Bariatric Surgery Frequently Asked Questions

What are the benefits of bariatric surgery?

The benefits–emotional and physical – of achieving normal and healthy weight are significant:

• Increased energy levels, endurance and ability to enjoy physical activities.
• Significant decrease in the risk of heart disease, and improved blood pressure.
• Effective treatment for diabetes, with many patients no longer requiring medication.
• Marked improvement in obstructive sleep apnea or respiratory problems.
• Resolution of skin problems related to obesity.
• Improvement or disappearance of acid reflux symptoms (indigestion, heartburn).
• Significant improvement in back and joint pain.
• Improved quality of life after surgery.

What are the risks of bariatric surgery?

Weight loss surgery is considered a safe procedure, with a mortality rate of less than half of 0.1 percent nationally. This is much lower than the health risks of life-threatening diseases linked to significant obesity, including diabetes, heart disease, respiratory problems and liver dysfunction.

Possible complications of bariatric surgery include:

• During surgery — Bleeding, a leak or narrowing of the surgically reconstructed stomach or intestines, abscesses inside the abdomen, wound infection, blood clots developing in the legs (deep venous thrombosis) or a blood clot going to the lungs (pulmonary embolism).
• After surgery — Incisional hernia, narrowing or stricture of the surgically altered stomach or intestines, small bowel obstruction, gallstone formation, anemia and diarrhea.

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

Minimally invasive approaches for surgery have been shown in studies to involve less pain, smaller scars, earlier discharge from the hospital and earlier return to routine activities and work when compared to open, larger-incision surgeries. However, not all surgeries can be done minimally invasively. Your surgeon will work with you to determine which type of surgery is best for your body and your medical situation.

How much weight can I expect to lose?

Weight loss after surgery depends on the type of surgery you have, and on how successful you are in making significant changes to your diet and exercise program.

How long do I have to be off work?

The average time needed off work to recover is three to four weeks.

Can I become pregnant after weight loss surgery?

It’s generally recommended to wait for one to two years after surgery before becoming pregnant. Some patients may need to wait even longer, based on any nutritional problems that occur after surgery. When you do become pregnant, you should consider nutritional counseling to ensure optimum nutrition for yourself and the developing baby.

Who is a candidate for weight loss surgery?

In general, you must have a BMI (body mass index) over 40, or a BMI over 35 plus certain chronic medical conditions made worse by obesity.

Even if you meet those criteria, weight loss surgery is not right for everyone. You should consider the hard work, restrictions in diet, lifestyle changes and motivation it will take after surgery to create and maintain weight loss. The surgery is only an aid to help achieve lasting results by forcing a limitation in your food intake.

Your surgeon will also evaluate your unique situation, including your age, weight, medical condition(s) and ability to follow through on the changes necessary after surgery.

Will my insurance pay for bariatric surgery?

Weight loss surgery procedures are not cosmetic and are covered by most healthcare plans if certain requirements are met. Insurance coverage for program components will depend on your individual health plan. In general, some will be covered and some may require self-pay. (Learn more in Is Bariatric Surgery Covered By Insurance?)

It is a good idea to contact your insurance company prior to making a consultation appointment with a surgeon.

There are more restrictions on payment by Medicare. Medi-Cal only covers the cost of surgery in certain counties. If you have Medicare or Medi-Cal coverage, please be sure to find out what coverage is available to you.

Will I have excess skin after my surgery?

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 to help tone those areas), and genetics (you may have a greater tendency toward loose skin).

Loose skin in the face, neck, arms and legs are very likely to occur regardless of other factors. Some patients opt for cosmetic surgery to remove excess skin, but it’s important to know that most cosmetic surgeries will not be covered by your health plan, unless you can document they are necessary for recurring problems like skin infections. (Learn more about Cosmetic Surgery After Bariatric Surgery.)

What are the dietary guidelines after bariatric surgery?

Your diet after surgery will depend on the type of surgery you had performed. Immediately after surgery, you will have a liquid or soft food diet, gradually advancing to solid foods. Your post-surgery diet will be crucial to the success of your surgery, so be sure to get specific instructions from your care team, and follow those instructions consistently. It is likely you will need to take vitamin supplements for the rest of your life. (Learn more in Maintaining a Healthy Diet After Bariatric Surgery.)

Are there certain medications I should avoid after surgery?

After your surgery do not take nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen or ibuprofen.

Is exercise an important factor after bariatric surgery?

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

How soon after surgery can I drive?

For your own safety, you shouldn’t 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 seven to 14 days after surgery.

Will I lose hair after weight loss surgery?

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

What is dumping syndrome?

If you have had a gastric bypass, eating sugars or other foods containing many small particles, on an empty stomach, can cause “dumping syndrome.” 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 to 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.