Wondering if Weight Loss Surgery is Right for You? Here are 10 Things to Know

Having bariatric surgery is a big decision, but it can also be a life-changing one.  

If you struggle to lose weight, despite making changes to your diet and exercise, bariatric surgery may be the right choice for you. For people with obesity and obesity-related medical conditions, bariatric surgery can be an important step toward a healthier life.

To learn more about bariatric surgery, we turned to Neil D. Ghushe, MD and the multispecialty team at the South Shore Hospital Center for Metabolic and Bariatric Surgery.

Here are 10 things you need to know about weight loss surgery.

What is bariatric surgery and how does it work for weight loss?

Bariatric surgeries, such as gastric bypass and sleeve gastrectomy, are surgical procedures performed on the stomach or intestines that make changes to the digestive system and induce weight loss.

Bariatric surgery works by limiting the size of the stomach, which causes patients to eat less. The surgery also fundamentally changes the way the body metabolizes food. This is the biggest difference between surgical treatment and medical treatment for obesity.

Bariatric surgery changes the signals for cravings and “feeling full” and changes way the body processes and senses food. The hormones thought to control these craving and fullness signals, are present in the part of the stomach that is removed.

What are the benefits of bariatric surgery?

The medical benefits of bariatric surgery go far beyond weight loss. They include long-term remission of type 2 diabetes, improved cardiovascular health, joint pain relief, resolution of sleep apnea, and improved fertility. Most patients can reduce the number of medications they take to manage these conditions, or stop taking them all together.

Patients also report an overall improvement in their quality of life. They often find relief from depression and find enjoyment participating in activities and social situations, they did not feel comfortable with before undergoing this process.

Are the procedures (sleeve gastrectomy, gastric bypass) safe?

Weight loss surgery is very safe. In fact, the benefits of bariatric surgery far outweigh the risks associated with having obesity.

The risks from bariatric surgery are considerably less than most other surgeries, including having your gallbladder removed and hip replacement.

Studies show that patients who have weight loss surgery reduce their risk of death related to diabetes by more than 90%.  The risk of death related to heart disease is reduced by 50% and there is a 40% lower risk of death overall.

How do I know if I qualify for weight loss surgery and if health insurance covers the cost?

Patients with a body mass index (BMI) over 40 qualify for bariatric surgery.  Those with a BMI between 35 and 40, with a serious weight-related health condition, such as diabetes, high blood pressure or sleep apnea are also eligible for weight loss surgery. 

Weight loss surgery requirements and the costs covered by insurance, vary based on the health insurance carrier. Patients should speak with their insurance company’s benefits representative to find out if bariatric surgery is a covered procedure, if South Shore Hospital and Brigham and Women’s Hospital is within your coverage network, and what mental health benefits you have.

After confirming coverage with your insurance company, call our access center to schedule an appointment with Dr. Ghushe at 617-525-3597.

How soon can I have weight loss surgery and what steps do I need to take prior to the procedure?

It takes time to make sure patients are prepared medically and psychologically to undergo bariatric surgery and the lifestyle changes they will need to make afterward. 

Patients can begin the process by attending one of our virtual bariatric surgery seminars. These virtual sessions provide information about surgical options, insurance coverage, diet and lifestyle changes and support resources. The next informational seminar is Wednesday, March 15.

Individual health insurance requirements may extend the time patients have to wait before surgery. Some insurance companies require 3-6 months of Pre-Operative Weight Reduction classes prior to the procedure.  The best way to find out is to call your health insurance provider and ask about weight loss surgery requirements.

How much weight loss can I expect after the surgery?

Weight loss will vary from patient to patient and depending on the procedure. 

For the sleeve gastrectomy, patients can expect to see a weight loss of 25% of total body weight and 50-60% of excess body weight. 

The average weight loss for those who have gastric bypass surgery is 30-35% of total body weight and 60-70% of excess body weight.  

How will my diet and lifestyle change after weight loss surgery?

For the first six weeks after surgery, there is a stricter four-stage progression to allow your stomach to recover from surgery. Once you have reached the fourth diet stage, no foods are off limits.

You can still eat your favorite foods, but you will likely enjoy them in moderation.  We do ask patients to abstain from coffee and alcohol for 3-6 months after surgery.

Your lifestyle after weight loss surgery should change for the better.  Most patients enjoy improved overall health and have more energy, allowing them to participate in activities they would not have done before losing weight.

Do people who have bariatric surgery regain their weight?

A small number of patients can regain their weight, but the vast majority lose significant weight and keep it off. It is important to remember that surgery is not a cure for obesity; it is just one piece of the puzzle in terms of obesity and long-term weight loss.

More than 95% of patients will successfully lose half of their excess body weight or more. Studies have shown that gastric bypass patients lose approximately 70% of their excess body weight initially and two years after surgery, will regain only approximately 5% of their excess body weight.

Can I get pregnant after bariatric surgery?

Yes, but we typically recommend waiting 12-18 months after surgery before getting pregnant. Most women are much more fertile after surgery, even with moderate weight loss.

After surgery, there is a decreased risk of experiencing problems during pregnancy and during childbirth. Studies show there is lower risk of needing a caesarian section and fewer miscarriages and stillbirths, than in women with obesity.

What support resources are available after weight loss surgery and beyond?

Choosing bariatric surgery is a lifelong decision, and we are a part of that process. Our multispecialty care team provides regular follow-ups with patients for life after surgery.

Patients will also continue to have nutrition and psychology services to help them through the early stages post-operatively and the maintenance stages, once they have lost weight. We also work closely with the medical weight loss group, for patients who need additional help keeping their weight off long term.

Other resources include a private Facebook page that allows discussion with other patients, information about education and support opportunities with our staff, recipes, and inspiration. We also have a monthly virtual forum hosted by a variety of providers including nutritionists, psychologists and plastic surgeons.

Learn more about Weight Loss Surgery at the South Shore Hospital Center for Metabolic and Bariatric Surgery.