weight loss : effective, Safe

1. OBESITY SURGERY
PUBLISHED BY YOUR NAME
OBESITY SURGERY

2. INTRODUCTION…..4
HISTORY OF WEIGHT LOSS SURGERY….5
CAUSES OF OBESITY…7
CANDIDATES OF OBESITY SURGERY…12
WHAT TO EXPECT FROM WEIGHT LOSS SURGERY…21
TYPES OF WEIGHT LOSS SURGERY…27
FINDING A GOOD WEIGHT LOSS SURGEON..37
RECOVERING FROM WEIGHT LOSS SURGEY...46
CONCLUSION……50

3. INTRODUCTION
For many people, being overweight is a part of life. They have struggled
with weight loss and the problems associated with being overweight for
much of their lives. It is hard to lose weight and some people just give up
altogether.
While eating healthy foods and exercise is beneficial for everyone, some
people find that this is just not enough to shed the excess weight. They
may have tried fad diets, pills and other forms of dieting only to find that
they may lose weight for a short amount of time, but it comes back. This is
frustrating and can take a hit on a person’s self esteem and confidence.
For these reasons, many people are turning to obesity surgery to help them
lose the unwanted pounds. There are several types of surgery that aids
weight loss and surgery may not be the right choice for everyone.
Life Changing Surgery
Weight loss surgery, also known as obesity surgery or bariatric surgery
comes in many forms. If you think that you are at a loss at how to lose
excess pounds, you may consider this option. You should know, however,
that this type of surgery is not right for everyone and it is a life-changing
surgery that will affect your life from day one.
Making the Commitment
Morbid obesity surgery will require that you make a life time commitment.
You must have realistic expectations and you must be willing to make
changes to your diet and exercise. Since these surgeries are radical, many
bariatric surgeons will recommend that you also make a commitment to get
counseling and see a dietician at regular intervals. This will ensure that
your surgery is a success.
If you are interested in learning more about weight loss surgery, read on
and learn how bariatric surgery has changed over the years and how you
can lose the excess weight.

4. HISTORY OF WEIGHT LOSS SURGERY
Bariatric obesity surgery has certainly changed along with technology over
the years. It used to be that weight loss surgery often did work correctly or
was a major risk to take. In fact, it is not uncommon to hear about people
that died after having this surgery years ago.
That has now changed thanks to today’s technology in the medical field.
While laparoscopic obesity surgery and other forms of weight loss surgery
are life changing and do take a commitment, it is not as nearly as
dangerous as it once was. Today people are finding more positive results
after surgery and it is becoming a popular choice for those who cannot lose
weight with diet and exercise.
The First Surgery:
The first weight loss surgery was developed and used on a patient in 1954.
At that time, technology was not as advanced as it is today and the surgery
was called “intestinal bypass” because it involved working with the
intestines rather than the stomach.
This early surgery linked the upper and lower regions of the small intestines
to the middle section. This is where much of the food absorption takes
place and by decreasing the intestines, it then decreased the amount of
food that the body processed. This enabled the body to absorb fewer
calories and weight loss was the result. Many patients at the time, tried
these surgeries, but found that the side effects and complications were
hard to live with.
Complications:
Over the years that followed this surgery, many variations of the surgery
were tried on patients with some degree of success. Mostly, however,
patients had many complications that were difficult to overcome including
electrolyte imbalance, severe diarrhea and dehydration. It was then
realized that these early weight loss surgeries were causing more problems
and intestinal bypasses were abandoned in favor of surgeries dealing with
the stomach, which had fewer complications over a longer period of time
and better results.
Gastric bypass surgery:

5. Around the mid sixties, another surgeon started looking at other ways to
create a successful weight loss surgery. His answer was to use surgical
staples to “staple” off a part of the stomach, which was called “vertical
banded gastroplasty”. This created less room in the stomach area for food.
The patient with a stapled stomach would have less room for food and
would feel full faster, resulting in taking in fewer calories. The end result of
stomach stapling was weight loss.
This was initially a successful surgery because weight loss was achieved.
There were complications, but the surgeons performing these surgeries
worked to refine the procedure so there were fewer complications. A few
years later, elastic bands were developed and eventually replaced the
surgical staples. One widespread problem with this surgery, it was found
that the bands would stretch out of place and patients would gain the
weight back after a few years. In addition, this obesity surgery cost was
expensive and many people could not afford to have it done.
Roux-en-Y bypass:
With more advances in technology, the surgery known as the Roux-en-Y
gastric bypass was developed. This method involved the early principles of
restricting food intake through the stomach and what is known as the
dumping syndrome.
With this surgery, the doctor creates a pouch using staples. It is then
attached to the small intestines. The pouch is very small—about the size of
the thumb. This causes a drastic decrease in the amount of food that can
be taken in while eating. Thus, fewer calories means that weight loss can
be achieved. This is still a popular weigh loss surgery because there are
fewer complications and because it works.
Other weight loss surgeries:
As technology advances, so do surgeries for weight loss. From the
Manhattan obesity surgery center to the Miami obesity surgery center,
there are now eight different weight loss surgeries performed in obesity
surgery centers across the United States.
CAUSES OF OBESITY

6. No one wants to be overweight. Carrying excess weight can cause many
problems including heart conditions, diabetes, gallbladder disease, stroke
and can even increase your risk for death.
However, the fact remains that obesity is a problem across the United
States. It is estimated that being overweight affects about 35 percent of all
adults ages 20 and over just in the United States alone. That means that
about 72 million people are overweight. These statistics are fairly equal
among men and women and cross all racial boundaries.
Facts about obesity:
In fact, you might be interested to know that the number of overweight
people in the United States is on the rise and has been on the rise since
the sixties. There are many reasons for this which includes eating habits,
living a sedentary lifestyle, age and even economic factors. More people
are living “fast” lifestyles—eating at fast food places several times a week
and spending a large portion of their time sitting in front of the television,
computer and video games. If you live a life like this, it is probably no
surprise to you that you might be heavier that you like.
Heredity:
In addition to living a sedentary lifestyle and not eating right, being
overweight may not be all your fault. In some cases, your weight could be
directly related to your relatives. Heredity may play a big role in your
weight, especially if you find that you have always been heavy, or those in
your family carry the same type of weight.
Obesity does have a strong genetic component. You may find that your
grandmother, mother and even your aunts have the same type of body
shape as you. This means that you have inherited your weight problem
passed down from generations. This type of weight is harder to lose and
you may find that more dieting and exercise will not do much in helping you
shed the unwanted pounds. In this case, weight loss surgery may be a
good option for you.
Dangers of being overweight:

