Bariatric Surgery FAQs

UT Medical Center’s University Bariatric Center offers weight loss options to help meet your needs. Medical weight loss options such as medications, meal replacements and/or behavioral modifications are all provided under medical supervision. Our physicians also perform weight loss surgery to those who qualify. Weight loss surgery options include: Laparoscopic Gastric Bypass Surgery and Laparoscopic Sleeve Gastrectomy. Learn more about our weight loss options.

Most health insurance companies do offer coverage for bariatric surgery. However, whether your insurance covers this surgery depends on the particular policy you have. Some employers opt for plans that do not carry coverage for bariatric surgery for their employees. The best way for you to tell if your policy offers these benefits is to call the customer service number on the back of your insurance card. Ask them if your policy includes benefits for bariatric surgery.

On another note, each policy that covers bariatric surgery will have a list of criteria that you have to meet in order for them to consider approving you for surgery. These requirements may include a 6-month medically supervised weight loss program, 2-5 year weight history, dietitian consultation and psychological evaluation.

You also can ask the customer service representative at your insurance company for a list of criteria that you have to meet.

Those who have a laparoscopic sleeve gastrectomy or laparascopic gastric bypass usually stay in the hospital for 1 or 2 nights.

To help you prepare for this life-changing event, the University Bariatric Center’s multidisciplinary team will guide you through an in-depth evaluation process. This includes medical testing, nutritional education and counseling as well as a one-on-one session with a trained dietitian to explain the impending changes in your dietary requirements after weight loss surgery. A dedicated bariatric staff will provide guidance and serve as a continuous resource throughout your experience.

Comprehensive support after your weight loss surgery includes post-surgical nutritional management as well as support group meetings to discuss lifestyle adjustments and to receive suggestions for continued weight loss success. Exercise specialists also are available to help you achieve fitness with structured and effective exercise routines.

Right away! To start, you will take easy, short walks while you are in the hospital. The key is to start slow. Listen to your body and your surgeon. If you lift weights or do sports, stay “low impact” for the first month.

As we age, lack of activity can lead to being frail or fragile, which is quite dangerous to overall health. Healthy bones and avoiding muscle loss partly depend on doing weekly exercise.

Most patients also think of exercise as something that must be intense and painful (like boot camp). Regular, modest activity is far more useful in the long term. Even elite athletes can’t stay at a peak every week of the year. Instead, work with your surgeon’s program to find a variety of activities that can work for you. There is no one-size-fits-all plan. Expect to learn and change as you go!

This will depend on the type of work that you do. For those who have sedentary jobs, most sleeve and bypass patients can go back to work in 2 weeks. Time off of work may be longer for those who have more strenuous job functions.

To schedule your one-on-one consultation or for more information, call 865-305-9355.

We advise waiting 12-18 months after surgery before getting pregnant. Most women are much more fertile after surgery, even with moderate weight loss.

Birth control pills do NOT work as well in patients who are overweight. Birth control pills are not very reliable during the time your weight is changing. For this reason, having an IUD or using condoms and spermicide with ALL intercourse is needed. Menstrual periods can be very irregular, and you can get pregnant when you least expect it!

Yes.

After surgery, there is much less risk of experiencing problems during pregnancy and during childbirth. There are also fewer miscarriages and stillbirths than in women with obesity who have not had surgery and weight loss.

Kids born after mom’s surgery are LESS at risk of being affected by obesity later, due to activation of certain genes during fetal growth. There is also less risk of needing a C section.

No. Weight loss surgery is very safe and decreases the chance of dying from obesity. In fact, weight loss surgery is safer than removing the gallbladder or having a knee replacement.

A recent study of 209,116 patients found the risk of death from weight loss surgery was 0.16%, or approximately 1 in 600. This rate is considerably less than most other surgeries, including gallbladder and hip replacement surgery. Large studies find that the risk of death from any cause is considerably less for patients after weight loss surgery than for those who have severe obesity and have never had the surgery. Patients who have weight loss surgery have a reduction in their risk of death by 40%. Death related to diabetes is reduced by more than 90% and from heart disease by more than 50% for patients after weight loss surgery. The benefits of weight loss surgery far outweigh the risks. As with any serious surgical operation, the decision to have weight loss surgery should be discussed with your surgeon, family members, and loved ones

Many people who suffer from obesity find it hard to lose weight and keep the weight off with diet and exercise alone. This is likely due to foods available and genes.

The National Institutes of Health (NIH) Expert Panel stated that, without surgery, long-term weight loss is nearly impossible for those affected by severe obesity. Studies show little long-term success with diet and exercise alone. Weight loss surgeries are effective in maintaining long-term weight loss, in part, because these procedures change the body’s natural responses to dieting that make weight loss so difficult. When a person goes on a diet, their body produces more hormones that cause an increase in hunger and a decrease in calories burned. This decrease in calories the body burns is more than explained by the decrease in body size. Therefore, there are significant differences between someone who has lost weight by diet and someone of the same size who has never lost weight. For example, the body of the person who reduces their weight from 200 to 170 pounds burns fewer calories than the body of someone weighing 170 pounds who has never been on a diet. This means that to maintain weight loss, the person who has been on a diet will have to eat fewer calories than someone who naturally weighs the same. Weight loss procedures, unlike diet, also cause biological changes that help reduce food intake. Energy (in the form of food) intake is decreased with surgery by restricting stomach size and limiting absorption. In addition, weight loss surgery changes the production of certain gut hormones (or signals) that communicate with the brain to reduce hunger, decrease appetite, and enhance the feeling of being full. In these ways, weight loss surgery, unlike dieting, produces long-term weight loss.

