1. What is morbid obesity?
If you're more than 100 pounds overweight with a body mass index (BMI) above 40, you are considered morbidly obese. Morbid obesity is associated with many health problems including diabetes, high blood pressure, heart disease, sleep apnea, joint pain, certain cancers and premature death.
2. How is eligibility for weight loss surgery determined?
Michigan Bariatric Institute follows guidelines supported by the National Institutes of Health in order to determine a patient's eligibility for weight loss surgery. Rather than using weight, we use body mass index (BMI) as a criteria for surgery. Individuals are candidates for surgery if:
- Have failed previous attempts at weight loss in a medically supervised program
- Have a BMI over 40, which means approximately 100 pounds overweight (calculate your BMI)
- Have a BMI of 35 with two medical co-morbidities (obesity-related conditions), such as diabetes, high blood pressure, or sleep apnea, etc.
- Are committed to the lifelong changes that include diet, exercise and behavior modifications
- Are committed to lifelong follow-up medical care
3. What are some reasons an individual should not have weight loss surgery?
One should not have weight loss surgery if:
- Are older than age 65 (some patients between 65-69 will be considered)
- Currently have a drug and/or alcohol addiction
- Have been diagnosed with unstable psychiatric disorders
- Are unwilling to comply with post surgery diet, exercise and behavior changes
- Are unwilling to commit to lifelong follow-up medical care
4. Is weight loss surgery right for everyone?
No. Surgery is not a solution for everyone. We only determine whether a patient is right for surgery after a complete evaluation and discussion with the patient. Because weight loss surgery is a life-altering procedure, we want to make sure patients are committed to making the lifestyle changes needed for a successful procedure.
5. What are the benefits of laparoscopic surgery?
|Large incision||Small incisions (most less than ½ inch)|
|Hospital stay of approximately 4 days||Hospital stay is 1-3 days|
|Return to work in approximately 4 weeks||Patients usually return to work in 2 weeks|
|More painful||Some pain|
|More chance of hernias||Less chance of hernias|
|Greater risk of infection||Technically more difficult for the surgeon|
|Complications more likely||Cosmetically more appealing|
6. Can surgery be done laparoscopically if previous open abdominal surgeries have been performed?
Each patient will be evaluated on an individual basis by the bariatric surgeon. It is possible to have a laparoscopic gastric bypass after having open abdominal surgery or other laparoscopic abdominal procedures. Our surgeon believes that every patient has the right to be given the opportunity to choose minimally invasive surgery as an option.
7. What are the risks of weight loss surgery?
All major surgeries have risks of complications. However, risks can be greatly reduced with an experienced bariatric surgery team and by carefully following instructions before and after surgery. You will undergo an extensive pre-surgical evaluation to optimize your medical condition and therefore minimize risks of the surgery.
8. Does insurance cover the cost of the procedure?
Since most insurance companies consider surgery for morbid obesity a special category, it is necessary that you contact your insurance company before seeking a surgical consultation to see if the operation is a benefit and if you are eligible for that benefit.
Many insurance companies require documentation from your primary care doctor detailing medical conditions (co-morbidities), treatment plans and written proof of supervised failed weight loss attempts with diet and exercise in order to establish whether you have met their insurance criteria. Michigan Bariatric Institute has an insurance specialist in place to help with the insurance authorization process.
9. What are the benefits of choosing MBI at St. Mary Mercy Hospital?
At the Michigan Bariatric Institute, we are focused on your individual success. Our experts will work hand-in-hand with you, to provide the best opportunity for success. We begin with an application process and offer:
- Easy accessibility
- A dedicated inpatient unit
- Fellowship trained surgeon
- Experienced bariatric program director
- Trained registered dietitians
- Experienced registered nurse
- Behavior modification specialist
- Exercise physiologist focused on the obese and post-bariatric patients- a component unique to our program
- Extensive pre-surgical nutrition and lifestyle classes
10. How much weight does a patient lose after weight loss surgery?
Weight loss begins immediately after surgery. The amount of weight lost and how fast it is lost depends on which weight loss surgery is performed. Adjustable gastric banding patients (Lap Band), on average, lose 50% of their excess body weight. Gastric bypass patients, on average, lose 70% of their excess body weight. On average, sleeve gastrectomy patients lose about 60-65% of their excess body weight.
11. How long is the hospital stay?
The length of the hospital stay depends on the type of weight loss surgery. Generally hospital stays are between one and three days.
12. Can the weight be regained?
Yes. Patients can regain some of the weight. The patient's overall behavior and compliance with the diet and exercise contribute to the long-term weight loss success. We emphasize that this surgical procedure is a "tool" which when used properly will produce good results. Long-term follow-up with the bariatric team is essential.
13. How does the diet change after weight loss surgery?
Each patient will be given a comprehensive list of appropriate and acceptable foods and beverages at the time of the surgical consult and during the pre-surgical nutritional classes. Patients will learn how to get the most benefit from the calories consumed by eating nutritious meals. Frequent meals are recommended but each one will be smaller and take approximately 30 minutes. Protein supplementation with shakes or bars, which should be selected pre-surgically, are critical to maintaining good nutrition after surgery.
14. What about vitamin supplementation?
Lifelong daily vitamins will also be needed. The lower part of the stomach and upper intestine play important roles in the absorption or iron, calcium, and other minerals, as well as vitamins such as folate, B1, B6, and B12.
15. How does exercise fit in?
Exercise is an important component with weight loss surgery. Not only does it burn calories, but it also improves mobility and overall health. An exercise program that is specifically designed for each individual will begin within a few months after surgery.
16. What happens to the excess skin?
The amount of excess skin depends on the total amount of weight lost, age, smoking habits, amount of exercise, and how much the skin was stretched. Some patients elect to have plastic surgery several years after weight loss surgery.
17. Can a patient become pregnant after weight loss surgery?
It is strongly advised to not get pregnant for at least 18 months after weight loss surgery. By delaying a post-operative pregnancy until this time, it is better assured that one will be able to get the proper nutrition for the health of mother and baby. Hormone levels are going to change after surgery and one may find themselves more fertile with an increased chance of pregnancy after surgery. Women of childbearing age should consult with their gynecologist to develop a plan.
18. What about alcohol consumption after surgery?
We do not recommend patients consume alcohol. Alcohol can cause marginal ulcers in the stomach pouch, which could cause bleeding. It can also lead to severe nutrient deficiencies.
19. What about tobacco use after surgery?
We require patients to stop smoking 4 weeks before surgery and strongly recommend patients continue not smoking after surgery. Smoking may increase the chance of stomach ulcers. It also increases the risk of complication in the operating room.
20. What are some keys to lowering health risks prior to surgery?
- The keys to reducing the risk of complications and ensuring weight loss are in the hands of the individual patient.
- Stop smoking now. It is the number one cause of preventable death and contributes to poor health.
- Exercise before surgery, even if it's just walking. Our exercise physiologists will develop an individual program that fits the personal needs and abilities.
- Prepare mentally. Weight loss surgery can be the beginning of a new life, so determine to make the most of this opportunity.
- Above all, one should listen to their medical team. Ask questions, provide information and follow instructions carefully.