Mar13 weight losssurgery_pdf

Table of Contents
INTRODUCTION
HISTORY OF WEIGHT LOSS SURGERY
CAUSES OF OBESITY
CANDIDATES OF OBESITY SURGERY
WHAT TO EXPECT FROM WEIGHT LOSS SURGERY
TYPES OF WEIGHT LOSS SURGERY
FINDING A GOOD WEIGHT LOSS SURGEON
RECOVERING FROM WEIGHT LOSS SURGEY
CONCLUSION

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.

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:
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
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:
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•
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 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:
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
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.

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 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:
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.
YoucanseethatyourheightwillalsocomeintoplaywhenlookingatyourBMI.Yourbariatric
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)
5 feet 10 inches
(70 inches)
6 feet 2 inches
(74 inches)

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.
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:•
Adulton-setdiabetesisalmostalwayscausedbybeingoverweight.
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 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•
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 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:•
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.

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.
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:•
Afact 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.
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 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 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.
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.

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 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.Aperson 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
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.
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 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 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.

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. 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.
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 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.

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 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.
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 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.
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.
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
Whenyoumeetwiththesurgeon,askthedoctorwhatyourpersonal
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 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?•
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 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.
Asurgeon 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.

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?
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:•
Thereisnodoubtthatyouwillexperiencesomepainanddiscomfort
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 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.
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.
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.

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