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Frequently asked Questions
Which surgery is right for me?
We offer three bariatric surgery options for our patients: the laparoscopic Roux-en-Y gastric bypass (bypass), the laparoscopic adjustable gastric band (band) and the laparoscopic sleeve gastrectomy (sleeve). The criteria for surgical candidacy are the same thus if you are a candidate for one, you are a candidate for all – but not all surgical procedures are for everyone. The bypass is the most popular because it has consistant and excellent results with low side effects and very low mortality. The band is the least invasive and requires greater discipline, a need for regular office adjustments, has slower weight loss and, on average, leads to less weight loss than the bypass. However, individual patients who are disciplined, patient and come for regular adjustments can do just as well as bypass patients. The sleeve is a newer procedure with results and risks that are between band and bypass and is currently covered by most but not all insurance policies. For more information, please review the procedure descriptions in the website or feel free to attend our office seminars held every Tuesday at 2:00 pm.
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How successful is medical weight loss?
Success in medical (or non-surgical weight loss) is defined differently than after surgery. First surgical patients have class 2 or 3 obesity while medical patients are in the overweight – class 1 obesity. Second, whereas surgical patients reach their final weight anywhere from 1 year (gastric bypass) to 2 years (sleeve) or 3 – 5 years (band), medical weight loss patients are fighting a longer battle. Third, the fight against obesity, a chronic disease, with medical weight loss is fought without the benefits of a surgically altered anatomy that offers excellent portion control, appetite suppression and profound metabolic benefits that impact cravings. We consider a successful result with medical weight loss as 10% total weight lost by six months and most people are able to achieve this. However, after six months, what percent continue to use these tools and lose weight versus what percent stagnate or regain weight is not well known and depends on each individual’s effort.
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Should I try medical weight loss before surgery?
All patients who suffer from obesity should try non-surgical attempts at weight loss prior to surgery. Programs that offer nutritional guidance and fitness training represent the first line. Failing these, patients should seek a more intensive, medically-supervised, comprhensive approach from a weight loss specialist (bariatrician). If such measures fail to achieve permanent and significant weight loss then a surgical treatment is warranted.
At the Advanced Bariatric Center, our approach to helping our patients achieve their goals and stay there is a little different. We offer a comprehensive, physician-supervised weight loss program to everyone including our surgical patients. In fact, surgical options are offered in the context of a greater comprehensive approach. That way, patients don’t really have to choose between medical and surgical weight loss: you get the best of both worlds.
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Will I have to give up the food I like after surgery?
It depends on what foods you like (not to sound like a smart-aleck). If you want to succeed in achieving your weight loss goals and staying there, with whichever treatment you opt for, you will have to give up high-carbohydrate, high-fat, energy-dense foods and liquids on a regular basis (occasional indulgences are fine). Obesity is a chronic disease and, as such, the battle to control your weight is a life-long one. Fortunately, you are not alone. Our physicians at the Advanced Bariatric Center enter into a life-long professional relationship with our patients that oversees your progress and helps you to arrive at your goals and stay there. But to achieve a successful outcome, you will have to make nutritious, protein-rich food choices in correct portion sizes and, as you begin to achieve your goals, it is our hope that these foods will be the ones that you will come to love.
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If I live far away from Fresno, should I still have my surgery there
Our patients live all over California, Oregon and Washington and we have patients who reside in the Midwest and east coast. We have international patients as well in Mexico, France, Indonesia and Guam. Living far away does not impact your candidacy or put you at increased risk for failure. We will conduct your follow-up visits by phone or email and blood tests, which we obtain annually, can be faxed in. We prefer that even if you live far away, you come for an annual visit, but if that is not possible we can work within your needs and travel capabilities.
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Is alcohol ok after surgery?
In general, no. Acohol is a calorie-dense liquid with little benefit (other than red wine in moderation). An occasional glass is fine, but in order to meet your weight loss goals permanently, you will have to significantly reduce your alcohol consumption. After a gastric bypass, alcohol consumption can be dangerous as even small amounts are quickly absorbed in your blood stream and can make operating any machinery (like driving) hazardous. In addition, your threshold for liver damage and alcoholism is substantially reduced after gastric bypass and some patients have been found to “transfer their addiction” from energy-dense foods to alcohol.
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Will I be able to get pregnant after surgery?
For many women of reproductive age, one of the main reasons for undergoing bariatric surgery is to be able to get pregnant. Obesity is associated with an alteration in hormones leading to irregular periods, no periods, polycystic ovarian disease and infertility. Losing weight with our without surgery can lead to a substantial improvement if not resolution of infertility. However, we strongly recommend that patients refrain from getting pregnant during their first year following bariatric surgery since there may be a risk to the baby’s development during a period of rapid weight loss by the mother. In addition, changes in hormonal levels and therefore improvements in fertility can increase the chance of pregnancy so extra measures of protection should be taken. Having said this, many of our patients have gotten pregnant during their first year and we have not seen one case of any birth defect or pregnancy-related complications.
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Will I regain my weight after surgery?
Obesity is a chronic disease, meaning lifelong, and the battle will continue for the rest of your lives. Bariatric surgery provides some very powerful tools in fighting this disease (and for the majority, beating it) but ultimate outcome is determined by each individual patient as to how well you use these tools. These tools include portion control, appetite suppression, and a profound metabolic change that alters tastes and hunger among other factors that help our patients achieve permanent and significant weight loss. The underlying message is that there are no 100% guarantees and the outcome you get is related to the extent that you follow our dietary, exercse and medical advice. We estimate that up to 20% will regain significant weight while 80% will achieve their goals and stay there. The people who regain their weight are those who go back to old habits of snacking, grazing, eating energy-dense high carbohdrate foods. The majority who achieve success are those that have changed their lives; they make healthy food choices, incorporate daily exercise and weight themselves on a regular basis.
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