7. No one has to tell you that carrying excess weight is not good for you. It
can cause you to suffer from a lot of problems—some more serious that
others. Those who are overweight often complain or suffer from one or
more of the following:
 High blood pressure
 Diabetes
 Heart disease
 Stroke
 Gall bladder disease
 Cancer-including breast cancer, colon cancer and
prostate cancer
 Cataracts
 Macular degeneration
 Asthma
 Problems with pregnancy
 Infertility

8.  Parkinson’s
 Neurological disorders
 Muscle aches and pains
 Joint swelling
 Arthritis
 Back pain
 Depression
 Blood disorders (high cholesterol, high lipids)
 Shortness of breath
 Sleep apnea
 Liver disease
 Skin ailments
In addition to these ailments, you will find that when people are obese, they
also suffer from a poor quality of life. Those who are morbidly obese find
that it affects their day-to-day living. They may have a harder time
performing tasks that other people do every day, such as bathing, dressing

9. and walking short distances. This can cause problems with relationships
and self esteem and can lead to:
 Severe depression
 Disability
 Discomfort and pain
 Shame
 Decreased self confidence and self esteem
 Sexual problems
 Isolation
It is very important that those who are obese get the help they need,
whether it is to lose weight or counseling. Weight loss surgery can often
help these people who feel like they are beyond help with losing weight.
Causes of weight gain:
Before you turn to an obesity surgery center to help you lose the weight, it
is important that you understand what cause weight gain. There are many
reasons why people are obese and some are easier to “fix” than others. In
addition, when you understand the reasons of obesity, you can better
pinpoint why you are overweight. This will help you find a solution to losing
weight that will be successful for your unique situation.
Understanding causes of obesity:

10. If you feel that lap band obesity surgery (or any other type of weight loss
surgery) is right for you, your doctor will talk to you about why you want to
lose weight. He or she will also help you find the root of your weight gain.
This will help the doctor determine whether or not this life-changing surgery
is right for you.
 Genetics:
Genetics is a major cause of obesity for many
people. In fact, it is known that the brain can induce
you to want to eat when you are really not hungry at
all. While it is often difficult to determine obesity
through your heredity, it is believed that it can be
passed down. When you look at your family tree
and see others that are overweight, it could be an
indication that your problems with your weight is
passed down from previous generations.
 Lifestyle:
As mentioned before, your lifestyle plays a major
role in your weight. If you have a poor diet and do
not get out to exercise on a regular basis, you could
be suffering from weight gain. This type of weight
gain is easier to treat than other causes. Lifestyle
changes can help you get back to a weight that is
more acceptable to you. This can include
incorporating healthy foods into your diet, cutting
back on foods high in fat and sugar and working
yourself into a regular exercise routine.
 Illness:
There are many diseases and illness (and even
medications) that can cause weight gain. Diabetes
will not cause weight gain, but it can lead to weight
gain and obesity surgery could be a cure for

11. diabetes. Diseases and other health issues that can
cause weight gain include hypothyroidism,
depression, and Cushing Syndrome. Steroids and
antidepressants can also cause weight gain that is
hard to control.
 Psychology:
There are several types of mental illnesses and
emotional problems that can cause weight gain.
Depression is one of them. If a person feels
depressed, he or she may resort to eating too much
or may withdrawal from daily activities, causing a
sedentary lifestyle.
In addition, anger, boredom, feeling lonely or
depressed can often lead to emotional eating.
People also will eat if they are feeling threatened or
confronted by a situation in which they have no
control. If a person fills unfulfilled in any way, they
could find that they eat to feel better about a
situation. Feeling deprived or having bad
experiences as a child can also lead to eating.
Another reason why people eat is because they
want control. They have control on what they eat
and no one can tell them no.
If psychological reasons are to blame for weight
gain, many times, treating these symptoms will lead
to weight loss.
If you can find the reason for your over eating, you
will find that your weight gain is easier to control and
treat whether it is through surgery or other means.

12. CANDIDATES OF OBESITY SURGERY
You know that you need to lose weight and you think that surgery for weight
loss might be the answer for you. However, before you decide to have this
life-changing surgery, you need to determine whether or not you are a
candidate for the surgery.
Not everyone who is overweight should get the surgery to help them lose
weight. In fact, even though you are overweight, you may not even qualify.
Only a qualified weight loss surgeon can tell you whether or not you are a
right fit for any weight loss surgery. There are many centers for
laparoscopic obesity surgery in the United States so if you think you want
the surgery; the first step is calling one to find out if you could have the
surgery.
Seeking help:
If you are overweight, you may want to seek help through gastric bypass
surgery. You should know that not everyone will qualify for the surgery.
Before any doctor will operate on you, he or she will walk you through a
series of tests and interviews to see if you are right for the surgery. You will
find that you will not be considered for the surgery unless you have made
valid attempts to lose weight through diet, exercise and other methods. If
you have, and you still have not found success, then you might qualify.
Body Mass Index:
After the doctor has talked to you and determined that you have, in fact,
have made several attempts at losing weight through diet and exercise, he
or she will then take a look at other factors. The first factor is your actual
weight. If you want to lose twenty pounds, then this is not enough to qualify
for surgery. You must have a body mass index that is more than or equal to
35.
If you are not sure about your body mass index, here are a few guidelines
to help you understand how these numbers will affect your goal to have
weight loss surgery.
When you look at the BMI, or the Body Mass Index, you will find that
“obesity” is defined as a BMI greater than 30. Your body mass index is
calculated by taking your weight in kilograms and dividing it by your height

13. in meters squared. (The formula for this is BMI=weight/height2 or kg/m2).
You can also calculate this number by taking your weight in pounds,
dividing it by your height in inches squared multiplied by 703. The BMI are
then classified in categories as follows:
BMI RANGE
CATEGORIES OF
OBESITY
18 - 24 Normal Weight
25 - 30 Overweight
30 - 35 Obesity, Class 1
35 - 40
Severe Obesity, Class
2
40+
Morbid Obesity, Class
3
Using the BMI:
When doctors use your BMI, they will look at the numbers to determine
your health risks, which will help them determine whether or not you are
good candidate for weight loss surgery. As you can see, you will be
considered a normal weight if your BMI falls between 18-24. Class 1
obesity is a BMI of 30-35 and this is normally when weight loss surgery can
become an option for some people. As the numbers go up, so do your
medical risks that can make weight loss surgery a good option for you. At
this point, the added weight that you carry will start causing a host of
medical issues that make losing weight a necessity for normal body
function.
Height & Weight Considerations:

