Weight loss surgery causes weight loss two ways: by restricting the amount of food that can be eaten, or by bypassing part of the small intestine so that less food is absorbed. Some surgeries use a combination of both methods, and all surgeries require patients to make lifelong changes to their lifestyles.

1. How do I know if I'm morbidly obese?
Morbid obesity is defined as a Body Mass Index (BMI) of 40 or greater, or 35 or greater for people who have obesity-related medical problems. This is about 100 lbs. overweight.

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2. How is morbid obesity treated?
For the morbidly obese, surgery offers the only proven method for achieving long-term sustained weight loss. It creates a permanent change in the amount of calories absorbed. Diet, exercise, weight loss drugs and behavioral therapy have had very little success for the morbidly obese, with long-term success rates less than five percent.

3. What is the Roux-en-Y Gastric Bypass procedure?
The Roux-en-Y Gastric Bypass is the most widely performed surgery for the treatment of morbid obesity. The procedure can reduce or eliminate obesity-related diseases such as diabetes, hypertension, heart disease and sleep apnea. The Roux-en-Y procedure generally has fewer metabolic complications and greater long-term weight loss than other weight loss surgeries.

4. How does the Roux-en-Y Gastric Bypass work?
The Roux-en-Y Gastric Bypass works by reducing the amount of calories your body absorbs. First, your stomach capacity is reduced to two to four ounces. Second, high-calorie sweets interrupt the digestive process, causing nausea and diarrhea when eaten. Fat absorption is also reduced.

5. What is adjustable gastric banding (Lap-Band® System) surgery?
The Lap-Band System It is a restrictive procedure which reduces how much food your stomach can hold, but allows for normal digestion.

6. How does the adjustable gastric banding (Lap-Band® System) surgery work?
In Lap-Band® System surgery, an adjustable gastric band is placed around the upper part of the stomach, creating a smaller stomach pouch. This restricts the amount of food that can be consumed at one time and increases the time it takes for the stomach to empty. Patients achieve sustained weight loss by limited food intake, reduced appetite, and slower digestion. Once placed around the stomach, the Lap-Band® System is connected by a tube to an access port fixed beneath the skin of your abdomen. This port will be used in the future to adjust your Lap-Band® system by adding or removing saline from the inner surface.

7. What are the most serious risks of bariatric surgery?
Any major surgery can be life-threatening. Obesity increases the risk of complications from blood clots and breathing problems. Surgery may be complicated by leaking from the suture lines, but the incidence of this occurring is small. As with any surgery, complications such as bleeding and anesthetic problems may also occur.

8. How do I decrease my risk of surgery complications?
It is important that you are honest and give the medical team your complete medical history, psychiatric stability, personal habits and medications. Part of your pre-surgery preparation will focus decreasing your risk status. By complying with this preparation, you can reduce your risk. Preparation may include diet and exercise.

9. Who is a candidate for bariatric surgery?
Patients must have a body mass index of 40 or greater, or about 100 lbs. or more of excess body weight, and have significant obesity-related medical problems. The patient must have a history of being unable to maintain a healthy weight through programs such as physician-prescribed plans, counseling by a nutritionist, or group weight-loss programs. A medically-supervised weight-loss program is recommended before a person considers weight-loss surgery. Patients must also successfully complete medical, nutritional and psychiatric evaluations. Candidates must be committed to the permanent lifestyle and behavioral changes that are necessary to achieve long-term weight loss.

10. In addition to surgery, what other lifestyle changes must be made?
Successful treatment for morbid obesity also includes permanent lifestyle changes such as reduced caloric intake, increased exercise, and other behavior modifications. Counseling and support groups can help with these changes.

11. How much weight can I expect to lose after surgery?
Immediately after surgery, you can expect to lose about 15 to 20 lbs. a month, slowing over time. However, each person is different, and weight loss will depend on your metabolism.

12. What can I eat after having bariatric surgery?
To begin, only two ounces can be eaten at one time, or about 400 to 600 calories a day. This amount gradually increases over time, up to about 1,200 calories a day. Your diet must be carefully balanced to include high-protein, low-fat, low-sugar foods. Protein is especially important to ensure healing after surgery, and to preserve muscle tissue. You will be able to eat regular food about six weeks after surgery, without concentrated sweets, in six small portions a day. You will have to eat only tiny amounts, chew your food well, and eat very slowly.

13. How will I make sure my body gets all the nutrients it needs after surgery?
You will need to take vitamin and mineral supplements for the rest of your life after surgery. Because bariatric surgery bypasses most of your stomach and duodenum, where vitamins are absorbed, your caloric intake of 1,200 calories a day cannot provide all the nutrients your body needs.

14. What will keep me from losing too much weight?
Your body will slow down weight loss over time and eventually stabilize its weight. We will also closely follow your weight loss to ensure your nutrition is stable.