Frequently Asked Questions about Bariatric/Weight Loss Surgery
A: Our program uses the NIH guidelines to determine whether a person is a potential candidate for surgery. We consider adult men and women with a body mass index (BMI) that exceeds 40, those with a BMI between 35 and 40 when the person also has at least one obesity-related, high-risk condition that requires medical treatment, or the person is about 100 pounds overweight as potential surgical candidates. Potential patients must be able to understand the operation, as well as the lifestyle changes necessary for successful weight loss. Consideration is given to those who have tried traditional weight loss methods and failed to achieve long-term weight loss. Our surgeons may exclude patients with surgical risks that outweigh the potential surgical benefits, including those that are unable to walk, cigarette smokers that are unwilling to quit, patients that require chronic steroid use and some with prohibitively severe medical problems.
A: The reasons for obesity are many and complex. It is not simply a result of overeating. Studies have shown that in many cases a significant, underlying cause of morbid obesity is genetic. Research demonstrates that once the problem is established, efforts such as dieting and exercise programs have limited success to provide effective long-term relief. Environmental factors, such as fast food, long days sitting at a desk and suburban neighborhoods that require cars all magnify hereditary factors such as metabolism and efficient fat storage. Science continues to search for answers. But until the disease is better understood, the control of excess weight is something patients must work at for their entire lives.
A: Being overweight is not a cosmetic issue or just a social consideration. The extra pounds bring with them an extraordinary amount of disease and disability, as well as a shortened lifespan. Certainly being seriously overweight (100 pounds or more over the ideal body weight), markedly reduces a person’s health even at a young age. Being overweight or obese leads to dramatic increases in diabetes, high blood pressure, high cholesterol, heart disease, sleep disturbance, degenerative joint disease, heart attacks and strokes. In addition, weight gain is associated with the cellular biochemical pathways that lead to cancer. So, we see that the rates of many of the most common forms of cancer are substantially higher in overweight people when compared to average weight people.
A: When obesity becomes so severe that it has negative effects on the person’s health and quality of life, they may look to a proven method of weight loss such as surgery. While most morbidly obese people are able to lose weight in the short term, the percentage of people that successfully keep the weight off over two years is less than 5 percent. Bariatric surgery has been shown to produce lasting weight loss of significant amounts of weight, as well as improve or cure numerous health risks such as hypertension, diabetes, sleep apnea and elevated lipid levels.
A: Dr. Philip Gachassin, Dr. Dennis Eschete and Dr. Robert Autin perform bariatric surgery at Lafayette General Medical Center. Dr. Gachassin also serves as the program Medical Director.
A: Dr. Gachassin, Dr. Eschete and Dr. Autin perform various different laparoscopic bariatric surgeries; they include the Roux-N-Y gastric bypass, the adjustable gastric band, the duodenal switch and the sleeve gastrectomy. Our practice also offers the non-surgical gastric balloon, in addition to medically supervised weight loss options that do not require a surgical or non-surgical procedure.
A: Because the size of the stomach pouch varies, the amount of food you can eat will depend upon the surgery you choose. However, all three of the operations involve a drastic reduction in food intake and require adherence to a healthy diet afterward.
A: The short answer is that some do and some don’t. The best thing to do is to contact your insurance company and ask if you have benefits for the surgical treatment of morbid obesity, if it is found to be medically necessary. The representative should be able to speak to you and explain your benefits and the criteria that you must meet for weight loss surgery. If you find you do not have benefits, you should know that both the surgeons and the hospital offer competitive cash pricing for all procedures. The hospital and surgeons are in-network with most plans. You can call Tiffany McZeal, our Bariatric Patient Advocate, at (337) 233-9900 for any questions.
A: The decision to have weight loss surgery is never easy, but is often a turning point in the lives of our patients. Medical evidence tells us that a very high percentage of patients who have surgery find that their energy levels increase and that many of their comorbid conditions, like diabetes and high cholesterol, disappear. Because the benefits of surgery often outweigh the risks, we want to help every patient find a financial solution that works for them. Below, you will find information on insurance options, as well as financial options for self-pay patients.