14. While you are looking at the BMI index, you might also be interested to
know how your weight and height work in relation to your BMI. A person
who is for example 5’6 and weighs 150 pounds will look very different than
a person who is 5’2 and weighs 150 pounds. A taller person weighing the
same as a shorter person may be a perfectly normal weight, while the
shorter person may be considered overweight or even obese.
You can see that your height will also come into play when looking at your
BMI. Your bariatric surgeon will take these numbers into careful
consideration when you are considering any time of weight loss surgery.
HEIGHT HEALTHY WEIGHT OVERWEIGHT OBESE
5 feet 2 inches
(62 inches)
101 to 136 pounds 137 to 163 pounds 164 pounds or more
5 feet 6 inches
(66 inches)
115 to 154 pounds 155 to 185 pounds 186 pounds or more
5 feet 10 inches
(70 inches)
129 to 173 pounds 174 to 208 pounds 209 pounds or more
6 feet 2 inches
(74 inches)
144 to 194 pounds 195 to 233 pounds 234 pounds or more
Other Considerations:
Your weight when you step on the scales is not the only consideration your
doctor will make when you go for a weight loss surgery consultation. Simply
weighing a certain number does not automatically make you a good
candidate. In fact, your doctor will take several other considerations into
account before declaring you a good candidate for the surgery.

15. Weight loss surgery factors:
Most weight loss surgeons will tell you that in order to qualify for weight
loss surgery, you must not only have a body mass index of 35 or greater,
but you must also have one or more obesity related medical conditions.
Those who are at a high risk for weight related disease or have a life-
threatening condition or those who are disabled from their weight will be
good candidates for the surgery. In addition, if you suffer from a genetic
condition that causes your weight gain, you might be a good candidate as
well.
Factors that your doctor will consider before declaring you as a good
candidate for a weight loss surgery will include:
 High Blood Pressure:
High blood pressure can cause many complications
and those who are overweight often suffer from high
blood pressure. Many times, those with high blood
pressure can alleviate this problem by losing weight
and exercising.
 Diabetes:
Adult on-set diabetes is almost always caused by
being overweight. Some people can control their
symptoms by diet and exercise and others must
depend on daily doses of insulin. In addition,
diabetes has many complications it can cause as
well. Diabetics who are overweight can alleviate
their symptoms many times by losing the excess
weight.
 Arthritis:
Added weight can put a strain on your bones and
muscles and many people who are overweight will
suffer from debilitating cases of arthritis.
 Sleep Apnea:
Sleep apnea is a serious problem that can affect
your daily activities in ways you may not consider.
First of all, when the added weight puts pressure on
your chest, you will suffer from sleep apnea. This
can cause you to not sleep well at night from
constant waking. In addition, sleep apnea will also

16. cause you to feel tired throughout the day, irritability,
snoring, impaired brain function and headaches.
 Coronary heart disease:
Another serious complication of obesity is coronary
heart disease. Those who have excess body fat,
especially around the mid-section are at a much
higher risk for heart disease. This can also lead to
stroke. The added weight to the body makes the
heart work harder all of the time and this will raise
blood pressure as well as triglycerides and
cholesterol levels. Losing weight can help lower the
risks of serious heart problems that are often
associated with obesity.
 Obesity hypoventilation syndrome:
This is a condition that those who are severely
overweight will suffer from and it can cause serious
complications. Overweight people tend to have a
harder time breathing and cannot breathe in deep
enough to support good oxygen levels. This can
result in low blood oxygen levels and high carbon
dioxide levels. This is also related to sleep apnea.
This condition is a health risk because it can put a
strain on the heat and can cause heart failure, leg
swelling and other problems. Sometimes ventilation
can help, but mostly losing weight can alleviate this
problem.
 High Cholesterol:
Another problem that is almost always associated
with obesity is high cholesterol. When you have
high LDL levels, or low HDL, you can suffer from
heart disease and stroke. This can be caused by a
fast food diet and a diet that is not rich in healthy
foods. You will also find that high cholesterol can
run in families, so if you have this in your family and
you are overweight, you are very likely to suffer
from high cholesterol.
 Pseudotumor cerebri

17. This condition is common to those who are
overweight. This happens when you have pressure
inside your skull that causes a variety of problems
such as symptoms similar to a brain tumor, even
though no tumor exists. This problem can often be
alleviated with weight loss.
Other factors taken into consideration when looking
into weight loss surgery include:
 Physical problems that interfere with daily activities
(these can include joint and back pain)
 Having a BMI greater than 40 along with several
other medical conditions.
 Weight and body size interferes with the ability to
make a living, or cause problems with moving
around or taking care of the family or children
 Between the ages of 20-60 years of age and have
tried several other weight loss methods with little to
no success
 Have tried unsuccessfully several attempts to lose
weight through supervised dietary changes,
behavioral changes and medical therapy
 Have realistic expectations of what the surgery can
and cannot do for you and you are motivated to
make it work
 You are capable of understanding the procedure
and the complications and possible implications of
the surgery
 You can show that you are willing to make a life-
long commitment to the changes that will take place

18. after the surgery and that you can handle the long
term follow up care that is required.
 Have had a high body mass index for five years or
more
 You have no history of drug abuse, alcohol use or
emotional or psychiatric disorders
Understanding the Risks:
When you are being considered for weight loss surgery, your doctor will
take a look at whether or not you understand the risks and you are willing
to accept those risks. Almost everyone that has weight loss surgery will
experience some difficulty after surgery. It is not easy on your system and
your way of eating and living will change drastically overnight.
So, what are some of the risks you should be aware of before you talk to
your doctor? Consider the following:
 Infection at the incision area
 Pulmonary embolism (a blood flow blockage in the
lungs)
 Peritonitis:
This is a common problem caused by weight loss
surgery. This is when there is a leak from the
stomach into another part of the body.
 Dumping:
This is very common and happens when food
moves too fast through the stomach after
eating.
 Lose staples
 Stomal Stenois:

19. This is a narrowing of the link between the
intestines and the stomach
Other Risks:
There are other risks from this surgery as well. These side effects will
include:
Vomiting
Nausea
Weakness
Headaches
Diarrhea
Faintness
Sweating
Hiccups
Bloating
Gas
Hernias
Gallstones
Nutritional deficiencies
Anemia
Osteoporosis
Stroke
Talk to your surgeon before your surgery so that you fully understand these
risks.

