Preparation for Surgery
Preparation for Surgery Q: What are the most important things to know about a
surgeon and a hospital prior to selecting one to perform my surgery?
> A: Experience, commitment, and collaboration are critical. Because of the
many health problems that obesity surgery patients have, most of the procedures
are considered 'high risk'. The surgeon's experience is, therefore, crucial.
Another determining factor should relate to the knowledge of your care team
about obesity surgery and collaboration among specialties. Obesity surgery isn't
just about losing weight. We believe that successful outcomes are best achieved
if patients are educated by a multidisciplinary team, including nursing,
dieticians and psychologists.
> Q: What are the routine tests before surgery?
> A: Certain basic tests are done prior to surgery: a Complete Blood Count,
urinalysis, and a chemistry panel, which gives results of about 20 blood
chemistry values. All patients except the very young get a chest X-ray and an
electrocardiogram.
> Many surgeons ask for a gallbladder ultrasound to look for gallstones. Other
tests, such as pulmonary function testing, echocardiogram, sleep studies, GI
evaluation, cardiology evaluation, or psychiatric evaluation, may be requested
when indicated.
> Q: What is the purpose of all these tests?
> A: An accurate assessment of your health is needed before surgery. The
best way to avoid complications is to never have them in the first place. It is
important to know if your thyroid function is adequate since hypothyroidism can
lead to sudden death post-operatively. If you are diabetic, special steps must
be taken to control your blood sugar. Because surgery increases cardiac stress,
your heart will be thoroughly evaluated. These tests will determine if you have
liver malfunction, breathing difficulties, excess fluid in the tissues,
abnormalities of the salts or minerals in body fluids, or abnormal blood fat
levels.
> Q: Why do I have to have a GI evaluation?
> A: Patients who have significant gastrointestinal symptoms such as upper
abdominal pain, heartburn, belching, sour fluid, etc., may have underlying
problems such as a hiatal hernia, gastroesophageal reflux or peptic ulcer. Up to
15 percent of reflux patients may show early changes in the lining of the
esophagus, which could predispose them to cancer of the esophagus. It is
important to identify these changes so a suitable surveillance or treatment
program can be planned. The staff at the UI Weight Management
Clinichttp://www.uihealthcare.com/depts/obesity/ will assist your surgical
evaluation in this regard.
> Q: Why do I have to have a sleep study?
> A: The sleep study detects a tendency for abnormal stopping of breathing,
usually associated with airway blockage when the muscles relax during sleep.
This condition is associated with a high mortality rate. After surgery, you will
be sedated and will receive narcotics for pain, which further depress normal
breathing and reflexes. Airway blockage becomes more dangerous at this time. It
is important to have a clear picture of what to expect and how to handle it.
> Q: Why do I have to have a psychiatric evaluation?
> A: The most common reason a psychiatric evaluation is ordered is that your
insurance company may require it. Most psychiatrists will evaluate your
understanding and knowledge of the risks and complications associated with
weight loss surgery and your ability to follow the basic recovery plan.
> Q: What impact do my medical problems have on the decision for surgery, and
how do the medical problems affect risk?
> A: Medical problems, such as serious heart or lung problems, can increase
the risk of any surgery. On the other hand, if they are problems that are
related to the patient's weight, they also increase the need for surgery. Severe
medical problems may not dissuade the surgeon from recommending gastric bypass
surgery if it is otherwise appropriate, but those conditions will make a
patient's risk higher than average.
> Q: If I want to undergo a gastric bypass, how long do I have to wait?
> A: New evaluation appointments are usually booked two to three months in
advance. Once a patient is seen, if the surgeon and patient agree it is
appropriate, the operation can usually be scheduled within six weeks.
> Q: What can I do before the appointment to speed up the process of getting
ready for surgery?
> A: You can:
>
> Select a primary care physician if you don't already have one, and
establish a relationship with him or her. Work with your physician to ensure
that your routine health maintenance testing is current. For example, women may
have a pap smear, and if over 40 years of age, a breast exam. And for men, this
may include a prostate specific antigen test (PSA).
