Bariatric Surgery FAQs

Frequently Asked Questions Related to Morbid Obesity and Bariatric Surgery

How does bariatric weight loss surgery work, and could it help you?

Below are some frequently asked questions about bariatric surgery, morbid obesity, co-morbid conditions and how to cope with concerns about bariatric surgery. For more information about bariatric surgery, support groups, or Virginia Mason's surgeons, call (800) 354-9527, ext. 11997.

  1. What is morbid obesity?
  2. What causes morbid obesity?
  3. What is a co-morbid condition?
  4. What is bariatric surgery?
  5. Is bariatric surgery right for me?
  6. What are complications and risks associated with bariatric surgery?
  7. What are the possible side effects of bariatric surgery?
  8. What is the difference between laparoscopic, or minimally invasive surgery and an open procedure?
  9. Why would I have an open procedure?
  10. What is Roux-en-Y gastric bypass surgery?
  11. What is a gastric banding procedure?

Co-Morbid Conditions

  1. What is a co-morbid condition?
  2. What is type 2 diabetes and how is it affected by bariatric surgery?
  3. What is high blood pressure (hypertension) and how is it affected by bariatric surgery?
  4. What is sleep apnea and how is it affected by bariatric surgery?
  5. What is acid reflux or gastroesophageal reflux disease (GERD) and how is it affected by bariatric surgery?

Coping with Concerns

  1. How can I deal with my fear of surgery?
  2. How does bariatric surgery change my body?
  3. What is "dumping syndrome?"
  4. What is the long-term follow-up schedule?

  1. What is morbid obesity?
    Morbid obesity is a Body Mass Index (BMI) of 40 or more, which is roughly equal to 100 pounds or more over ideal body weight. The disease of morbid obesity often interferes with basic physical functions such as breathing or walking. Long-term effects of the disease include shorter life expectancy, serious health consequences in the form of weight-related health problems (co-morbid conditions) such as type 2 diabetes and heart disease, and a lower quality of life with fewer economic and social opportunities.
     
  2. What causes morbid obesity?
    The causes of morbid obesity are multiple and complex. Despite conventional wisdom, it is not simply a result of overeating. Research has shown that, in many cases, significant, underlying causes of morbid obesity are genetic, environmental and social. Studies have demonstrated that once the problem is established, efforts such as dieting and exercise programs have a limited ability to provide effective long-term relief.
     
  3. What is a co-morbid condition? 
    There are two definitions for a co-morbid condition: the presence of one or more disorder or disease in addition to a primary disorder or disease; or, the presence of a disorder or disease that is caused by or otherwise related to another condition in the same patient. The primary disease of morbid obesity can lead to several co-morbid conditions.
     
  4. What is bariatric surgery?
    Bariatric surgery is a procedure designed to make the stomach smaller so the patient feels satisfied with less food. It is intended for people who are 100 pounds or more overweight (with a Body Mass Index of 40 or greater) and who have not had success with other weight loss therapies such as diet, exercise, medications, etc. A person with a Body Mass Index (BMI) of 35 or greater and one or more co-morbid condition also may qualify for bariatric surgery.
     
  5. Is bariatric surgery right for me?
    Talk with your surgeon about the different surgical treatments, as well as the benefits and risks. Remember: 

    1. Bariatric surgery is not cosmetic surgery.
    2. Bariatric surgery does not involve the removal of adipose tissue (fat) by suction or surgical removal.
    3. The patient must commit to long-term lifestyle changes, including diet and exercise, which are key to the success of bariatric surgery.
    4. Problems after surgery are rare, but corrective procedures may be required.
      
  6. What are complications and risks associated with bariatric surgery?
    As with any surgery, there are immediate and long-term complications and risks. Possible risks can include, but are not limited to:
      
    • Bleeding
    • Complications due to anesthesia and medications
    • Deep vein thrombosis
    • Dehiscence (separation of areas that are stitched or stapled together)
    • Infections
    • Leaks from staple lines
    • Marginal ulcers
    • Pulmonary problems
    • Spleen injury
    • Stenosis (narrowing of a passage, such as a valve)
    • Death
     
  7. What are the possible side effects of bariatric surgery?
    Side effects include:
      
    • Vomiting
    • Dumping syndrome
    • Nutritional deficiencies
    • Gallstones
    • Need to avoid pregnancy temporarily
    • Nausea, vomiting, bloating, diarrhea, excessive sweating, increased gas and dizziness
     
  8. What is the difference between laparoscopic, or minimally invasive surgery and an open procedure?
    Open surgery involves the surgeon creating a long incision to open the abdomen and operating with "traditional” medical instruments. Laparoscopic, or minimally invasive surgery is an approach that allows the surgeon to perform the same procedure using several small incisions, a fiber-optic camera, video monitor, and long-handled instruments.
      
  9. Why would I have an open procedure?
    The decision to perform minimally invasive or open surgery (laparoscopic) is made by your surgeon before the operation. For some patients, the laparoscopic, or minimally invasive, technique cannot be used due to dense scar tissue from prior abdominal surgery. Also, the inability to see organs and/or bleeding during the operation can cause your surgeon to switch from minimally invasive to open surgery during your operation.
     