20. WHAT TO EXPECT FROM WEIGHT LOSS SURGERY
As you explore your options for weight loss surgery, you should also take
the time to learn about the expectations. Weight loss surgery is not a quick
fix and it is not a diet or exercise program you can abandon when you get
tired of it. Instead, weight loss surgery will help you lose weight over time,
slowly. You must make a firm commitment to change your lifestyle and diet
forever—not just a few months or a couple of years.
Changing you:
Many people who have weight loss surgery or restorative weigh loss
surgery endo, are prepared to show physical signs of change, but often are
not prepared for other changes that will take place. Bypass patients often
experience a whole new outlook on life—as they begin to lose a large
amount of weight, they look at themselves differently and they look at those
around them differently as well. In most cases, these are all good changes
—you will get a boost in your confidence and self esteem, but it can be bad
as well. A person that has always been heavy may suddenly find that they
attract more attention once they start losing weight. This may be a change
that some people find uncomfortable.
People also may change how they act around you and how they interact
with you, whether intentional or not. They may be careful about offering you
food or stop inviting you out to eat for fear of ruining your diet. They may
seek you out more than they did because they find your surgery a
fascinating topic of discussion. These are changes that often happen that
you need to think about.
You must remember that the surgery itself will not change you. Your entire
outlook on food, exercise and life in general will start to change and you will
find that you are changing for the better. Your quality of life will start to
improve and you will find that you are capable of doing things you shied
away from before.

21. Expectations:
When you realize that losing the weight may not be all you have to do after
surgery, you should consider what else will need to be done. You know that
you will have to carefully follow the post surgical instructions and carefully
monitor what you eat and how much you eat. You know that your attitudes
and behavior will change. What else should you expect?
 Removing excess skin:
A fact about obesity surgery is that many patients
will need several cosmetic procedures once the
weight starts coming off. When you visit the center
for laparoscopic obesity surgery center, your doctor
should talk to you about this.
If you are losing an excess amount of weight, your
skin has stretched over time. Once you start losing
the weight, the skin will sag. Pounds of skin weight
can be removed after weight loss surgery. Most
patients want to have the skin on their arms done as
well as procedures to remove extra skin from other
sagging body areas. Sometimes this can include
having a facelift, breast augmentation,
abdominoplasty, liposuction and breast lift.
If you lose 100 pounds or more, then you may find
that in order to look and feel “normal” again, you will
want corrective plastic surgery to get rid of the skin.
Many doctors will tell you that if you are younger,
your body will have a better chance of repairing
itself with exercise because your skin is still elastic
than someone who is older.

22. The idea of needing cosmetic surgery should not
sway your decision to have weight loss surgery,
especially if your weight is causing medical
problems.
 Immediately after surgery:
You will also want to know what to expect
immediately following your weight loss surgery. After
your surgery is performed, you will probably stay in
the hospital for about five days. During this time,
your doctor will carefully monitor your recovery and
to make sure that there are no complications from
the surgery.
 Pain and discomfort:
Most all patients having this procedure will
experience some pain and discomfort. During your
hospital stay your health care provider will also
make sure that you are given the right type of pain
medication. You will not be released from the
hospital until you can function without the pain
medication. You will also be expected to be able to
keep down some amount of liquids and pureed food
without vomiting.
 Follow up appointments:
After you go home from the hospital, you will be
expected to make and keep follow up appointments
with your health care provider. This is to ensure that
you are recovering well and that your surgery is a
success.
Most weight loss surgery patients will also be asked
to make an appointment with a registered dietician.
This will help you fully understand how you should

23. be eating and what you should be eating as well.
This is a very important step to ensure that you are
allowing your body to work in conjunction with your
new surgery.
 Up to 12 weeks after:
After your surgery and up to about 12 weeks
afterwards, you will be instructed to follow a very
restricted diet. You will start off with liquids first and
then you will be allowed to add ground or soft foods.
As your body heals and you start adjusting to the
diet, you can start adding in small amounts of
regular food.
Your stomach will start shrinking in size and as this
happens you will only be able to take in very small
amounts of food. Your stomach will be about the
size of a walnut. You will be instructed to eat several
very small meals throughout the day. If you eat too
much food or you eat too fast, you will experience
nauseous, vomiting and pain under your
breastbone.
As the stomach adjusts, you will find that eventually
you will be able to increase the amount of food you
eat, but it will never be very much. Getting back into
your old habits of eating will cause you too much
pain and discomfort.
 Three to six months after surgery:
Within three months, you will have healed enough
to start eating more types of food. During the three
to six month phase after surgery, you will still
experience some side effects. This is due in large
part to the body reacting to rapid weight loss in such

24. a short period of time. You should expect to
experience the following during this healing time
after weight loss surgery:
 Feeling cold much of the time
 Body aches and pains
 Mood swings/mood changes
 Thinning hair and hair loss due to depleted
nutritional intake
 Dry skin
 Feeling tired much of the time
 Faintness
After surgery, you can expect that you will lose about fifty percent of your
weight in the first two years. With the right diet and following the doctor’s
orders, you can expect that you can keep this weight off long term without
too much difficulty. If, however, you get back into your old habits of eating,
you can gain that weight back faster than you lost it.
In addition, there are a few other things that you should know about this
surgery. When you realize that losing the weight may not be all you have to
do after surgery, you should take care of yourself.
Taking supplements:
Remember that vitamins, minerals and obesity surgery go hand in hand.
After you have weight loss surgery, remember that you are taking in a lot
less nutrients. These are nutrients that are vital to your body and will help
you support your health when you need it the most. Your doctor or dietician
will probably recommend that you take the right amount of vitamins and
other nutritional supplements for the long term. These will help ensure that
you stay healthy even though you are eating less foods.

