Preparing for Bariatric Surgery FAQs

Bariatric surgery is like other major abdominal surgery. You can best prepare by knowing the benefits and risks of surgery, and by closely following your doctor’s instructions.

• Understand the surgical process and what to expect afterward.
• Keep in mind that you’ll never be able to eat the way you did before, and that you’ll have to watch what and how you eat for the rest of your life.
• Talk to people who have had bariatric surgery.
• Write down your reasons for having bariatric surgery and outline your plans to maintain your weight loss after surgery.
• Practice the post-op diet, including the transition from an all-liquid diet, to pureed food, to a normal diet of smaller portions with 4 ounces of protein.
• Start a journal. Record how you feel now, the challenges you face, and the things you hope to be able to do after bariatric surgery.
• Ask your family and friends for their support. Talk to them about why you want to have bariatric surgery. It helps to have people behind you, waiting to help.

It varies from person to person. Generally, the hospital stay (including the day of surgery) can be one to two days for a gastric band, two to three days for laparoscopic gastric bypass or sleeve gastrectomy. There is no hospital stay for the gastric balloon procedure.

Medical problems, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, many serious medical conditions may improve or resolve after successful bariatric surgery.

Type 2 diabetes is a long-term metabolic disorder where the body produces insulin, but resists it. Insulin is necessary

• 80% of patients who had gastric bypass surgery experienced complete resolution of type 2 diabetes.
• 40% of patients who had gastric banding surgery experienced complete resolution of type 2 diabetes.
• Patients who had bariatric surgery had lower insulin resistance, and their risk for metabolic syndrome, high blood pressure, and high amount of fats in the blood also decreased.

Excess body weight is associated with an increased risk of heart disease, elevated cholesterol, and high blood pressure. These conditions can lead to heart attacks, strokes, and heart and kidney damage. Bariatric surgery reduces excess body weight.

• 65% of patients who had gastric bypass surgery experience complete resolution of high blood pressure.
• 50% of patients who had sleeve gastrectomy experienced complete resolution of high blood pressure.
• Changes in diet and exercise after surgery can lead to significant improvement of cardiovascular problems.

High cholesterol is a disorder of lipids—the fat-like substances in the blood. A common form of dyslipidemia is hyperlipidemia (or high cholesterol), the condition that exists when someone has too much of certain lipids in the blood. As these lipids build up inside the artery walls, harmful scar tissue and other debris begin thickening and hardening the walls. Long-term, this can lead to heart disease and high blood pressure.

• 95% of patients who had gastric bypass surgery experienced improved cholesterol health.
• 78.3% of patients who had gastric banding surgery experienced improved cholesterol health.
• 85% of patients who had sleeve gastrectomy experienced improved cholesterol health.

Obstructive sleep apnea is when breathing suddenly stops because soft tissue in the back of the throat collapses and closes during sleep. Morbid obesity can cause sleep apnea and other respiratory.

• 86.6% of patients who had gastric bypass surgery experienced complete resolution of sleep apnea.
• 94.6% of patients who had gastric banding surgery experienced complete resolution of sleep apnea.

Acid reflux, also known as gastroesophageal reflux disease, is injury to the esophagus caused by chronic exposure to stomach acid. It is a serious disease that can cause esophagitis, ’s esophagus, and esophageal cancer (adenocarcinoma).

• 98% of patients who had gastric bypass surgery experienced complete resolution of acid reflux/GERD.
• 32.3% of patients who had gastric banding surgery experienced complete resolution of acid reflux/GERD.

Morbid obesity may put you at a higher risk for several types of cancer, such as colon, breast, and kidney cancer. In 2003, an article in the New England Journal of Medicine estimated that obesity could account for:

• 14% of all deaths from cancer in men
• 20% of all deaths from cancer in women

Depression is an illness that involves the body, mood, and thoughts. It affects the way a person eats, sleeps, thinks, and feels. There are many reasons people with morbid obesity experience depression. Emotional health goes hand in hand with physical health. Lifestyle improvements and renewed health can help resolve depression. Weight loss, combined with counseling, can be very helpful in improving mental health.

• 47% of patients who had gastric bypass surgery experienced improvement of depression symptoms.

Osteoarthritis is one of the most common forms of arthritis. Known as the wear-and-tear kind of arthritis, osteoarthritis is a chronic condition in which there is a breakdown of joint cartilage.

For anyone who is living with morbid obesity, the excess body weight placed on joints, particularly knees and hips, results in rapid wear and tear, and pain caused by inflammation.

Bariatric surgery can reduce much of this weight over a long period of time and can be very effective in treating osteoarthritis.

• 41% of patients who had gastric bypass surgery experienced complete resolution of osteoarthritis.

Among women, morbid obesity is a risk factor for stress urinary incontinence, or uncontrollable urine loss. A large, heavy abdomen and relaxation of the pelvic muscles due to morbid obesity may cause the valve on the urinary bladder to weaken, leading to leakage of urine with coughing, sneezing, or laughing.

Bariatric surgery has been found to improve stress urinary incontinence. Less weight is placed on the bladder, and other physical changes take place to improve this condition.

• 44% of patients who had gastric bypass surgery experienced complete resolution of stress urinary incontinence.

Reproductive health can be a concern for women struggling with morbid obesity. Issues such as infertility (the inability or reduced ability to produce children) and menstrual irregularities may occur due to morbid obesity. Fertility issues include possible miscarriage, reduced success with fertility treatments, and polycystic ovarian syndrome (PCOS).

Additionally, women living with morbid obesity are more likely to have children with certain birth defects. A recent study of women following gastric bypass surgery

• 100% of patients who had gastric bypass surgery experienced complete resolution of menstrual dysfunction due to PCOS.
• 79% of patients who had gastric bypass surgery experienced complete resolution of excess hair due to PCOS.
• Patients who had gastric bypass surgery experienced restored ovulation and fertility.

The fear of surgery is not irrational or abnormal; in fact, it’s very common. Bariatric surgery creates a smaller stomach pouch and, depending on the procedure, may shorten the digestive tract—all while the patient is under general anesthesia.

• Share your concerns and fears with your surgeon.
• Attend a support group and speak with patients who likely share the same fears.
• Understand the complication rates and mortality rates of surgery.
• Listen to bariatric surgery patients share their own fears and concerns.