> Make a list of all the diets you have tried (a diet history) and bring it
to your surgeon
> Bring any pertinent medical data to your appointment with the surgeon -
this would include reports of special tests (echocardiogram, sleep study, etc.)
or hospital discharge summary if you have been in the hospital
> Bring a list of your medications with dose and schedule
> Stop smoking. Surgical patients who use tobacco products are at a higher
surgical risk.
> Back to top Insurance Issues Q: Why does it take so long to get insurance
approval?
> A: After your initial consultation is completed, it usually takes your
doctor one to two days to send a letter to your insurance carrier to start the
approval process. The time it takes to get an answer can vary from about three
to four weeks or longer if you are not persistent in your follow-up. UI
Hospitals and Clinics has insurance analysts who will follow up regularly on
approval requests. It may be helpful for you to call the claims service of your
insurance company about a week after your letter is submitted and ask about the
status of your request.
> Q: How can they deny insurance payment for a life-threatening disease?
> A: Payment may be denied because there may be a specific exclusion in your
policy for obesity surgery or "treatment of obesity." Such an exclusion can
often be appealed when the surgical treatment is recommended by your surgeon or
referring physician as the best therapy to relieve life-threatening
obesity-related health conditions, which usually are covered.
> Insurance payment may also be denied for lack of "medical necessity." A
therapy is deemed to be medically necessary when it is needed to treat a serious
or life-threatening condition. In the case of morbid obesity, alternative
treatments - such as dieting, exercise, behavior modification, and some
medications - are considered to be available. Medical necessity denials usually
hinge on the insurance company's request for some form of documentation, such as
one to five years of physician-supervised dieting or a psychiatric evaluation,
illustrating that you have tried unsuccessfully to lose weight by other methods.
> Q: What can I do to help the process?
> A: Gather all the information (diet records, medical records, medical
tests) your insurance company may require. This reduces the likelihood of a
denial for failure to provide "necessary" information. Letters from your
personal physician and consultants attesting to the "medical necessity" of
treatment are particularly valuable. When several physicians report the same
findings, it may confirm a medical necessity for surgery.
> When the letter is submitted, call your carrier regularly to ask about the
status of your request. Your employer or human relations/personnel office may
also be able to help you work through unreasonable delays.
> Back to top
> Surgery: Q: How safe is this surgery?
> A: No surgery is without risk and obesity surgery has particular risks.
During the consultation visit, these risks will be discussed in detail so that
an informed decision can be made. 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.
> Q: Does laparoscopic surgery decrease the risk?
> A: 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.
> Q: Will I have a lot of pain?
> A: 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. Various methods of pain control, depending on your type of
surgical procedure, are available. Ask your surgeon about the pain management
options.
> Q: How long do I have to stay in the hospital?
> A: As long as it takes to be self-sufficient. Although it can vary, the
hospital stay (including the day of surgery) can be three days for a
laparoscopic gastric bypass, and five to seven days for an open gastric bypass.
> Q: Will the doctor leave a drain in after surgery?
> A: 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 week after the surgery. Generally, it produces no more than minor
discomfort.
> Q: If I have surgery, what can I expect when I wake up in the recovery room?
> A: Pain will be addressed at your doctors direction. 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
one percent. Your doctors will have assessed you for risks and prepared
accordingly.
> Q: How soon will I be able to walk?
> A: 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. We generally do not
encourage sitting in the chair for the entire duration of your hospital stay for
fear of developing blood clots in your legs. 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.
> Q: How soon can I drive?
> A: 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 seven to 14 days after surgery.
> Back to top
> The Hospital Stay: Q: Is blood transfusion required?
> A: Infrequently - If needed, it is usually given after surgery to promote
healing.
> Q: What is thrombophlebitis and is it preventable?
> A: Thrombophlebitis, also called deep venous thrombosis (DVT) is undesired
blood clotting in veins, especially of the calf and pelvis due to prolonged
ambulation. It can cause a condition called pulmonary embolism (PE) if pieces of
clot break off from the calf and get impacted in the lung. It is not completely
preventable, but preventive measures will be taken, including:
>
> Early ambulation
> Special stockings
> Blood thinners
> Pulsatile boots
> Q: What is done to minimize the risk of deep vein thrombosis/pulmonary
embolism or DVT/PE?
