Keep in mind that weight loss surgery is for people who are obese (body mass index, or BMI, is 30 or more).
How much weight you lose in the first year after surgery depends on the type of surgery. You may lose between 50% and 70% of your extra body weight within two years after surgery.
How Do I Find a Surgeon?
When you're considering bariatric surgeons, ask the following questions:
Are they board-certified by the American Board of Surgery?
Are they members of the American Society for Metabolic and Bariatric Surgery?
What’s their success rate?
How many weight loss surgeries do they perform each year?
How often do their patients have complications? What side effects are most common?
Look for a center or hospital that offers educational seminars, or for support groups that you can turn to before and after your operation.
What Should I Expect Before the Surgery?
Your doctors may ask you to lose some weight before surgery to show your commitment to change, and to improve your health. Some surgeons ask people to try to lose 15 pounds to 30 pounds before surgery.
If you smoke, your doctor will likely tell you to quit, both for your long-term health and to cut the chances of problems from your operation. Smokers are more likely to have complications, such as pneumonia, from surgery.
You may also meet with a nutritionist about changing the way you eat. When people start building better food habits before surgery -- eating smaller portions, eating slowly, paying closer attention to the nutritional makeup of meals -- they often adapt better to life after surgery.
The process may also require a psychological evaluation.
What Are the Risks?
All surgeries carry some risk of infection or blood clots. Being obese makes complications more likely, particularly if you have early signs of diabetes or heart disease.
You should get a thorough checkup to find any potential problems before surgery. Using an experienced and qualified surgeon is also critical.
There’s also a chance of getting medical problems due to nutritional deficiencies such as anemia. Your doctor will want to monitor your nutritional health with regular checkups as well as have you follow a healthy diet and exercise plan that may include taking supplements.
What’s the Recovery Period?
Recovery time varies depending on the type of surgery. Recovery from gastric banding usually takes at least 1 week, and with a gastric bypass, it is often up to 4 weeks.
Because of new techniques, weight loss surgery can often be performed with minimum invasion, via small incisions. In a few centers around the country, weight loss surgery is even done on an outpatient basis.
How Do I Pay for Surgery?
Contact your insurance company to ask what it covers and what it requires. Many insurance companies want to know what you've done to try to lose weight before surgery.
Paying for weight loss surgery yourself is very expensive. A typical weight loss operation can run from $20,000 to $25,000. There may be financing options; check the terms carefully so you know what you're getting into.
Daniel Herron, MD, bariatric surgery chief, Mt. Sinai Hospital, New York.
James Kolenich, MD, former University of Pennsylvania Medical Center bariatric surgeon.
Joe De Simone, PhD, psychologist, New York.
Harvey J. Sugerman, MD, editor-in-chief, Surgery for Obesity and Related Diseases; bariatric surgeon, Sanibel, FL.
American Obesity Association.
National Institute of Diabetes and Digestive and Kidney Diseases.