25. You will find that the following are very important to take:
Iron
Vitamin D
Folate
Iron
Vitamin B12
In fact, there are supplements that you can buy that are just for patients
that have had weight loss surgery. These types of products will ensure that
you are getting the right amount of vitamins, minerals and other nutritional
supplements that you need.
Eating Smaller Meals:
Another expectation that you should have after surgery is that you will no
longer be able to eat everything you want at a sitting. You will probably
have the ability to eat only a small fraction of what you ate before your
surgery. You must teach yourself that you can only eat a very small
amount--maybe three or four small bites at one meal. This drastically cuts
down on the number of calories you take in.
When you eat smaller portions, you will also find that you have to eat more
frequently. This means that binge eating is out of the question. You will
probably eat six to seven very small meals each day. You will feel full much
faster when you eat as well. Eating slowly will help your digestion and will
help you avoid common problems such as dumping or diarrhea.
Before you decide on obesity surgery, it is very important that you
understand how this will affect you long term. You should have realistic
expectations going into the surgery for the best results.

26. TYPES OF WEIGHT LOSS SURGERY
Weight loss surgery is a not “one size fits all” option. If you are exploring
weight loss surgery it is because you are interested in having the procedure
done or because a friend or a loved one is exploring their options. You
should know that what works for one person may not work for you. There
are several different types of weight loss surgery and the only way you will
know which one works for you is to talk to your doctor about your options.
Changes over the years:
Weight loss surgery has changed dramatically over the years. Since it’s
invention, more people are getting the chance to experience this radical
surgery with greater success. While it is still a major surgery, there are not
as many complications with this surgery as their once was. It was not
uncommon to hear about debilitating side effects and even death
associated with weight loss surgery. From New York City obesity surgery
centers to bariatric obesity surgery in Oregon, there are options for you.
Types of Weight Loss Surgery:
Major types of weight loss surgery include the gastric bypass, gastric
banding, gastric sleeve, the duodenal switch and the incision free surgery.
There are different methods of performing each of these surgeries and not
all weight loss doctors perform each of these types of surgery. For
instance, if you are interested in gastric bypass, then a doctor that performs
that surgery may not perform the gastric banding.
Each one is a little different, but the long term goal is the same—to help
you reach your weight loss goals. Here is a look at each type of weight loss
surgery method to help you learn the differences between them.
 Gastric Bypass:
The gastric bypass weight loss surgery is one of the
most popular and is designed to reduce the food
that you eat. This is a good choice for those that
have tried to lose weight through diet and exercise

27. and have had no success. In addition, this surgery
is good to help not only lose weight but to improve a
person’s quality of life. A person that loses a large
amount of weight through gastric bypass will gain
lost mobility and reduce the number of health
related problems they have had since gaining the
weight.
Gastric bypass is not an easy surgery and it is
performed under anesthesia. The surgery generally
takes one to four hours depending on the case and
will require a hospital stay of two to seven days
depending on the rate of the recovery.
There are two different types of surgeries that fall
under the gastric bypass category. These include
the biliopancreatic diversion bypass and the Roux-
en-Y gastric bypass, both traditional and
laparoscopic.
The Roux-en-Y-Gastric Bypass

28. This form of surgery is very common and often is
less complicated than the other form of gastric
surgery. The lap-band is another form gastric
bypass surgery that is gaining popularity, but it does
not involve a bypass.
When a doctor performs the Roux, it is done
through open surgery that takes one large incision.
This incision often leaves a permanent scar on the
patient. Unlike other forms of weight loss surgery,
this form of surgery leaves the stomach intact.
The laparoscopic Roux surgery will require several
small incisions and will leave less scarring than the
traditional method.
Biliopancreatic Diversion Bypass
This surgery will require open surgery and a long
incision that will leave scarring. This surgery is less
common that the Roux-en-Y gastric bypass and has
more complications and side effects.

29. Often patients that have had this surgery will suffer
from a loss nutrition, which causes long term health
problems.
During this surgery, portions of the stomach are
removed and the bypass is then attached to the
distal illium. The small pouch that is created then
serves as the stomach to hold food.
Both of these gastric bypass surgeries are designed
to curb food intake, thus allowing a person to take in
fewer calories and lose weight faster. A bypass is
formed through surgery in the small intestines to
decrease the absorption of food. This will help curb
hunger too. With bypass surgery, about half of the
weight is lost in the first year and most patients
reach their weight loss goal within the second year
after surgery.
The cost of a bypass surgery can vary a great deal.
Typically these surgeries can cost anywhere
between $18,000-$40,000. The cost will vary
according on where you live, your case and the
doctor that you use. If you are considering this
surgery, you should know that more insurance
companies are paying for these surgeries. In some
states obesity surgery paid by government agencies
is common.
If your insurance pays for this surgery, you can
expect it to cover you anesthesia fees, hospital
fees, surgeon fees, x-rays and some post operative
care. It probably will not cover post surgery
consultations such as exercises and diet
counseling, the cost of supplements and vitamins,
and any post surgery procedures that you want to

30. have done that includes plastic surgery, liposuction
and lifts.
 Gastric Banding
Gastric banding is known by several different
names including laparoscopic adjustable gastric
banding, gastric banding, Realize Band and the
Lap-Band System. Gastric banding is another type
of weight loss surgery that is gaining in popularity.
This surgery involved putting a silicone band that is
outfitted with an inflatable inner collar around the
upper part of the stomach. This will restrict food
intake by creating a very small pouch for food. The
passage that is created will slow the emptying of
food and will help you feel fuller for a longer amount
of time. The good thing about the gastric band is

31. that it can be adjusted and it can even be removed
if necessary.
Less Scarring:
Because this surgery is done laparoscopically, only
very small incisions are needed, reducing the
amount of scarring. Healing time is faster and the
surgery only takes about an hour to complete. Many
patients prefer this method of weight loss surgery
because it can be done on an outpatient basis,
meaning that you are in and out in one day.
The gastric banding system has become so popular
that there are many centers such as the Texas
Center for Obesity surgery center and the Obesity
Surgery Center of Louisiana that focuses on offering
this type of surgery.
Cost of Gastric Banding:
The cost of these gastric banding surgeries can
vary a great deal. You can expect that it will cost
about $16,000 to $32,000. Some insurance
companies will cover some or part of the surgery
and just like the bypass surgeries, they will not
cover plastic surgery procedures and follow up care.
The Lap-band and Realize band will cost about the
same.
The price that you are charged will depend on
where you live and where you go to have the
procedure done. It will also depend on how long you
will have to stay in the hospital after the procedure
is done.

