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What Happens During Weight Loss Surgery?

Deciding on Weight Loss Surgery continued...

The basic requirements for weight loss surgery are:

  • Body mass index (BMI) of 40 or greater
  • BMI of 35 to 40 for people with heart disease, diabetes, high cholesterol, or obstructive sleep apnea
  • For the LAP-BAND surgery, someone only needs a BMI of 30 or higher if they also have at least one obesity-related condition, such as diabetes.

In general, doctors want to operate on people who've been unable to achieve lasting weight loss with lifestyle changes alone. Some doctors, but not all, even require patients to lose some weight before having surgery.

"They ought to try diet and exercise first," says Walter Pories, MD, a bariatric surgeon at East Carolina University's Brody School of Medicine. But when that's not enough, "surgery can be extremely effective."

After Weight Loss Surgery

All weight loss surgery, whether open or laparoscopic, is done under general anesthesia and involves a short hospital stay. Laparoscopy is a technique used to operate without cutting open the abdomen to get at the organs. Laparoscopy leaves smaller scars than open surgery and tends to have fewer complications and quicker recovery time. Ninety percent of gastric bypasses are done this way.

Fortunately, there is very little risk of dying during bariatric surgery, with rates near .1%. Serious complications after surgery are possible, but rare. To have the best chance of avoiding complications, it's important to go to all your follow-up visits and stick to your prescribed diet and lifestyle plan.

Immediately after surgery, your digestive system will be very tender. "It's like being a baby," Higa says. "You don't feed a baby prime rib."

For the first day or two after bariatric surgery, you will only have a tiny amount of clear liquids such as water, fruit juice, and broth. After that you may start to sip denser liquids such as milk, smooth cooked cereal, and pudding. For the next three to four weeks, you'll eat several tiny portions each day of pureed food and liquids. In the second month, you may begin to eat soft, moist, chewed food, including ground meat. Three months after bariatric surgery, you may be back to a regular diet. Nevertheless, you'll never be able to eat big portions again.

Weight loss after bariatric surgery can be dramatic and immediate. After gastric bypass surgery, for example, people may lose as much as a pound a day for the first three months.

Weight loss surgery can also improve or cure some health conditions related to obesity. For example, research published in The New England Journal of Medicine in April 26, 2012 found that in obese patients with diabetes, bariatric surgery resulted in better blood sugar control than medication.

People preparing to have weight loss surgery should expect a lot of things to be different afterwards. "This is not just to lose weight or get rid of diabetes," Pories says. "This will totally change their lives."

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WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on May 29, 2012

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