> A: Because a DVT originates on the operating table, therapy begins before
a patient goes to the operating room. Generally, patients are treated with
sequential leg compression stockings and given a blood thinner prior to surgery.
Both of these therapies continue throughout your hospitalization. The third
major preventive measure involves getting the patient moving and out of bed as
soon as possible after the operation to restore normal blood flow in the legs.
> Q: What should I bring with me to the hospital?
> A: Basic toiletries (comb, toothbrush, etc.) and clothing may be provided
by the hospital, but most people prefer to bring their own. Choose clothes for
your stay that are easy to put on and take off. Because of your incision, your
clothes may become stained by blood or other body fluids. Other ideas:
>
> reading and writing materials
> crossword and other puzzles
> personal toiletries
> bathrobe
> Back to top
> Life after surgery: Q: What do I need to do to be successful after surgery?
> A: The basic rules are simple and easy to follow:
>
> Immediately after surgery, your doctor will provide you with special
dietary guidelines. You will need to follow these guidelines closely. Many
surgeons begin patients with liquid diets, moving to semi-solid foods and later,
sometimes weeks or months later, solid foods can be tolerated without risk to
the surgical procedure performed. Allowing time for proper healing of your new
stomach pouch is necessary and important.
> When able to eat solids, eat two to three meals per day, no more. Protein
in the form of lean meats (chicken, turkey, fish) and other low-fat sources
should be eaten first. These should comprise at least half the volume of the
meal eaten. Foods should be cooked without fat and seasoned to taste. Avoid
sauces, gravies, butter, margarine, mayonnaise and junk foods.
> Never eat between meals. Do not drink flavored or carbonated beverages,
even diet soda, between meals.
> Drink two to three quarts or more of water each day. Water must be consumed
slowly, one to two mouthfuls at a time, due to the restrictive effect of the
operation.
> Exercise aerobically every day for at least 30 minutes (one-mile brisk
walk, bike riding, stair climbing, etc.). Weight/resistance exercise can be
added three to four days per week, as instructed by your doctor.
> Q: What's so important about exercise?
> A: When you have a weight loss surgery procedure, you lose weight because
the amount of food energy (calories) you are able to eat is much less than your
body needs to operate. It has to make up the difference by burning reserves or
unused tissues. Your body will tend to burn any unused muscle before it begins
to burn the fat it has saved up. If you do not exercise daily, your body will
consume your unused muscle, and you will lose muscle mass and strength. Daily
aerobic exercise for 30 minutes will communicate to your body that you want to
use your muscles and force it to burn the fat instead.
> Q: What is the right amount of exercise after weight loss surgery?
> A: Many patients are hesitant about exercising after surgery, but exercise
is an essential component of success after surgery. Exercise actually begins on
the afternoon of surgery - the patient must be out of bed and walking. The goal
is to walk further on the next day, and progressively further every day after
that, including the first few weeks at home. Patients are often released from
medical restrictions and encouraged to begin exercising about two weeks after
surgery, limited only by the level of wound discomfort. The type of exercise is
dictated by the patient's overall condition. Some patients who have severe knee
problems can't walk well, but may be able to swim or bicycle. Many patients
begin with low stress forms of exercise and are encouraged to progress to more
vigorous activity when they are able.
> Q: What if I have had a previous weight loss surgical procedure and I'm now
having problems?
> A: Contact your original surgeon - he or she is most familiar with your
medical history and can make recommendations based on knowledge of your surgical
procedure and body.
> Q: What happens to the lower part of the stomach that is bypassed?
> A: In some surgical procedures, the stomach is left in place with intact
blood supply. In some cases it may shrink a bit and its lining (the mucosa) may
atrophy, but for the most part it remains unchanged. The lower stomach still
contributes to the function of the intestines even though it does not receive or
process food - it makes intrinsic factor, necessary to absorb Vitamin B12 and
contributes to hormone balance and motility of the intestines in ways that are
not entirely known. In the BPD procedures, some portion of the stomach is
completely removed.
