Patients most frequently asked questions about weight-loss surgery

• What are the benefits?
• What are the risks?
• Will my insurance pay?
• Do I qualify for this surgery?
• How much weight can I expect to lose?
• How long do I have to stay in the hospital?
• What changes will I need to make after surgery?
• Will my hair fall out?

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What are the benefits?

The emotional and physical benefits of achieving a healthy weight are significant. People who lose at least 50 percent of their excess weight report they have more energy, endurance, and ability to enjoy physical activities, as well as significant improvement in back and joint pain. Research on the effects of major weight reduction have demonstrated a significant decrease in the risk of heart disease, and often improved blood pressure in patients with hypertension. Many people with obstructive sleep apnea or respiratory problems enjoy marked improvement. The majority of significantly overweight people who have diabetes enjoy tremendous improvement in blood sugar control following major weight reduction, and many no longer require medication. Skin problems related to obesity usually resolve. Acid reflux (indigestion) symptoms often improve or disappear.
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What are the risks?

Obesity surgery has a mortality rate of .5 percent or less. However, significant obesity itself increases the risk for many life-threatening diseases, including diabetes, heart disease, respiratory problems and liver dysfunction. Complications which may occur during surgery, or soon after, include bleeding, a leak or narrowing of the anastomosis (where the loop of bowel is attached to the stomach pouch), 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). Between 5 - 10 percent of patients experience a post-operative problem that requires medical attention.

Some patients may require up to 24 hours on the breathing machine (ventilator) following surgery, particularly those with existing respiratory problems such as sleep apnea.

Complications which may occur later include incisional hernia, narrowing or stricture of the anastomosis, small bowel obstruction, gallstone formation, anemia and diarrhea. Some complications may require additional surgeries.
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Will my insurance pay?

Many health plans will cover this surgery if the person meets all requirements. For example, you must be able to document that you have seriously tried to lose weight multiple times through conventional methods without lasting results. We encourage patients to call their provider and familiarize themselves with their respective plan. Please check with the local program regarding acceptance of Medicare.
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Do I qualify for this surgery?

Obesity is determined by measurement of body fat, not merely body weight. People might be over the weight limit for normal standards, but if they are very muscular with low body fat, they may not be obese.

You must be at least 100 pounds over your ideal weight and have a Body Mass Index (BMI) greater than 40.

People with a BMI greater than 35 may be eligible if they have two or more diseases associated with their obesity, such as diabetes, obstructive sleep apnea, heart disease or arthritis.

Use our online BMI calculator to determine your Body Mass Index.

If your score is below 35, you are not eligible for this surgical procedure. However, many Sutter Health affiliates offer other programs and services for weight management.

The age range for this surgery is generally 16 - 60 years old. However it may be appropriate for some older people in extreme situations. People with substance abuse issues are not appropriate candidates.
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How much weight can I expect to lose?

Weight loss after surgery depends on how successful you are in making significant dietary and lifestyle changes. The programs offered by Sutter Health affiliates are designed to support you in making those changes. The actual amount of weight-loss varies from person to person. However, research studies show that a person after weight-loss surgery is expected to lose anywhere from 60 - 90% of his or her excess body weight, depending on the type of surgery performed.

Successful habits include eating three small, well-balanced meals, and a maximum of two low-fat snacks each day. Avoid carbonated or sugary beverages and alcohol. Carbonated bubbles over-fill the stomach pouch. Sugar and alcohol add empty calories.

A program of regular exercise is very important for promoting and maintaining weight loss. Patients tend to gain weight if they start eating larger portions, consume high fat or "junk" foods, or drink high-calorie beverages. In about 6 percent of cases, surgery cannot produce the physical changes required to achieve the expected weight loss.
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How long do I have to stay in the hospital?

The length of your hospitalization is determined by your surgeon, and is often dependent on the type of surgery. Hospital stays can range from one to three days, depending on your recovery rate, which is different for everyone. Factors include your level of post-operative discomfort, your ability to take in adequate fluids, and your mobility.
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What changes will I need to make after surgery?

After surgery your stomach will be extremely small and only able to hold a few ounces at a time.
1. You need to be compliant with the slow dietary progression from liquids, to soft foods, and eventually to solid foods.
2. You need to learn how to eat smaller portions, slowly.
3. You must do your part in restricting high-calorie foods by avoiding sugar, fatty foods, and strictly following the guidelines set by your surgeon.
4. You need to develop an exercise program to maximize weight-loss, help prevent muscle wasting, and to avoid regaining the weight.
5. You need to take a multi-vitamin, calcium, and potentially other supplements for the rest of your life.

Failure to follow these guidelines not only puts you at risk for regaining the weight, but also for other medical complications resulting from poor nutrition.
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Will my hair fall out?

Many patients do experience some hair loss. This usually takes place between the third and eighth month after surgery. Consistent and adequate protein intake can minimize hair loss. Most patients do experience natural hair re-growth after a period of time. Please consult your surgeon regarding vitamins or supplements that may help reduce hair loss.
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