General Surgical and Administrative Questions
What kind of weight loss expectations should I have?
It is impossible to predict the exact amount of weight that a patient is expected to lose. Factors that change excess weight loss potential include the procedure being performed and the patient’s habits and lifestyle after surgery. The success of the procedure will also, of course, determine the amount of weight that can be lost.
It is important to note that weight loss surgery is not a silver bullet, meaning that it does require significant lifestyle changes in the form of dietary and exercise modifications after surgery in order to achieve weight loss goals. On average, we hope for our patients to lose between two to three pounds a week in the first year after the operation, however, one pound a week is a more realistic expectation.
In total, gastric banding patients can expect to lose between 45 and 55% of their excess body weight over the course of three years, and gastric sleeve patients may lose between 50 and 60% of their excess body weight.
Losing weight too quickly can be dangerous, however, and it is important to remember that the primary goal of weight loss surgery is to improve the diseases associated with morbid obesity and improve overall health. Losing weight too quickly works against that goal.
Do I qualify for insurance coverage for bariatric surgery?
Each patient’s insurance policy is unique and as a result it is important to understand the covered items and exclusions from your policy. Contact your insurance company or agent to fully understand the terms of your policy. You may also contact us for a free insurance verification. You may also learn more about Paying for Bariatric Surgery.
How do gastric banding results compare with gastric bypass?
Generally speaking, the weight loss potential after gastric banding is lower than that of the gastric bypass, since gastric bypass patients both restricts the intake of food and limits the number of calories being absorbed into their bloodstream. The weight is also lost at a more gradual pace with gastric banding. Gastric bypass patients typically lose all of their excess weight within the first 12 months, while banding patients may take two to three years to lose their excess body weight.
While gastric banding does offer less excess weight loss potential, it also has the lowest serious complication rates of all the major bariatric surgeries.
What is the recovery time after surgery?
Both the gastric banding procedure and the gastric sleeve / sleeve gastrectomy are performed in a minimally invasive manner, which means that patients are usually able to leave the hospital after spending one night. In most cases, patients will return to work within a week or two, and exercising and more strenuous activity can be resumed after six weeks of healing. If there are any complications during or after surgery, full recovery may take longer.
Is recovery painful?
Most patients will feel discomfort and soreness rather than pain. This varies between patients however and recovery is different for all of us.
Does the band preclude me from enjoying strenuous physical activity?
The gastric band should not affect a patient’s ability to perform physical activity, including strenuous activity such as weight lifting, aerobics and sports. It is very important to remember, however, that during the recovery period after surgery, patients should limit their strenuous physical exercise and follow doctor’s orders very carefully to avoid complications
Will I need to frequently visit the office after surgery?
The gastric band is adjustable, and therefore, regular checkups at your bariatric surgeon’s office, both to monitor your weight loss progress and to adjust the band will be necessary for the first year after surgery. After the first year, you will likely have to visit your bariatric surgeon twice a year for the next couple years and then once per year after that.
The gastric sleeve does not require as intense a follow-up. In the first year you will visit your surgeon a few times to make sure all is well. Longer-term you will likely only need a yearly check-up.
How is the band adjusted?
Band adjustments are quick and relatively painless procedures performed right here in our office. Depending on the patient local anesthesia can be administered. A very fine needle is passed through the skin to inject saline into or remove saline from the band. The entire process takes about 10 minutes.
Is the Access Port under my skin fragile?
Generally speaking, no. The port is sutured to the abdominal wall so it will take a bit of time to heal. After healing, the access port is meant to conform to your body and lifestyle and should not limit activities or cause discomfort. You will only feel a sensation from your port during adjustments. If the port causes persistent discomfort, please contact Dr. Lublin as soon as possible.
Can the gastric band be removed?
The gastric band is fully adjustable and it can indeed be removed in cases of need. However, the gastric band is meant to be a permanent fixture in the abdomen. If the band is removed, the stomach usually returns to its original shape which also means that patients will likely regain the weight that they lost as a result of surgery. It’s possible that some patients will gain even more. Because of potential scarring, other bariatric procedures may not be able to be performed.
Will I need plastic surgery for excess skin?
Many patients will have some sort of excess skin as a result of either the amount of weight they lost, the time in which they lost it, or their age and skin elasticity. Generally speaking, cosmetic surgery is a possibility after about a year of recovery. Cosmetic procedures are still major surgery and patient should be at there at or near their goal weight before they undergo the procedure to remove excess skin.