> Q: How big will my stomach pouch really be in the long run?
> A: This can vary by surgical procedure and surgeon. In the Roux-en-Y
gastric bypass, the stomach pouch is created at one ounce or less in size
(15-20cc). In the first few months it is rather stiff due to natural surgical
inflammation. About six to 12 months after surgery, the stomach pouch can expand
and will become more expandable as swelling subsides. Many patients end up with
a meal capacity of three to seven ounces.
> Q: What will the staples do inside my abdomen? Is it okay in the future to
have an MRI test? Will I set off metal detectors in airports?
> A: The staples used on the stomach and the intestines are very tiny in
comparison to the staples you use in the office. Each staple is a tiny piece of
stainless steel or titanium so small it is hard to see other than as a tiny
bright spot. Because the metals used (titanium or stainless steel) are inert in
the body, most people are not allergic to staples and they usually do not cause
any problems in the long run. The staple materials are also non-magnetic, which
means that they will not be affected by MRI. The staples will not set off
airport metal detectors.
> Q: What if I'm not hungry after surgery?
> A: It's normal not to have an appetite for the first month or two after
weight loss surgery. If you are able to consume liquids reasonably well, there
is a level of confidence that your appetite will increase with time.
> Q: Is there any difficulty in taking medications?
> A: Most pills or capsules are small enough to pass through the new stomach
pouch. Initially, your doctor may suggest that medications be taken in liquid
form or crushed.
> Q: Will I be able to take oral contraception after surgery?
> A: Most patients have no difficulty in swallowing these pills.
> Q: Is sexual activity restricted?
> A: Patients can return to normal sexual intimacy when wound healing and
discomfort permit. Many patients experience a drop in desire for about six
weeks.
> Q: Can I get pregnant after weight loss surgery?
> A: It is strongly recommended that women wait at least two years after the
surgery before a pregnancy. Approximately 18 months to two years
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.
> Q: Is there a difference in the outcome of surgery between men and women?
> A: Both men and women generally respond well to this surgery. In general,
men lose weight slightly faster than women do.
> Q: Will I be asked to stop smoking?
> A: Patients are encouraged to stop smoking at least one month before
surgery.
> Q: If I continue to smoke, what happens?
> A: Smoking increases the risk of lung problems after surgery, can reduce the
rate of healing, increases the rates of infection, and interferes with blood
supply to the healing tissues. We might even consider canceling your surgery if
you do not show compliance.
> Q: How can I know that I won't just keep losing weight until I waste away to
nothing?
> A: Patients may begin to wonder about this early after the surgery when
they are losing 20 to 40 pounds per month, or maybe when they've lost more than
100 pounds and they're still losing weight. Two things happen to allow weight to
stabilize. First, a patient's ongoing metabolic needs (calories burned) decrease
as the body sheds excess pounds. Second, there is a natural progressive increase
in calorie and nutrient intake over the months following weight loss surgery.
The stomach pouch and attached small intestine learn to work together better,
and there is some expansion in pouch size over a period of months. The bottom
line is that, in the absence of a surgical complication, patients are very
unlikely to lose weight to the point of malnutrition.
> Q: What can I do to prevent lots of excess hanging skin?
> 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 "snap
back." Some patients will choose to have plastic surgery to remove loose or
excess skin after they have lost their excess weight. 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.
> Q: Will exercise help with excess hanging skin?
> A: Exercise is good in so many other ways that a regular exercise program
is recommended. Unfortunately, most patients may still be left with large flaps
of loose skin.
> Q: Will I be miserably hungry after weight loss surgery since I'm not eating
much?
> A: Most patients say no. In fact, for the first four to six weeks patients
have almost no appetite. Over the next several months the appetite returns, but
it tends not to be a ravenous "eat everything in the cupboard" type of hunger.
> Q: What if I am really hungry?
> A: This is usually caused by the types of food you may be consuming,
especially starches (rice, pasta, potatoes). Be absolutely sure not to drink
liquid with food since liquid washes food out of the pouch.
> Q: Will I have to change my medications?
