Question: What is weight loss surgery?
Answer: Weight-loss surgery, also known as bariatric surgery, is an option for some severely obese people who have not been able to lose weight through traditional means. Most bariatric procedures promote weight loss by surgically reducing stomach size to restrict food intake.
Question: Is weight loss surgery right for everyone?
Answer: The short answer is no. Surgery is not a solution for everyone. We will determine whether a patient is right for surgery after a complete evaluation and discussion with the patient. Because weight loss surgery is a life-altering procedure, we want to make sure patients are committed to making the lifestyle changes needed for a successful procedure.
Question: How is eligibility determined?
Answer: In order to determine a patient's eligibility for weight loss surgery rather than using weight management, we use body mass index (BMI) as a criteria for surgery -- excess fat in relation to height.
Individuals are candidates for surgery if:
- they have failed previous attempts at weight loss in a medically supervised program
- their (BMI) Body Mass Index (ratio between height and weight) is greater than 40 or between 35 and 40 with major obesity-related medical problems.
Question: What are the risks of weight loss surgery?
Answer: All major surgery comes with risks, and the risks are different for each patient. During your appointment with your surgeon, the risks of surgery will be explained. The amount of weight lost and how fast it is lost depends on which weight loss surgery is performed. Patients who have adjustable gastric banding (Lap-Band®) procedures usually lose about 1-2 pounds a week and a total of 40 percent excess body weight. Those who have gastric bypass (RYGB) lose about 50-60 percent of excess body weight. Women should avoid pregnancy for at least 18 months after surgery. Please discuss any pregnancy plans with the surgeon. The length of hospital stay for gastric bypass surgery is between one and three days.
Question: How long will I be off of work after surgery?
Answer: The gastric bypass (RYGB) procedure averages four to five weeks in recuperation.
Question: Do patients have to take vitamins?
Answer: Yes, patients have to take a multivitamin and calcium supplement every day.
Question: When can patients stop taking vitamin and mineral supplements?
Answer: Never. It is critical that supplements are taken. We will check the patient's blood several times during the first year after surgery and every year for the rest of their life to ensure they are absorbing the nutrients.
Question: Can the weight be regained?
Answer: YES. Patients can regain some of the weight. The patient's overall behaviour and compliance with the diet and exercise contribute to the long-term weight loss success. We emphasize that this surgical procedure is a "tool" which when used properly will produce good results. Long term follow-up with the Bariatric Team is essential.
Question: What about alcohol?
Answer: We do not recommend patients consume alcohol. Alcohol can cause marginal ulcers in the stomach pouch which could cause bleeding. It can also lead to severe nutrient deficiencies.
Question: How long does it take to schedule surgery?
Answer: Usually several months are needed for evaluation, meeting and various tests to be completed. We ask patients to focus on weight loss during this time. We prefer they begin to lose weight prior to surgery as they begin to change eating and exercise behaviours in accordance with our dietitians and exercise therapists recommendations. The pre-operative weight loss will help the surgical team to perform surgery as safely as possible.
Question: Can patients who have had a previous bariatric surgical procedure, but have regained the weight, have another procedure?
Answer: "Redo" or revision surgery is possible, but not everyone should have it. The potential complications are higher than for the first-time bariatric surgery patient. We will assess the individual situation carefully and make recommendations. Since diet and exercise play a crucial role in weight loss success, we will ask patients to do their part as well.
Question: How will this affect my diabetes?
Answer: Note that different types of bariatric procedures had different degrees of impact. Gastric bypass surgery resolved diabetes in 84% of patients, whereas gastric banding procedures resolved it in 73%.
Question: How quickly does surgery improve diabetes?
Answer: For some patients, diabetes disappears almost immediately, within days of surgery. For some others, blood sugar levels begin to fall soon after surgery, becoming completely normal within a year. Your results may vary.
Question: Does weight-loss surgery work for type 1 diabetes?
Answer: Weight-loss surgery has been shown to improve type 2 diabetes, not type 1 diabetes.
Question: I have pre-diabetes. Can weight-loss surgery help me?
Answer: In studies, patients with a condition called "impaired glucose tolerance" - which can be part of pre-diabetes - showed improvement after weight-loss surgery.
Question: What are other potential health benefits of weight-loss surgery?
Answer: Potential health benefits can include:
- Reduced risk of diabetes complications, such as blindness, limb amputation, kidney disease, and stroke
- Lower cholesterol
- Resolved (ended) high blood pressure
- Resolved sleep apnea (breathing disturbance during sleep)
- Reduced joint pain
- Less heartburn
- Improved mood and self-esteem
- More energy
- Longer life
Question: Am I too old/young to qualify for weight-loss surgery?
Answer: The main eligibility criteria are related to health rather than age. People over age 65 do have weight-loss surgery. Adolescents can also qualify, although they may have to meet slightly different eligibility requirements (eg, reaching certain height/growth stages). The average age of weight-loss surgery patients is 41.
Question: Will I have to follow a special diet?
Answer: Over the first 6 to 8 weeks post-surgery, your diet will gradually increase from liquids to semi-solid foods; this regimen will help you heal. Longer-term, you will need to eat healthfully in order to lose weight and maintain a healthy weight, following basic guidelines such as: eating at mealtimes only, avoiding sugary foods, drinking enough fluids throughout the day, and avoiding overeating/overfilling your stomach.
Question: Will I be able to eat only tiny amounts of food?
Answer: Surgery reduces your stomach to a small pouch, which means you will feel full and satisfied with less food. Right after surgery, the pouch's capacity is a couple of tablespoons. By 6 months, it can hold about 1 cup of food. And over the long term, it can stretch to hold around 1 1/2 cups.
Question: If I'm eating so much less, will I get enough nutrients to stay healthy?
Answer: If you have gastric bypass, you will take a multivitamin and mineral supplements after surgery because the procedure changes the way nutrients are absorbed by the intestines. Our Team Dietitian will work with you before and after your surgery to assist you in meeting your goal of healthy eating as well as nutritional health.
Question: Will I have to exercise?
Answer: Studies show that regular exercise after surgery leads to better weight-loss results. In the early months post-surgery, walking is a good choice; if you have knee or hip problems, you may want to consider non-weight-bearing exercise, such as water aerobics. As with eating healthfully, regular exercise can help you sustain your weight-loss results over the long term. Our Team Physiotherapist will work with you to assess your needs and capabilities and get you on the right track through physical exercises.
Question: How soon will patients start losing weight?
Answer: Patients begin losing weight immediately after surgery.