If patients take their appropriate vitamins, it is rare to have health problems from vitamin deficiency.

Weight loss surgery can lead to reduced amounts of vitamins and minerals because people eat less and may absorb less in the intestines. Weight loss surgeries have different effects on vitamins and minerals based on how much change in absorption they cause. Deficiencies in vitamins, minerals, and protein can negatively affect health causing:

• fatigue (feeling tired)
• anemia (low levels of red blood cells that carry oxygen through your body)
• bone and muscle loss
• impaired night vision
• low immunity (your body’s ability to stay healthy)
• loss of nerve function (can affect your senses such as touch, taste, and smell)
• mental function deficits (changes how clearly you think)

Fortunately, nutrient deficiencies following surgery can be easily avoided with a good diet and the use of supplements including vitamins, minerals, and sometimes protein supplements. Before and after surgery, patients are advised of the appropriate diet and vitamin supplement needed. Most weight loss surgery programs also require patients to have their vitamins and minerals checked on a regular basis after surgery. Nutrient deficiencies and any associated health problems are preventable with monitoring and patients following diet and supplement (vitamin and mineral) recommendations. Health problems due to deficiencies usually occur in patients who do not regularly follow-up to monitor healthy vitamin and mineral levels. Be sure you stay in touch with your weight loss surgery team for best results!

Food addiction as a cause of obesity is extremely rare.

Although some people with obesity have eating disorders, such as binge eating disorder syndrome, most people have obesity caused by many factors. When treating addiction, such as alcohol and drugs, one of the first steps is to stop using drugs or alcohol. This does not work with obesity as we need to eat to live. Also, there may be other issues causing a person’s weight gain. Weight gain generally occurs when the amount of food eaten is greater than the number of calories burned. There are other conditions, however, that affect weight gain that do not involve too much eating or a less active lifestyle including:

• Poor sleeping habits
• Eating foods that may increase body fat (sugar, high fructose corn syrup, trans fat, processed meats, and processed grains)
• Low intake of fat-fighting foods (fruits, vegetables, legumes, nuts, seeds, quality protein)
• Stress and mental distress
• Many types of medications
• Pollutants

Obesity also leads to more obesity, which is one of the reasons why the disease is considered progressive. Weight gain causes several signals (hormones) in the body that increase the risk for even greater weight gain and obesity. To make matters worse, obesity affects certain body functions that control appetite and hunger in a manner that can cause an increase in the amount of food eaten at any given meal and the desire to eat more often. There are many causes for obesity and the disease of obesity is far more than just an ‘addiction’ toward food. The treatment of obesity only as an addiction may help for a very small percentage of individuals whose only underlying cause for obesity is excessive and addictive eating, but would be unlikely to benefit most people, particularly those individuals affected by severe obesity.

There is a small group of patients after weight loss surgery who have a problem with alcohol abuse. Most of those people, but not all, already had experiences with alcohol abuse before surgery.

• Avoid alcoholic beverages during the rapid weight loss period, and then drink only rarely
• Be aware that even small amounts of alcohol can cause intoxication (‘being drunk’)
• Avoid driving or operating heavy equipment after drinking any alcohol
• Remember that you may feel less intoxicated than you are, and will not be a reliable judge of whether it is safe for you to drive
• after drinking.
• Seek help if drinking becomes a problem
• If you feel drinking alcohol may be an issue for you after surgery, please contact your primary care doctor or surgeon and discuss this further. They will be able to help you identify resources available to address any alcohol-related issues.

It has been found in scientific research that a small percentage of weight loss surgery patients report having problems with alcohol after surgery (7-10%).  Many who abuse alcohol after surgery had problems with alcohol abuse at some time prior to surgery, but occasionally alcohol problems can arise in patients who never had such issues before their surgery. Alcohol sensitivity is increased after weight loss surgery so that the effects of alcohol are felt with fewer drinks than before surgery. Studies also find that with certain weight loss procedures (such as the gastric bypass or sleeve gastrectomy), drinking an alcoholic beverage increases blood alcohol to levels that are considerably higher than before surgery or in comparison to the alcohol levels of individuals who have not had a weight loss procedure. In addition, studies have found that alcohol takes much longer to clear out of a person’s system if they have had weight loss surgery, which can pose safety and legal hazards for driving. Furthermore, it has been found that some patients may feel as though they are sober (‘not drunk’) even when they are over the legal blood alcohol limit for driving. For all these reasons, weight loss surgery patients are advised to take precautions regarding alcohol.

After surgery, most patients have improved mental health but there may be a small increase in the risk of suicide. Therefore, patients are required to have a mental health screening before surgery.

People affected by severe obesity who are seeking weight loss surgery are more likely to suffer from depression or anxiety and to have lower self-esteem and overall quality of life than someone who is normal weight. Weight loss surgery results in significant improvement in mental health for most patients. However, studies have found a small but significant increase in suicide following weight loss surgery.  In some cases, these may have been patients with undiagnosed mental disorders, and in others, patients may have experienced major life stressors that can increase the risk for suicide, but in rare cases, the suicides are unexplained. For this reason, comprehensive bariatric programs require psychological evaluations prior to weight loss surgery. Many programs have therapists available for patient counseling after surgery. In addition, if a patient sees a psychologist or psychiatrist before surgery, they should continue seeing them after surgery.