  10. What is Roux-en-Y gastric bypass surgery?
    Roux-en-Y (pronounced ROO-en-why) gastric bypass surgery is the most popular bariatric surgery in the United States. In this procedure, the surgeon creates a small stomach pouch and then constructs a “bypass” of some of the small intestine. The smaller stomach pouch restricts the amount of food the patient can comfortably eat, and the bypass decreases the number of nutrients and calories absorbed.
     
  11. What is a gastric banding procedure?
    Gastric banding is a purely restrictive surgical procedure in which a silicone band is placed around the uppermost part of the stomach. The band is adjustable and can be periodically tightened or loosened depending on the patient’s needs.

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Co-Morbid Conditions

  1. What is a co-morbid condition?
    There are two definitions for a co-morbid condition: the presence of one or more disorder or disease in addition to a primary disorder or disease; or, the presence of a disorder or disease that is caused by or otherwise related to another condition in the same patient.
     
  2. What is type 2 diabetes and how is it affected by bariatric surgery?
    Type 2 diabetes is a long-term metabolic disorder where the body produces insulin, but resists it. Insulin is necessary for the body to utilize sugar.

    • 83.8 percent of patients who had gastric bypass surgery experienced complete resolution of type 2 diabetes.
    • 47.8 percent of patients who had gastric banding surgery experienced complete resolution of type 2 diabetes.
    • Patients who had bariatric surgery had lower insulin resistance, and their risk for metabolic syndrome, high blood pressure, and high amount of fats in the blood also decreased.
     
  3. What is high blood pressure (hypertension) and how is it affected by bariatric surgery?
    Excess body weight is associated with an increased risk of heart disease, elevated cholesterol, and high blood pressure. These conditions can lead to heart attacks, strokes, angina and arrhythmias. Bariatric surgery reduces excess body weight over time, which decreases strain on the heart.
     
    • 75.4 percent of patients who had gastric bypass surgery experienced complete resolution of high blood pressure.
    • 38.4 percent of patients who had gastric banding surgery experienced complete resolution of high blood pressure.
    • Changes in diet and exercise after surgery can lead to significant improvement of cardiovascular problems.
     
  4. What is sleep apnea and how is it affected by bariatric surgery?
    Obstructive sleep apnea is when breathing suddenly stops because soft tissue in the back of the throat collapses and closes during sleep. People with obstructive sleep apnea are at risk for heart disease, high blood pressure, heart attack, and daytime drowsiness.
     
    • 86.6 percent of patients who had gastric bypass surgery experienced complete resolution of sleep apnea.
    • 94.6 percent of patients who had gastric banding surgery experienced complete resolution of sleep apnea.
     
  5. What is acid reflux or gastroesophageal reflux disease (GERD) and how is it affected by bariatric surgery?
    Acid reflux, also known as gastroesophageal reflux disease, or GERD, is injury to the esophagus caused by chronic exposure to stomach acid. It is a serious disease that can lead to esophagitis, Barrett’s esophagus, and esophageal cancer (adenocarcinoma).
     
    • 98 percent of patients who had gastric bypass surgery experienced complete resolution of acid reflux/GERD.
    • 32.3 percent of patients who had gastric banding surgery experienced complete resolution of acid reflux/GERD.

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Coping with Concerns

  1. How can I deal with my fear of surgery?
    The fear of surgery is not irrational or abnormal; in fact, it’s very common. Bariatric surgery creates a smaller stomach pouch and, depending on the bariatric procedure, may shorten the digestive tract — all while the patient is under general anesthesia. If you have concerns, consider the following:
     
    • Share your concerns and fears with your surgeon.
    • Attend a support group and speak with patients who likely share the same fears.
    • Understand the complication rates and mortality rates of surgery.
    • Listen to bariatric surgery patients share their own fears and concerns.
     
    And remember, you’ll have a team of health care professionals dedicated to your best possible care.
     
  2. How does bariatric surgery change my body?
    For people who have spent years living with morbid obesity, bariatric surgery can transform their lives. However, it’s important to be prepared for all aspects of the treatment. Surgery changes your body by creating a smaller stomach pouch. Learn more about the different types of bariatric procedures.
     
  3. What is "dumping syndrome?"
    Eating simple sugars (such as sugar, honey and corn syrup) or high-fat foods can cause dumping syndrome in patients who have had gastric bypass surgery. This occurs when these products, which have a small particle size, are “dumped” from the stomach into the intestine at a rapid rate. Water is pulled into the intestine from the bloodstream to dilute the sugar load. This flush of water causes symptoms that can include diarrhea, rapid heart rate, hot flashes or sweating and clammy skin, and dizziness.
     
  4. What is the long-term follow-up schedule?
    Band patients need to work with their surgeons to have their band adjusted several times during the first 12 to 18 months after surgery. Bypass patients typically see their surgeons for three to five follow-up appointments the first year, then once per year thereafter. Over time, gastric bypass patients will need regular checks for anemia (low red blood cell count) and vitamin B12, folate, and iron levels.

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