Common Aftercare Considerations:
What is life like after surgery?
Both gastric banding and gastric sleeve procedures require you to embark on a lifelong lifestyle change for the healthier. You will have to limit the amount they eat and exercise regularly. The procedure will help you accomplish this by allowing for satiety and the feeling of fullness with less food. Very positive changes will become a reality if you follow the post bariatric surgery lifestyle recommended by our office.
Does the band seem tighter in the morning?
Some patients do feel like the band feels tighter at certain times of day. This is usually because of the patient’s water retention, which is also why some women feel like the band is tighter when they are menstruating. The body constantly changes its water content and as such the band may feel different at different parts of the day. Patients may also feel some tightening after a band adjustment
Will I experience nausea or vomiting after bariatric surgery?
Gastric banding restricts the amount of food that can be ingested in any one sitting, therefore, if you feel nauseous, bloated, or uncomfortable regularly, it is possible that your food is not being chewed properly or fully, or that you are deviating from the prescribed gastric banding diet. The gastric sleeve also works by limiting the amount of food that can be consumed, and while the feelings may be slightly different, diet and chewing habits have a great deal to do with the discomfort that you may feel. Occasionally, uncomfortable feelings may mean a more serious problem, specifically with the placement of the band.
If the problem continues, you should contact your bariatric surgeon. Try to avoid vomiting since it can make the stomach pouch stretch and enlarge. It can also cause part of the stomach to move up through the band, called slippage. Both cases reduce the weight loss potential of the surgery and occasionally may require a second revisional surgery.
What happens if I become ill?
Because the band is adjustable, it does allow us to change the restriction based on your general health. If you become ill and need to eat more, the band can be loosened until you recover from your illness and wish to get back on your weight loss journey. If the band cannot be loosened significantly enough, it may have to be removed. Please note that the gastric sleeve is not a reversible procedure.
Can I become pregnant?
Getting pregnant becomes easier as you start to lose excess weight because hormonal imbalances start to correct themselves. Generally, menstrual cycles become more regular as a result. The gastric band can be loosened during pregnancy if the patient needs to eat more. The gastric sleeve is not adjustable, however usually allows a patient to eat significant enough quantities for pregnancy. Vitamin supplementation is also an option.
Will I need vitamin supplementation?
Starting immediately after surgery, you will need to begin taking a multivitamin depending on your blood levels at your annual checkups. Other supplements such as protein, may have to be taken for a period of time as well. Learn more about vitamin supplementation.
What about other medications?
Patients should continue to take their usual medications as prescribed by their physician. In the cases of larger capsules or big tablets, they may be broken half or dissolved in water to allow them to pass more easily through the band. Gastric sleeve patients should not have to modify their medications.
Diet and Exercise
Will I feel hungry?
Both gastric banding and gastric sleeve procedures are meant to help you eat less and feel full sooner. While, at first, hunger may be a challenge, the brain is usually retrained to feel satisfied on less food. Further because of the nature of the gastric band, food tends to pass more slowly through the stomach into the intestine meaning that there is a constant flow food for longer periods. The most important part of your diet after surgery is to follow the guidelines provided by our office they are meant to balance satiety with effective weight loss.
Can I go out to eat after surgery?
The short answer is yes, with some conditions. Be sure to order or take a small amount of food. You may consider sticking to appetizers rather than entrees. Other tips include eating slowly, chewing thoroughly and finishing at the same time as your table companions who may be eating more. If you are going to a friend or family member’s house, you may wish to let them know you won’t be eating very much.
What about Alcohol?
The occasional glass of wine or other alcoholic beverage is generally suitable after fully healing from a weight loss surgery procedure. Remember though that alcohol is high in calories, especially mixed drinks and it can break down vitamins in your body.
Can I eat just about anything in moderate portions?
The rule of thumb is that after fully healing, patients can safely eat just about anything that doesn’t cause them discomfort. It is important to remember a few things however. First, you will be eating much less food and therefore you must make sure that what you eat is nutritious. Second, eating or drinking lots of sugary or fatty foods and drinks will negate the weight loss that you should experience after your procedure. Please refer to your post-operative plan to understand more about what to and not to eat.
How much exercise is necessary after weight loss surgery?
Exercise is a critical part of success after weight loss surgery. Within the first few weeks after surgery, you will be expected to start basic exercises. These exercises will increase in intensity as you build stamina and lose weight. The ultimate goal is for 30 minutes of vigorous exercise, three or more times per week.