> A: Your doctor will determine whether medications for 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. Two classes
of medications that should be used only in consultation with your surgeon are
diuretics (fluid pills) and NSAIDs (most over-the-counter pain medicines).
NSAIDs (ibuprofen, naproxen, etc.) may create ulcers in the small pouch or the
attached bowel. Most diuretic medicines make the kidneys lose potassium. With
the dramatically reduced intake experienced by most weight loss surgery
patients, they are not able to take in enough potassium from food to compensate.
When potassium levels get too low, it can lead to fatal heart problems.
> Q: What is a hernia and what is the probability of an abdominal hernia after
surgery?
> A: A hernia is a weakness in the muscle wall through which an organ
(usually small bowel) can advance. Approximately 20 percent of patients develop
a hernia. Most of these patients require a repair of the herniated tissue. The
use of a reinforcing mesh to support the repair is common.
> Q: Will I lose hair after surgery? How can I prevent it?
> A: Many patients experience some hair loss or thinning after surgery. 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.
> Q: Does hair growth recover?
> A: Most patients experience natural hair regrowth after the initial period
of loss.
> Q: What are adhesions and do they form after this surgery?
> A: Adhesions are scar tissues formed inside the abdomen after surgery or
injury. Adhesions can form with any surgery in the abdomen. For most patients,
these are not extensive enough to cause problems.
> Q: What is the "Candida Syndrome?"
> A: Some patients have a type of yeast present on the surface of their
skin, intestine or vagina at the time of surgery. This leads to overgrowth in
certain cir****tances. A whitish coating may occur on the tongue or throat. This
syndrome is associated with a frothy mucous, nausea, difficulty swallowing, sore
throat, loss of taste and appetite, and occasionally abdominal bloating and
diarrhea.
> Q: What causes it to appear?
> A: It is promoted by the use of most antibiotics and some other
medications, by stress, by reduced immune response, and by diabetes.
> Q: Can it be cured?
> A: There are several effective medications now available for treating the
overgrowth of Candida.
> Q: What is sleep apnea (SA)?
> A: It is the interruption of the normal sleep pattern associated with
repeated delays in breathing. Sleep apnea often shows rapid improvement after
surgery. In most patients, there is a complete resolution of symptoms by six
months following surgery.
> Back to top
> Diet Q: How can I improve my chances of losing (and keeping) the weight
off?
> A: Adopting a healthy lifestyle, such as exercising, eating well-balanced
meals, avoiding sugar and fatty foods, and following our other recommendations
will improve your chances of losing and maintaining weight. Our
multidisciplinary program, which has evolved over the past 40 years, includes
thorough education in order to teach you how to succeed. In addition to a 2 1/2
hour educational class, each patient receives a reference book, written by our
experts, about gastric bypass surgery.
> Q: How long will I be off of solid foods after surgery?
> A: Most surgeons recommend a period of four weeks or more without solid
foods after surgery. A liquid diet, followed by semi-solid foods or pureed
foods, may be recommended for a period of time until adequate healing has
occurred. Your surgeon will provide you with specific dietary guidelines for the
best post-surgical outcome.
> Q: What are the best choices of protein?
> A: Eggs, low-fat cheese, low-fat cottage cheese, tofu, fish, other
seafood, chicken (dark meat), turkey (dark meat).
> Q: Why drink so much water?
> A: When you are losing weight, there are many waste products to eliminate,
mostly in the urine. Some of these substances tend to form crystals, which can
cause kidney stones. A high water intake protects you and helps your body to rid
itself of waste products efficiently, promoting better weight loss. Water also
fills your stomach and helps to prolong and intensify your sense of satisfaction
with food. If you feel a desire to eat between meals, it may be because you did
not drink enough water in the hour before.
> Q: What is Dumping Syndrome?
> A: 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.
> Q: Is there a problem with consuming milk products?
> A: Milk contains lactose (milk sugar), which is not well digested. This
sugar passes through undigested until bacteria in the lower bowel act on it,
producing irritating byproducts as well as gas. Depending on individual
tolerance, some persons find even the smallest amount of milk can cause cramps,
gas and diarrhea.