32.  Gastric sleeve
Another surgery that is performed to help a patient
loss the unwanted pounds is the gastric sleeve, also
called the gastric sleeve resection. This is a fairly
new procedure and can be used to start the weight
loss process. This is often recommended for
patients that are too obese to have invasive surgery
done and need help getting started. This is also a
good option for those that are not good candidates
for the Lap-band or Realize band.
Many times, the gastric sleeve is used on patients
that have to wait until a later time to have a more
invasive surgery done. It can help high risk patients
lose weight faster and safer than other methods.
How this surgery works:
During this procedure, the surgeon actually
removes about fifty percent of the stomach and
reshapes it to resemble a narrow tube. This is done
using a laparoscope and very little scarring is left.

33. When the stomach has been removed, it is stapled
closed.
Because this surgery is relatively new and results
long term have not been determined, insurance
companies normally do not cover this procedure. It
can cost about $10,000.
This surgery is non-reversible and requires a long-
term commitment. Patients that have this surgery
will need to be very careful to follow their diet plan.
They are at risk of gaining the weight back after
time because the stomach can stretch if over-eating
occurs.
 Duodenal switch:
Another type of weight loss surgery is the duodenal
switch. This is the most complicated and most
involved weight loss surgeries and is more invasive
than the others. Other names for this surgery
include vertical gastrectomy with duodenal switch,
biliopancreatic diversion and BPD-DS.

34. This surgery is more complicated because it
combines two weight loss surgeries in one—it is
considered a restrictive surgery as well as a
malabsorptive.
During this surgery, the doctor will first reduce the
size of the stomach. It divides the stomach vertically
and about 85 percent of the stomach is removed. It
will end up looking a little bit like a tube and it about
six ounces. Next, the biliopancreatic diversion
procedure is performed.
The basic idea behind this surgery is that the switch
keeps a small portion of the duodenum in the
digestive system and will regulate the stomach.
About 20,000 of these surgeries are performed
each year in the United States.
Candidates for this surgery:
Not everyone is the right candidate for this surgery.
It is generally reserved for the morbidly obese—
those with a BMI of 55 or higher and who suffer
from diabetes or other weight related illnesses. It is
not, however, a good choice for those that will have
a difficult time recovering from a high risk surgery.
The recovery time for this surgery takes longer and
it is a life time commitment. It cannot be reserved.
There are several side effects and complications
can arise after surgery and if post-surgical
directions are not followed carefully.
Cost:
The cost for this surgery will be anywhere from
$20,000 to $30,000. Insurance often covers the
expenses related to this surgery, except for cost that

35. have to do with cosmetic surgery and other post-
operative consultations and counseling.
 Incision Free weight loss surgeries
Technology has certainly changed the face of
weight loss surgeries over the years. At one time,
having any type of weight loss surgery would leave
the patient with a large visible scar. That is no
longer the case and there are several weight loss
surgeries that are incision free.
How to incision free surgeries work?
Surgeons are now learning how to use their tools to
complete surgeries using natural orifices to the
body, such as through the throat or vagina. Some of
these surgeries are still quite new and experimental,
but are becoming more commonplace and they are
proven to work well. Incision free surgeries mean
that there is less recovery time and no scarring.
Types of incision free weight loss surgeries:
There are several different types of these surgeries
that will aid in weight loss without the use of
incisions. These surgeries include:
Gastric Balloon
Endoluminal Sleeve (EndoBarrier)
StomaphyX
Transoral Gastroplasty (Toga)
Transoral ROSE
If you are interested in these new techniques, talk to
your weight loss doctor.

36. FINDING A GOOD WEIGHT LOSS SURGEON
Now that you know more about weight loss surgery and the types of
surgery that is recommended, maybe you are ready to find a doctor. A
weight loss surgeon can help you reach your weight loss goals so that you
can live your life to its fullest.
How do you go about finding a good weight loss doctors? There are many
of them out there and before you let anyone operate on you, you should
take the time to do some research.
Where do you live?
The first consideration to make when looking for a doctor that can help you
is to look at where you live. Do you live in or near a big city? If so, then you
probably have many options to choose from right near your home, such as
the Detroit Obesity Surgery center or the Center for Obesity Surgery San
Antonio. If you do not live near a big city, then you may have to find out
where the nearest weight loss surgeon is to you.
Check the Internet:
Since there are so many weight loss doctors out there, you may want to
start by logging on to the Internet. A quick search engine search may yield
many results in your area. Start off by typing in the type of surgery and the
city, for example, “Michigan obesity surgery”, “center for obesity surgery in
Gainesville”, “golden isle center for obesity surgery”, “morbid obesity
surgery kansas city”, “long island obesity surgery”, “bariatric obesity
surgery Missouri”, or “morbid obesity surgery orange county”. You can also
look for recommendations from places such as the Federation International
Obesity surgery for more information on surgeons in your area.
Once you have narrowed down your choices and found some surgery
centers in your location, you can start looking at individual surgeons. If you
know anyone who has had the procedure done, you can also get
recommendations. You may even be able to find seminars and information
workshops in your area that will help you get an idea of where to go for

37. these surgeries. Many people who have had bariatric surgery are more
than happy to share their experiences with you.
Making the appointment:
The first step in finding the new you is making that appointment. Sure there
is a lot of information out there and you will have to take the steps to
ensure that you are getting the best care. You will also want to do the
necessary research into your insurance company to find out if the
procedure is covered and how much you will be expected to pay out of
pocket.
When you make your appointment to talk to a weight loss surgeon, you
should know what to look for. Nothing says that you have to stick to the first
doctor that you talk to. You can take your time and get second opinions.
You can also using the internet to your advantage to look up ratings of the
doctors and read reviews.
Your first appointment:
When you arrive at your first appointment, you can expect that the health
care staff will be asking you many questions. They will want to give you a
complete health exam and take down your health history. You will want to
be completely honest because your answers can determine if the surgery is
right for you and which surgery will work best for your particular case.
You will also want to disclose any medications you are taking, whether or
not you have had professional care for emotions, and prior health care
issues, such as surgeries that you may have had and whether or not you
suffer from any illnesses or diseases.
During this appointment, the doctor may ask you questions about why you
would like to have the surgery done, whether or not you are committed to
the lifestyle change and how you plan on following post operative
appointments.