A: Yes, in most cases you do. We ask our patients to eat light meals with adequate protein and plenty of fluids for the last one to two weeks before surgery. This rapid weight loss helps to shrink the fatty stores in the liver, reducing strain on the heart and lungs and creating some extra space within the abdomen to facilitate the operation being done efficiently and safely. Our dietitians are available to assist with a weight loss plan tailored to your special needs.
A: Yes. We ask you to begin a walking or pool exercise program prior to surgery. For those who are unable to walk long distances you can break the walks up in to multiple short walks. In some cases of extreme joint pain we recommend water exercise, which is much gentler on the ankle, knee and hip joints. You will be given information on a variety of exercises that you will need to perform before and after surgery. Your success and overall health will be improved with regular exercise. You must always make sure that you are medically cleared before participating in any exercise program.
A: Yes. Our dietitians will work with you so that you can read and understand food labeling. You should know how much protein, fat, sugar and carbohydrates your foods contain so that you can make informed choices to meet your specific dietary needs. The dietitians will provide you with a protein goal and numerous suggestions for a high protein, low-fat and low-sugar diet. You will eat measured amounts of foods until you become a good judge of the portions that are appropriate for you and to be sure you are consuming the required protein. Eating a nutritious, low-calorie diet is one of the ways you will lose the amount of weight you desire.
A: Yes. You will need to take a multiple vitamin and calcium daily. You may also need to take additional supplements and vitamins depending upon the operation you have and any dietary deficiencies you may develop over time.
A: This varies with age, smoking history, etc., but most patients that lose 100 pounds or more will have significant loose folds of hanging skin. Many patients opt for plastic surgery to remove the excess skin. Insurance companies usually consider body contouring surgery as cosmetic, but some plans will pay for removal of loose skin when you have a history of skin infections and irritation.
A: Most patients are well enough to return to work within two weeks of surgery, but you will discuss your job requirements with the surgeon and base your return to work date accordingly.
A: Average weight loss figures are available for each of the three types of surgery performed in our program; however, the amount and rate at which each person loses weight varies depending on the type of surgery, total caloric intake and exercise for the individual. Lap Band patients typically lose 45-55% of excess body weight, while Roux-en-Y and Sleeve Gastrectomy surgery offers 70-75% loss of excess body weight.
A: Most patient lose weight for a period of approximately 18 months. Weight loss tends to level off sometime between 12 and 24 months. It would be quite unusual for a weight loss surgery patient to lose too much weight. Your weight and laboratory values will be monitored on a regular basis to insure that you maintain a healthy weight after surgery.
A: The risks involved in weight loss surgery are the same as with most other abdominal surgeries: Bleeding, leaks, blood clots, nutritional deficiencies, hernias, bowel obstruction, vomiting, gallstones, dumping syndrome, low blood sugar, stroke, heart problems, pneumonia, distension of stomach, ulcer formation, diarrhea, depression, infection, dehydration and death among others. In the most recently published ASMBS studies, the mortality rate for bariatric surgery was ≤ .03-.05%. Those in the higher BMI ranges and those with significant obesity-related conditions are at highest risk of complications.
A: Our bariatric program believes that proper patient selection and patient education are the keys to success and good outcomes.
A: View our seminars and support groups to see dates and times of our monthly meetings.
A: We strongly suggest that you wait at least 18 months after surgery to have a child. And even after that, you must make sure that your obstetrician is aware that you had weight loss surgery. You should be closely monitored during the entire pregnancy. If you had the Lap Band procedure, you may have the fluid in the band removed during your pregnancy. After delivery, the band can be readjusted.
A: The typical minimum age in our program is 18 years. However, there is no absolute limit. As long as you are physically able to withstand an operation and you fulfill the other criteria for surgery, you are a candidate.