> Q: Why can't I snack between meals?
> A: Snacking, nibbling or grazing on foods, usually high-calorie and
high-fat foods, can add hundreds of calories a day to your intake, defeating the
restrictive effect of your operation. Snacking will slow down your weight loss
and can lead to regain of weight.
> Q: Why can't I eat red meat after surgery?
> A: You can, but you will need to be very careful, and we recommend that
you avoid it for the first several months. Red meats contain a high level of
meat fibers (gristle) which hold the piece of meat together, preventing you from
separating it into small parts when you chew. The gristle can plug the outlet of
your stomach pouch and prevent anything from passing through, a condition that
is very uncomfortable.
> Q: How can I be sure I am eating enough protein?
> A: 50 to 65 grams a day are generally sufficient. Check with your surgeon
to determine the right amount for your type of surgery.
> Q: Is there any restriction of salt intake?
> A: No, your salt intake will be unchanged unless otherwise instructed by
your primary care physician.
> Q: Will I be able to eat "spicy" foods or seasoned foods?
> A: Most patients are able to enjoy spices after the initial six months
following surgery.
> Q: Will I be allowed to drink alcohol?
> A: You will find that even small amounts of alcohol will affect you
quickly. It is suggested that you drink no alcohol for the first year.
Thereafter, with your physician's approval, you may have a glass of wine or a
small ########.
> Q: Will I need supplemental vitamins?
> A: Yes, Vitamin supplementation will need to be taken for the rest of your
life.
> Q: What vitamins will I need to take after surgery?
> A: Our surgeons recommend: Daily chewable multivitamin, B12 (under the
tongue for better absorption), B complex, ferrous sulfate (iron tablet) and
chewable calcium tablets.
> Q: Is it important to take trace elements or female hormone replacements?
> A: Some patients require these supplements, but your need for these can be
determined by your surgeon.
> Q: Do I meet with a nutritionist before and after surgery?
> A: Our surgeons require patients to consult with a nutritionist before
surgery. Counseling after surgery is available on an individual basis as needed
or required by your physician.
> Q: Will I get a copy of suggested eating patterns and food choices after
surgery?
> A: Yes. Surgeons provide patients with materials that clearly outline
their expectations regarding diet and compliance to guidelines for the best
outcome based on your surgical procedure. After surgery, health and weight loss
are highly dependent on patient compliance with these guidelines. You must do
your part by restricting high-calorie foods, by avoiding sugar, snacks and fats,
and by strictly following the guidelines set by your surgeon.
> Back to top
> General: Q: What is the youngest age for which weight loss surgery is
recommended?
> A: Although generally accepted guidelines from the American Society for
Bariatric Surgery and the National Institutes of Health indicate surgery only
for those 18 years of age and older, we currently offer surgery to those at
least 20 years of age. There is a real concern that young patients may not have
reached full developmental or emotional maturity to make this type of decision.
It is important that young weight loss surgery patients have a full
understanding of the lifelong commitment to the altered eating and lifestyle
changes necessary for success.
> Q: What is the oldest patient for whom weight loss surgery is recommended?
> A: Patients over 60 require very strong indications for surgery and must
also meet stringent Medicare criteria. The risk of surgery in this age group is
increased, and the benefits, in terms of reduced risk of mortality, are reduced.
> Q: Can Weight Loss Surgery prolong my life?
> A: There is good evidence from scientific research that if you have type 2
diabetes (or other serious obesity-related health conditions), are at least 100
pounds. over ideal body weight, and are able to comply with lifestyle changes
(daily exercise and low-fat diet), then weight loss surgery may significantly
prolong your life.
> Q: Can weight loss surgery help other physical conditions?
> A: According to current research, weight loss surgery can improve or
resolve associated health conditions.
> Condition
> Percentage found in preoperative individuals
> Percentage cured two years after surgery
> Diabetes or insulin resistance
> 34 percent
> 85 percent
> High blood pressure
> 26 percent
> 66 percent
> High triglycerides
> 40 percent
> 85 percent
> Sleep apnea
> 22 percent in males, one percent in females
> 40 percent