How to Prepare for Weight Loss Surgery

Exactly what your surgeon will do when you get weight loss surgery depends on what type of surgery you're having. Weight loss surgery works in three basic ways:

  • Drastically limiting how much food your stomach can hold at any time. This is "restrictive" weight loss surgery.
  • Preventing your digestive system from absorbing all the nutrition in the food you eat. This is "malabsorptive" surgery.
  • A combination of these two ways

The differences in the procedures are:

Restrictive Weight Loss Surgery

Restrictive types of weight loss surgery include intragastric balloon and vertical sleeve gastrectomy.

They make less room in the stomach for food right after it's swallowed.

The intragastric balloon is a saline-filled silicone balloon that is placed in the stomach, limiting the amount of food you can eat and making you feel full faster.

Vertical sleeve gastrectomy involves removing about 75% of the stomach. What remains of the stomach is a narrow tube or sleeve, which connects to the intestines.

Malabsorptive Weight Loss Surgery

Gastric bypass and biliopancreatic diversion are malabsorptive surgeries.

Gastric bypass surgery involves leaving the stomach as a small pouch. The difference between gastric bypass and restrictive surgeries is that food doesn't pass through the pouch to be further digested in the larger part of the stomach.

Instead, the pouch empties directly into the small intestine. To make this work, the small intestine is severed. The surgeon connects one end of it to an opening in the new stomach pouch.

After this surgery, when you eat, food bypasses most of your stomach and the first part of your small intestines. That makes this surgery both restrictive and malabsorptive.

Surgeons rarely do weight loss surgery that's only malabsorptive. One exception is a surgery that removes much of the stomach. That surgery is called a biliopancreatic diversion with a duodenal switch.

What Happens Before Weight Loss Surgery?

Ahead of any weight loss surgery, you'll go through an evaluation that includes counseling and various tests.

All types of weight loss surgery have pros and cons. Those that involve more cutting, sewing up, and rearranging things inside your body may give slightly better results, but they also may come with more side effects.

You may want to ask:

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How Much Weight Will I Lose?

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 2 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.

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What’s the Recovery Period?

Recovery time varies depending on the type of surgery. Recovery from restrictive weight loss surgery like the intragastric balloon 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 $15,000 to $25,000 on average. There may be financing options; check the terms carefully so you know what you're getting into.

WebMD Medical Reference Reviewed by Jabeen Begum on October 08, 2021

Sources

SOURCES:

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.

News release, Allergan.

American Society for Metabolic and Bariatric Surgery: "Bariatric Surgery."

Kelvin D. Higa, MD, program director of minimally invasive and bariatric surgery, Fresno Heart & Surgical Hospital, Fresno, CA; past president, American Society for Metabolic and Bariatric Surgery.

Walter Pories, MD, professor, founding chair of surgery department, Brody School of Medicine at East Carolina University, Greenville, NC.

Buchwald, H. The Journal of the American Medical Association, Oct. 13, 2004.

Sjöström, L. New England Journal of Medicine, Dec. 23, 2004.

Colquitt, J. Cochrane Database of Systematic Reviews, 2009.

Brolin, R. The Journal of the American Medical Association, Dec. 11, 2002.

Buchwald, H. Surgery, October 2007.

McMahon, M. Mayo Clinic Proceedings, October 2006.

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