Who Qualifies For Bariatric Surgery?

There are certain criteria established by the National Institute of Health for bariatric surgery. A patient may meet the standards that classify them as “eligible” for surgery, but insurance still may not cover the surgery. (See the section on insurance to learn more.) The following are criteria used to determine eligibility; however, these criteria are not universal standards:

• 75 to 100 lbs. over “ideal” body weight. The Metropolitan Life Weight Table is the standard used in determining a patient’s ideal body weight.
• Medical conditions that are likely to benefit from weight reduction, including hypertension, sleep apnea, diabetes, congestive heart failure, arthritis, reflux disease, back or joint problems, or other obesity related disorders.
• Inability to maintain weight loss through other methods.
• Free from alcohol or drug dependence. If there is a history of alcohol or drug dependency, the person should be well into a good treatment program with a minimum of one-year sobriety.
• No severe psychological, emotional, or medical problems that would make the surgery unsuccessful.
• Highly motivated to follow a weight loss regimen.
• A willingness to make a formal commitment to a dramatic change in lifestyle.

What Are the Complications or Risks of Bariatric Surgery?

It is important to understand that all surgeries carry a risk of complication, and this procedure is no exception. The risk of death is about .5 percent, as documented in the 20,000 patients accessed to The National Bariatric Surgery Registry. Complications can be divided into two categories: those specific to the bariatric procedure and those common to any major abdominal surgery.

The following complications may occur after bariatric surgery, but are not limited to:

• Stricture (partial closing) of the surgically created anastomosis (1 percent)
• Disruption of the suture lines with leak and/or abscess, peritonitis (1 percent)
• Injury to spleen during surgery or major hemorrhage (1.5 percent)

It is important to recognize that disruption of the suture line can occur due to overfilling the pouch. This occurs from eating past the point of being satisfied. Overfilling can cause the stomach to stretch, as well as the sutures to pull apart. This can cause leakage or failure of the operation. It is extremely important to avoid fibrous foods for the first six weeks after the operation – the stomach and intestines cannot digest these foods properly. Food that cannot be easily digested sits in the stomach and can form a mass, called a bezoar. The body causes severe vomiting in an effort to expel undigested foods. This violent vomiting can cause disruption to the suture line as well.

The following complications may occur after any abdominal surgery, but are not limited to:

• Incisional hernia (10 percent)
• Marginal ulcer or obstruction (1 percent)
• Intestinal obstruction (1 percent)
• Respiratory complications (1 percent)
• Stroke or heart attack (0.1 percent)
• Wound dehiscence (1 percent)
• Anesthetic complications (0.1 percent)

What Can I Expect After Bariatric Surgery?

Success for permanent weight loss involves committing yourself to a new way of life. As you consider bariatric surgery as a possible option, it is necessary to understand that success depends on making significant life style changes. The operation itself will bring weight loss by forcing you to change your eating habits. For a successful outcome, it will be necessary to exercise regularly and follow the postoperative dietary guidelines. With compliance, the surgery will help you lose weight, and with continued commitment you can maintain that weight loss.

What Can I Do to Achieve Optimal Results and Maintain Weight Loss?

There are several steps you can take to achieve optimal results and maintain weight loss, including:

• Precisely follow postoperative diet instructions.
• Regular exercise five to seven days a week, lasting approximately 45 minutes a day.
• Utilize support groups.
• Begin eating three meals a day six weeks after your surgery. Make healthy choices.
• No snacking.
• No high calorie beverages.
• Do not skip meals.
• No liquids with meals. Stop drinking 30 minutes before meals and wait to start drinking 30 minutes after meals.

General Information

The surgery usually requires a hospital stay between two and four days. Each individual recovers at a different rate.

It generally takes about six weeks to recover from any type of major abdominal surgery. Some patients feel a sense of well being soon after surgery as their weight begins to come off. If you have a desk job you can usually return to work three weeks after discharge from the hospital. However, if you have a job that requires lifting or excessive stretching and bending, you will need to wait six to eight weeks.

It is important to be examined in our office the first, third, sixth, ninth, and 12th month following surgery. Your first follow-up visit will be between one and two weeks after surgery. At that time we will check your incision and answer any questions. Gastric bypass surgery-related follow-up visits are free of charge for three months. However, there will be a charge for any necessary laboratory work or x-rays.

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