Surgery Expectations
Health and Diet After Bariatric Surgery
Side Effects and Precautions
Surgery Expectations
Am I eligible for bariatric surgery? How much do you have to weigh to get bariatric surgery?
Individuals with a body mass index of 35kg/m2 and a weight related condition (diabetes, sleep apnea, high blood pressure) or 40kg/m2 or greater are eligible for bariatric surgery.
Who is not a candidate for weight loss surgery?
Individuals who do not meet the BMI criteria are typically not candidates for bariatric surgery. Someone with complex medical and surgical needs may meet the BMI criteria but after meeting with a surgeon, it can be determine that the individual risk is greater than the potential benefit of the surgery. These situations are rare and are discussed individually with your care team.
Do you have to lose weight before weight loss surgery?
Some insurances require weight loss prior to surgery in order for the operation to be covered. However, research has found losing weight before surgery is typically not beneficial enough to require it. Unless your clinician specifically discusses weight loss as a method to reduce your individual surgical risk or your insurance requires it, it is up to you whether you’d like to work towards weight loss before the surgery. Losing weight before can increase your total weight loss (i.e. if your expected weight loss is 50lbs, and you lose 10lbs prior to surgery, your expected total weight loss is 60lbs).
What should I expect during my initial evaluation with the Penn Bariatric and Weight Loss Surgery Program?
During the initial evaluation, you will meet with the surgeon, nurse/nurse practitioner and dietitian, and undergo a complete history, physical exam and nutrition assessment. You will also discuss what to expect from surgery. This entire process takes about one to two hours. Learn more about the process.
What are my responsibilities after the initial evaluation prior to surgery?
You will be provided with a list of consultations and upcoming appointments that are to be completed before surgery. Our office can assist you in scheduling many of these visits if you choose to complete them at Penn Medicine.
How long do I have between the initial evaluation and my bariatric surgery?
On average, the time between your initial visit with the Penn Bariatric and Weight Loss Surgery Program and surgery is four to seven months. This time frame can vary depending upon the insurance company and the rate at which medical clearances are obtained.
Individuals interested in scheduling an appointment with the Penn Bariatric and Weight Loss Surgery Program should call 800-789-7366 (PENN). Patients already enrolled in the Penn Bariatric and Weight Loss Surgery Program should call their surgeon office directly.
How much does weight loss surgery cost?
Procedure costs depend upon the patient, the surgery and any post-operative difficulties that may occur. In many cases, insurance companies will cover the cost of the surgery since morbid obesity can be a life-threatening condition. You should speak with your insurance company to confirm that the surgery and any related expenses are covered.
If you are interested in paying out of pocket for weight loss surgery, one of our coordinators can discuss the process with you.
How long will I be in the hospital for bariatric surgery?
On average, a patient who experiences no complications will stay in the hospital for one to three days. This stay may be extended if you experience any complications or need additional observation. Patients can usually return to work four to six weeks after surgery but should not do any heavy lifting or heavy manual labor until cleared by their surgeon (typically six to eight weeks).
Health and Diet After Bariatric Surgery
Will I be able to return to my regular diet after weight loss surgery?
Following surgery, your meals will likely only consist of two to four tablespoons of food. As you advance your diet, you should be eating “regular” food in very small portions within six to eight weeks of surgery.
How do I get my protein when I eat such small amounts?
Protein is a very important part to both healing and weight loss after surgery. Since your food intake is limited, you should incorporate high protein drinks that are low in fat and sugar into your diet. You may also add protein powder to liquids or certain foods. As you continue to increase the amount and types of food that you eat, you should continue to rely on foods high in protein.
Do I have to take vitamin and mineral supplements for the rest of my life?
Yes, most people do. After surgery, you physically will not be able to eat enough volume of food to get enough vitamins and minerals. There are certain vitamins and minerals that are not absorbed properly after surgery also. Most patients need to take a multivitamin, calcium and vitamin B12 for the rest of their lives. Other vitamin and mineral supplements may also be needed and will be determined on a case-by-case basis.
How long after bariatric surgery can you exercise?
Most people are able to walk and do light exercises immediately after surgery. It is recommended to avoid heavy lifting for 6 weeks after surgery to allow for healing.
What is dumping syndrome and how do I know if I have it? Are there ways to avoid it?
Dumping syndrome happens when foods or drinks that are high in sugar rapidly enter – or dump into – the small intestine. Following gastric bypass surgery, people are particularly sensitive to sugar, making dumping syndrome a concern.
Dumping is not dangerous but it can cause nausea, dizziness, sweatiness, heart palpitations, stomach cramps, and diarrhea. Over time, as the pouch and small intestine learn to work better together, incidents of dumping may decrease.
To avoid dumping syndrome, patients who have had gastric bypass should avoid foods that have sugar – in any form – listed as one of the first three ingredients. Some other names for sugar include:
- Sucrose glucose
- Corn syrup maltose
- Fructose
- Lactose fruit sugar
- Dextrose honey
- Mannitol
People who have undergone gastric bypass surgery should also avoid eating and drinking at the same time as this can also cause dumping syndrome.
Side Effects and Precautions
Are there any side effects?
Side effects vary and are difficult to predict before surgery. Some people report problems such as diarrhea, constipation, excessive gas, nausea and vomiting. Most side effects can be minimized with changes in the diet. Malnutrition is rare with the current procedures although vitamin and mineral supplementation is essential.
Will I lose all of my hair after weight loss surgery? How do I keep it from falling out?
Hair loss after bariatric surgery is common and tends to happen three to five months post-operation. It is generally caused by poor protein intake, but can be stopped if you commit to consuming a protein-rich diet, particularly right after surgery. It can be caused by many things including not eating enough protein, not taking your multivitamin, or even just from the rapid weight that that happens immediately after surgery. If you are concerned about hair loss, work with your dietitian to help minimize hair loss.
Can I get pregnant after weight loss surgery?
It is very important that you do not get pregnant for at least 12 to 18 months after any type of weight loss procedure. You must use a reliable method of birth control throughout this time period. Once your weight has stabilized and the appropriate months have passed, you can become pregnant. It is important, however, to be monitored closely by an obstetrician and nutrition expert familiar with your weight loss surgery.
Will I regain some of the weight I lost following bariatric surgery?
In some cases, it is possible to regain weight after weight loss surgery, and there can be many causes. Patients are encouraged to contact their surgeon’s office for a follow up appointment with a nurse practitioner and a dietitian to discuss weight regain and work towards reversing it.