38. You will also want to ask the doctor some questions as well. This will help
you make the right decision on choosing a surgeon for your weight loss
surgery.
Some of the questions you will want to ask include:
 How many weight loss surgeries have you
performed?
You will want to know how experienced your doctor
is before making an appointment. You probably do
not want to choose a doctor that is just getting
started in the field. Whether you are looking to have
Lap-Band or gastric bypass, you should know that
complications after surgery have a lot to do with
how many surgeries the doctor has done. The more
surgeries the doctor has performed like yours, the
better for you.
If you feel uncomfortable with the number of
surgeries performed or if the doctor is unwilling to
disclose this number, perhaps you should look for
another doctor.
However, you should also know that with any
doctor, no matter how many surgeries he or she has
performed, complications can still arise and
sometimes it has nothing to do with experience. If
you like the doctor and he or she has good ratings
and recommendations, then even if the doctor is
just getting started, you should consider it.
 Find out the type of bariatric procedures that the
doctor performs:
Another question you will want to know the answer
to is which type of surgeries for weight loss does the
doctor perform. This is important to know because

39. some weight loss doctors perform only one kind of
bariatric surgery, while others do several different
types.
If you find that a surgeon only performs one kind of
surgery, such as only the latest one, you should find
out why. This may be a doctor that has moved into
the weight loss field recently and is looking to find
more business.
Weight loss doctors that perform all types of
surgeries might be a better option because you
know that this doctor can tell you which surgery is
right for you and cares about your personal success
rather than making a quick buck.
 Is the doctor board certified by the American Board
of Surgery?
You also need to know whether the doctor is
certified by either the American Board of Surgery or
the American Osteopathic Board of Surgery. It is
imperative that the doctor you choose is board
certified. This means that he or she has meet the
criteria and standards set forth to operate on
patients and they have the necessary training in
their field.
 Is the doctor a member of the American Society for
Metabolic and Bariatric Surgery?
This is an important credential that your weight loss
surgeon should have. This shows that your doctor
has the right training and experience necessary to
perform bariatric surgery. This also means that your
doctor has at performed at least 25 bariatric
procedures within the last two years.

40. Make sure that your doctor holds this certification
and if not, then you will need to make sure you look
for another surgeon to perform the procedure.
 Is the surgery center recognized as a Bariatric
Surgery Center of Excellence?
Surgeries of any kind are often performed in
surgical centers, hospitals and day surgery centers,
but not all of them are equipped to handle bariatric
patients and their unique needs after the procedure.
Before you choose your doctor, find out a little more
about where the surgery will be performed. You will
need to not only deal with the doctor, but you need
to know that the place of the surgery also has
nurses and staff on hand to help you afterwards.
They also need to be trained in bariatric surgery.
A Center of Excellence means that the surgical
center has performed at least 125 bariatric
surgeries and the surgeon has also performed at
least 125 procedures over his or her career.
These stringent guidelines ensure that you are
getting the best care from everyone on the staff
including the surgeon, dietician, anesthesiologist,
nurse and the psychologist. Look for this recognition
when you are seeking out a surgical center for your
weight loss procedure.
 Can the doctor tell you what your personal risks of
surgery will be at your appointment?
Because every patient is different, this is the
approach your doctor should take. Not every
surgery will affect each person the same. Not every
surgery is right for every person.

41. Each surgery should be personalized to the
person’s needs and their weight loss goals. You
should find a doctor that recognizes this and takes
the time to find out more about your health history
and how the surgery will affect you both long term
and short term
When you meet with the surgeon, ask the doctor
what your personal risks may be after surgery. If, for
example, you are diabetic, you may find that you
are at a higher risk of not healing as fast as others.
If you have heart disease, then a high risk surgery
may not be the right choice for you. Find a surgeon
willing to talk to you about which surgery is right for
you and why.
 Who will be assisting the surgeon during your
weight loss procedure?
It is also a good idea to know whether or not your
doctor will be performing the surgery alone or if
another doctor will be in on the case. If there will be
another doctor present, find out about this person’s
qualifications.
 Is the staff on hand at the center or the hospital
trained to take care of post-operative bariatric
surgery patients?
Bariatric surgery is difficult. It is hard on the body
and it does take time to recover properly. After you
have a major surgery such as this one, you need to
make sure that those caring for you are specially
trained to help you.
If the staff on hand is not knowledgeable about the
ins and outs of bariatric patients, you may not get

42. the best care or the best advice. Seek out a doctor
that performs surgery in centers where the nurses
and other staff are skilled and trained to help weight
loss surgical patients.
You will also want to make sure that the center is
equipped with the right size equipment such as
wheelchairs, beds, blood pressure cuffs, scanners
and gowns.
 Is the anesthesiologist experienced with overweight
surgical patients?
Make sure that you ask your surgeon whether or not
the anesthesiologist can handle working with obese
patients. You should know that being obese can
increase your risks under anesthesia and only a
trained person in this field and one with experience
can make sure that it is done correctly.
It is to your benefit to have one that is trained and
has experience working with the obese.
 Will the doctor help you find support after the
surgery is over?
When you are wheeled out of the operating room,
the major part for the surgeon is done, but you will
still need that doctor. You need to make sure that
the doctor can help you get the care you need after
the surgery is over. You should also make sure that
he or she keeps your post-op appointment and
follow ups as well.
 Who will cover for the surgeon when he or she is
not on call?

43. Your surgeon does not work around the clock.
When he or she is not on call, who is taking those
calls? Is it someone else who is skilled at caring for
bariatric patients? If you go home and have a
complication a couple of days after surgery, you
need to know that there will be someone who can
care for you.
 Can the surgeon’s office file your insurance and
help guide you through the red tape?
Dealing with insurance is never pleasant and when
you are having a procedure that may or may not be
covered by your insurance, you may need help
making sure you are getting the coverage that you
need.
Make sure that the doctor that you choose can help
you obtain your insurance policy on bariatric surgery
and can help you with your questions regarding
insurance coverage.
Additionally, if your insurance does cover, does your
doctor take your insurance? You need to find out
that information before scheduling your surgery. If
you are paying for your procedure out of pocket,
you may want to find out if your doctor will accept
payment plans, as bariatric surgery is very
expensive.
 Do you like the doctor?
You have probably heard that first impressions
mean a lot and that holds true for doctors as well.
The second you walk into a doctor’s office you will
get a feel of whether or not you feel comfortable
with this person. Is the waiting room nice and

44. clean? Is the staff nice and helpful? Is the doctor on
time and personable? These are all questions that
you will answer to yourself after you meet the
doctor.
After your initial appointment with the doctor, you
will probably have a good idea if this is someone
that you can trust.
 Is there help for follow up?
Last but not least, you should ask the doctor if he or
she can give you the help you need for follow up
care after your surgery. You will need help finding a
dietician, getting counseling and making sure that
you stay on track with your diet and exercise
program.
Your nutrition will play a huge role in the outcome of
your surgery so make sure that your surgeon gives
you the information and the tools that you need to
make good choices after the surgery. You need to
have the names and contacts for everyone that will
play an instrumental role in the success of your
surgery and your doctor should be the one to help
you with that.
A surgeon that fails to follow up with his or her
patients after surgery probably is not too concerned
about the patient individually and is instead more
interested in the money it brings in. This should
never be the case. If you do not follow up with your
surgeon, he or she will never know if the procedure
is effective. Make sure that you use a doctor that is
committed to helping you reach your weight loss
goals before, during and after the surgery is
complete.

