One of the most important considerations for deciding whether or not to have bariatric surgery revolves around expectations for weight loss and disease resolution after surgery. After all, even a successful bariatric procedure maybe a disappointment if your expectations are set unreasonably high.
Before Getting Into Weight Loss Expectations
Patients must explore the true reason for bariatric surgery – and that is to improve or eliminate the disease associated with morbid obesity. Your weight loss number, albeit the most tangible measure of success, is actually secondary. Most patients lose a significant amount of weight after bariatric surgery. On the lower end patients who undergo a weight loss balloon or a gastric band procedure can expect to lose between 15 and 40% of their excess body weight. Being that there are significant drawbacks associated with both of these procedures however, we do not perform them. We believe that stapled procedures, such as the gastric bypass or gastric sleeve, have significantly better results, including up to 85% excess body weight loss potential and significant improvement or complete elimination of many diseases associated with obesity, such as high blood pressure, high cholesterol, sleep apnea and acid reflux.
You must also set expectations for what you will experience after surgery. After all, surgery is not the "be all and end all" of weight loss – your lifestyle changes in the months and years after surgery will go along way to determining your ultimate success. You will experience changes in your body and mind and will feel a range of emotions, from excitement to frustration. It will take time for your life to normalize after surgery.
You should also know what to expect in the form of risks and considerations. Of course, all surgeries have some risk. However, with improvements in technique and technology, bariatric surgery has become safer than many common procedures such as hysterectomy, appendectomy and gallbladder removal. In the immediate post-operative time, you will be at greater risk of infection and will experience some discomfort, but following your post-operative instructions can minimize the risks.
You will also learn that each procedure comes with some very specific considerations after surgery. Because of the combination of malabsorption and restriction offered with the gastric bypass, patients will have a more restricted diet and will likely require more vitamin and nutrient supplementation. Further, gastric bypass patients will be more affected by alcohol and may experience an uncomfortable but not life-threatening condition known as dumping syndrome when they eat large meals, or those with high amounts of fat and/or sugar.
Gastric sleeve patients will not experience dumping syndrome, will have fewer dietary restrictions and may have fewer supplementation needs after surgery. However, a small number of gastric sleeve patients can develop new or worsening gastroesophageal reflux as a result of the procedure. Bariatric surgery is the only proven long-term treatment for obesity, however success requires a combination of expertise on the part of the surgical practice and commitment to lifestyle change on the part of the patient. We hope that you spend the time noting down your questions, concerns and expectations, so that we may review them before surgery and ensure that your procedure is successful.