgery has been endorsed by the National Institutes of Health as the only effective means of inducing significant long-term weight loss for the vast majority of patients with clinically severe obesity.

Before you decide to have weight loss surgery, you should consider the following questions.

1. Do I really need surgery for weight loss success?

Weight loss surgery isn't something to be considered lightly or for those with just a few pounds to lose. Before you turn to surgery, it's important that you have exhausted all medical approaches to weight loss through diet and exercise. Weight loss surgery is only a tool to help you lose weight, but it will not do it all. You will need to dramatically change your diet and eating habits. Weight loss surgery involves permanent changes to your stomach and your digestive process. There are risks to surgery and it should only be considered by those whose weight is high enough that the health risks of continued obesity outweigh the risk of surgery. However, it has been proven that weight loss surgery is an effective way for patients with severe obesity to achieve significant long-term weight loss. Studies have shown that only three to five percent of people with clinically severe obesity have lasting success with non-surgical methods.

2. Do I qualify for weight loss surgery?

To qualify for weight loss surgery, you must meet the following criteria:

  • 100 pounds overweight and have a body mass index (BMI) of 40 or higher, or BMI between 35-40 if you have significant obesity-related health problems, such as diabetes, sleep apnea or high blood pressure.
  • You have been obese for at least five years.
  • You have tried multiple medical weight loss attempts in the past five years.

To see the full list of requirements for eligibility, please click here.

3. Do I understand the life-changing effects I will face after surgery?

Gastric bypass and sleeve gastrectomy will permanently change the size of your stomach and cannot be reversed. In addition, gastric bypass will permanently change your digestive process, preventing the full absorption of nutrients, vitamins and minerals. You will need to take vitamin and calcium supplements for life. Though the lap-band can be removed, it should be treated as a permanent change. Your diet after any of the surgical procedures will be radically different. Your new stomach will only hold one to three ounces, and you will only be able to eat as much as a small child. There will be food that you will not be able to tolerate, and you will have to have to eat very slowly and chew your food completely. You will need to avoid carbonated, caffeinated and alcoholic beverages as they will irritate your new stomach, and your diet will focus on protein and vegetables. You will need to incorporate exercise into your life to achieve your desired weight loss.

4. Have I considered the risks and benefits of each of the surgical procedures?

Weight loss procedures, like any surgery, come with some risks and every case is different. While there are risks associated with surgery, NSMC values patient safety above all else. Our surgical weight management program has had an extremely low complication rate and we have been recognized as a Level 1A Bariatric Surgery Center, the highest level of accreditation awarded by the American College of Surgeon's Bariatric Surgery Center Network, for the safety and quality of our program.

Some potential post-surgery complications include gallstones, bowel obstruction, stomach ulcer, and iron deficiency anemia. Each weight loss procedure has its own risks and benefits. Click here to see an overview of each.

5. Am I willing to incorporate exercise into my lifestyle?

To achieve maximum weight loss, skin and muscle tone, you will need to incorporate exercise into your new routine. Exercising will improve your cardiovascular fitness and build muscle mass, which will help you burn more calories. After surgery, your body will be under stress trying to adjust to the limited calories you can consume. If muscle is not regularly used for exercise every day, it will be consumed to meet your energy needs.

You will be required to participate in NSMC’s post-surgery 12-week cardiac risk reduction program, which includes medically supervised exercise. We can help you with strategies for motivation and suggestions for trying a variety of exercise. As you lose weight, exercise will become easier and you may even discover that you enjoy it.

6. Am I prepared to change my diet and eating habits for life?

After surgery, you will be able to eat very little food before your stomach will be full. Therefore, you must make every calorie count. You will need to see food as fuel for your body, and will need to concentrate on protein, fiber and vegetables. There will be foods that you will need to stay away from, like high fat or high sugar foods, and some that you will no longer be able to eat because they make you sick or that get “stuck” and can’t get past the lap-band. Many patients find that their cravings for certain foods change over time.

7. Am I willing to postpone pregnancy for at least two years after surgery?

Because your body will be going through rapid weight loss and changes, it is critical that you postpone pregnancy for at least two years after surgery so that you can obtain the proper nutrition to support a growing fetus. For lap-band patients, your surgeon can reduce the amount of fluid in the band to increase the size of your stomach opening to allow for more nutrition during pregnancy.

8. Will my insurance company cover weight loss surgery?

Weight loss surgery is still seen as elective surgery by some insurance companies. Each insurance policy is different and you should check with your company to see if it has elected to provide coverage for bariatric surgery before you schedule an appointment with a surgeon. If you do have coverage, our staff will help you provide the proper documentation to receive approval for surgery.

9. Am I prepared for the emotional changes that could occur after surgery?

The period after weight loss surgery is a time of radical change for you and your body. You will be adjusting to your new diet, exercising, and learning what works and what doesn’t. You may experience euphoria, excitement, joy, frustration, sadness, anxiety, anger, disappointment, and even a sense of loss about what used to be a major part of your life. You will need to find a new outlet for stress and a way to find comfort in something other than in food. You may find it difficult to be in social situations that revolve around eating. You may experience changes in relationships with family and friends. Weight loss surgery is not a fix for your everyday problems with your spouse, friends, family, employment or social life. This surgery will allow you to begin to gain control over one aspect in your life: your weight.

All of these emotions are all natural parts of change and NSMC's support team can help you through. We have monthly support groups where patients can draw strength from their peers and we can also provide personal counseling with a professional experienced in working with patients who have had weight loss surgery.

10. Am I willing to commit to NSMC’s post-surgery program and life-long follow up with my surgeon and support team?

Weight loss surgery is a lifetime commitment to eating and living a healthy life. As part of this commitment, you will be required to attend NSMC’s 12-week post surgery cardiac risk reduction program. For three hours every week you will learn about cardiac risk factors, exercise, nutrition, and lifestyle and stress management strategies. This is a learning lab to give you the tools to change your behaviors and give you strategies for lifetime success. For the first year, you will have several follow-up appointments with your surgeon and with our support team. After that, you will need to meet yearly with your surgeon. Our team is available any time, if you have questions or concerns, or just need help getting back on track.

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