45. RECOVERING FROM WEIGHT LOSS SURGEY
Taking the step to have weight loss surgery done is just half of the battle. If
you know that having bariatric surgery is right for you, then you are making
an important first step in realizing your weight loss goals. You know that
you can do it and you are willing to make the changes necessary in your
life. After you have talked to your doctor and set a date, you should also
take the time to learn more about the recovery process following your
weight loss surgery.
Planning your recovery:
Recovery from weight loss surgery, whether you are choosing the Lap-
Band procedure or another type of surgery, is not easy. It takes time and a
lot of planning and patience to recover successfully. Everything that you
know about eating and your behavior will have to change. Failure to make
these changes from the very start can mean that your weight loss surgery
will not be a success.
As soon as you have made the choice to have weight loss surgery, you will
need to plan both for the short term and the long term. You will need to take
special care in managing your weight loss surgery, the postoperative
treatment and follow up appointments and your diet and exercise plan. You
will need to meet with your surgeon, but also other health care providers
such as a nutritionist that is trained to work with obese patients following
weight loss surgery and perhaps a therapist or counselor who can work
with you on your eating behavior.
You will see right after surgery that the success of your surgery will depend
on you making that commitment to change your life, as well as working with
the professionals that are trained and want to help you succeed. With
planning and work, you will find that you can transition quite well after
weight loss surgery into your new weight loss routine.
Why have surgery?

46. We have explored reasons why many people choose to have surgery, but
the reasons why you personally want to have this surgery may differ. When
you take the time to pinpoint why you want to make that change, you can
then begin the process of recovering. If you are interested in losing weight
to look and feel better, then you will know that is your ultimate goal. Some
people choose this surgery because it is right for their health. When you set
these goals for yourself, it will give you something to look towards during
your recovery, both in the long term and in the short term.
After surgery:
After your weight loss surgery, you will be able to tell that you are
experiencing something that will change the way you look and feel forever.
This is a chance to change for the better-not only for your looks, but for
your health as well.
In order to make your surgery a success, you need to follow all of the
orders that your doctor gives you. Some of the instructions you will get will
help your body digest the food better and will help you get up and around
slowly and carefully.
The following are all things that you should expect to hear from your doctor
after your weight loss surgery:
 Moving around right after surgery:
There is no doubt that you will experience some
pain and discomfort after your surgery. However,
your doctor will want to see that you are able to get
up and move around before you are sent home.
After you have recovered from the anesthesia, the
doctor will ask that you get up and move at least a
little before going home. You will probably start off
by walking around your hospital room and once the
doctor sees that you are able, you are one step
closer in going home.
Once you are home, you will be expected to walk
around your house several times a day. This will not

47. only give you a little exercise, but it will also ensure
that you are recovering from your surgery.
 Getting help:
After you get home from your surgery, you will need
to make sure that you have someone there that can
assist you for a few days. It is a good idea to have
someone that can help you get up when you should,
make sure that you are taking the right medications
and to help drive you to and from appointments for
a few weeks. You will also want to get help
preparing your meals in the right portions, helping
you dress and help you bath and shower.
 Driving:
As mentioned above, you will need help getting to
and from appointments after your surgery. Your
doctor will probably recommend that you do not
drive for two to three weeks after surgery. He or she
will also tell you to refrain from strenuous activities
for at least six to eight weeks. After this time is over,
and the doctor is certain you have recovered, you
will probably be allowed to return to your normal day
to day activities.
 Changing the way you eat:
After your surgery, it is imperative that you follow
your doctor’s orders on how much food and what
type of foods you can eat.
For the first few days, you will be on a liquid only
diet and then will be able to add back in bland soft
foods little by little.
You will also want to change how you eat. Not
following the directions on how to eat after surgery
can cause to you have vomiting and severe pain.

48. You will be told to try the following when you eat:
Chew food slowly.
Consider eating meat that is ground or pureed.
Wait a couple of minutes between each bit to make
sure that you are not over eating.
Drink plenty of fluids throughout the day, but not
during meals.
Avoid foods with sugar and high fat content. Avoid
non diet soda, baked goods, milk shakes and juices.
Eat a variety of food that focuses mainly on fresh
fruit and vegetables.
Eat only lean meats.
Avoid refined and processed foods.
Take your daily vitamins and supplements.
Try to avoid alcohol.
Eat several small healthy meals each day.
As you can see, weight loss surgery will not fix your
problem alone. You must take the time and make
the commitment to make the changes necessary to
find success.
CONCLUSION
If you are overweight and have spent a large amount of your time
trying various diets and exercise programs with little to no success,
you are not alone. Obesity is a major problem in the United States
and around the world.

49. Lifestyle choices:
There are many reasons why people are overweight, but a lot of it
has to do with the lifestyles and poor choices in eating that people
make in today’s world. It is not common any more for people to enjoy
healthy home cooked meals as it once was. Today people are always
on the go and fast foods have become a staple in our diets.
Not enough exercise:
In addition, people are getting less exercise than ever before. This is
in part due to our fast lifestyles—always on the computer, watching
the television or not getting out to move around. This, combined with
a poor diet, makes people overweight. Obesity strikes men and
women of all ages and of all races.
What you can do:
The good news is that there are things that you can do to fight you
weight gain. Even if you have spent time before with diet and
exercise, there is still weight loss surgery. While weight loss surgery
is not for everyone, it can help many people who feel that they have
tried everything.
If you are interested in losing excess weight, then you should talk to
your doctor. You can find a weight loss doctor in your area that will
work with you to reach your goals.