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Bariatric Surgery: Frequently Asked Questions

1. Why does the Roux-en-Y Gastric Bypass work better than other weight loss operations?
   The Roux-en-Y gastric bypass has been the most successful surgical procedure for total weight long-term maintenance with the least metabolic complications. Several factors appear to play to this success:
   • Gastric Restriction: After the surgery, your stomach will only be able to hold about two to four tablespoons at a time, and the connection between your stomach and small intestine is approximately one-third to on-half inch in diameter. This drastically reduces the amount of food you can easily consume at one time, and food must be chewed into small particles to enter the small intestine for absorption.
   • Calorie and Nutrient Malabsorption: The body normally absorbs calories and nutrients during all stages of digestion. With two of the three areas of the small intestine bypassed, the body has less of an opportunity to absorb digestive material. The fewer calories your body takes in, the greater the weight loss.
   • Lower Tolerance of High-Fat Foods: Many Roux-en-Y gastric bypass patients become less tolerant of foods high in refined sugar, starches and fates because these foods enter the small intestine very quickly. These foods may cause nausea, vomiting, diarrhea, weakness, sweating faintness known as "Dumping Syndrome".
   
   
   
2. Is this procedure like liposuction?
   The surgery is NOT at all like liposuction. In liposuction, fat it suctioned from your body. In gastric bypass surgery, your stomach is reconstructed, reducing the amount of food you want to eat and your intestine shortened and reconnected, reducing absorption of calories from food you do eat.
   
   
3. Will my insurance cover this procedure?
   Many insurance plans will cover Bariatric surgery if you meet the National Institutes of Health guidelines. It is your responsibility to contact your insurance company to be sure they will pay for the surgery. We will request approval from your insurance company and send copies of all your medical records.
   
   
4. Is any of the cost tax deductible?
   In April 2002, the Internal Revenue Service issued a new regulation that acknowledged obesity as a disease itself. By doing so, the IRS agreed to treat costs for obesity treatment including weight loss surgery - assuming a medical diagnosis of obesity - as any other medical expenses. All obesity medical treatment expenses beyond the existing minimum 7.5% of gross income are now deductible.
   
   
5. What is the cost of the surgery if my insurance does not pay for it?
   The cost of the hospital portion of the surgery will be approximately $13,000.
   
   
6. Can I get pregnant after Roux-en-Y gastric bypass surgery?
   It is strongly recommended that appropriate means of birth control be utilized for 2 years after Bariatric surgery. The maximum weight loss from surgery is incurred 18 - 24 months post operatively. Caloric intake needs change and new lifestyle behaviors begin. Pregnancy demands higher daily caloric intake, and dieting is not an option during pregnancy.
   
   
7. How do I know that I won't just keep losing weight until I waste away to nothing?
   Patients may begin to wonder about this early after the surgery when they are losing 20 - 40 pounds per month, or maybe when they've lost more than 100 pounds and they are still losing weight. Two things happen that allows the weight to stabilize: the patient's ongoing metabolic needs from calories decrease as the body sheds excess pounds and there is a natural progressive increase in calories and nutrient intake of the months following the weight loss surgery. The stomach pouch and attached small intestine learn to work together better and there is some expansion in the pouch size over a period of months. The bottom line is that patients are very unlikely to lose weight to the point of malnutrition.
   
   
8. Will I lose any hair?
   Hair loss can accompany any rapid and significant weight loss. pproximately 30% of patients complain of hair thinning which usually develops between two and four months after surgery. Most re-growth occurs when their weight stabilizes and they have eaten enough protein and vitamin supplements.
   
   
9. When will I be able to return to work?
   Most patients are able to return to work in 4 - 6 weeks.
   
   
10. Will I need to have the surgery reversed after losing the weight?
    No. Bariatric surgery is a life-long procedure that helps maintain weight loss. Most patients lose 70 percent of their excess weight within the first 18 months after surgery. They will continue to lose weight until the goal weight is reached.