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Center for Surgical Weight Loss | Is Surgical Weight Loss Right for You?

The Program  |  Eligibility  |  Expectations  |  Patient Stories

Surgery for morbid obesity is about one and only one thing: improving your overall quality of life; this is done by addressing health issues you may have.

The Program

Quality of Life
We consider weight loss of more than 30% of preoperative weight a good result. For instance, a person weighing 300 pounds who loses 90 pounds would be considered to have a good weight loss result. We hope and expect about 90% of patients to achieve a good to excellent result. We anticipate that the average patient will probably lose about 30% of the preoperative weight, but there is a great deal of variation with some losing more and some losing less. As with all forms of treatment for obesity, your results will depend greatly on your motivation and long-term compliance.

Thus, a distinct minority of patients will reach a truly normal weight. In fact, such marked weight loss may not be desirable because of baggy skin and other related problems.

Addressing Health Issues
Successful weight loss corrects or improves diabetes, high blood pressure, reflux, and high cholesterol in more than 90% of patients with these obesity-related problems, and helps to resolve sleep apnea, urinary incontinence, and osteoarthritis in more than 75% of patients. Many patients are able to significantly reduce the amount of medications they take on a daily basis for these conditions.

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Eligibility

Qualifications for Surgery
Only very obese persons (greater than twice their ideal weight) are considered for surgical treatment. Otherwise, the expected risks may outweigh anticipated benefits. The ideal patient:

  • Should clearly and realistically understand surgical risks and benefits and how his or her life may change after surgery.
  • Has a severely impaired quality of life due to morbid obesity.
  • Is able to participate in treatment and commit to long-term follow up.
  • Is 100 pounds over Ideal Weight or have a Body Mass Index (BMI) of 40 or above (BMI = weight in kg / height in meters2), or has a BMI of 35 to 40 with associated severe medical conditions.
  • Has failed non-surgical measures within the last year or more as shown by detailed weight loss history in established weight control programs.
  • Should have no contraindications for surgery.

Surgical Weight Loss May Not Be Right For Everyone
Not every morbidly obese patient should undergo bariatric surgical procedures.

Some reasons an operation should be avoided include:

  • Heart valve disease and/or angina pectoris
  • Active peptic ulcer disease
  • Patient is unfit for general anesthesia
  • Patient is not prepared to make necessary lifestyle and/or behavior changes
  • Active alcoholism or drug abuse
  • Hepatic cirrhosis with impaired liver function tests
  • Serious psychiatric disability
  • Patients in very poor overall health
  • Persons desiring the surgery for the wrong reasons

Unfortunately, there are many who want surgery for the wrong reasons. If you feel that the surgery will help you attain a “normal” weight, make you “skinny,” or make people like you more then you should probably avoid an operation. Additionally, if you believe that the operation will allow you to eat anything that you want, this procedure is not appropriate for you.

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Expectations

Q: Is Surgical Weight Loss Permanent?
A: Yes, surgical weight loss is permanent.

Although it is technically possible to reverse the operation, it is an extremely difficult and potentially dangerous procedure. It would most likely require an open operation with a large incision.

Although it has been done before, it is not routinely done by many surgeons in the U.S. Your weight would come back after a reversal of the operation. If, for any reason at all, you feel that you could not live with this permanent change and the required lifestyle modifications, do not have this operation.

Weight loss surgery is not for everyone who is obese. We will work closely with you to determine if it's right for you.

Q: What are the risks?
A: There is one key difference with respect to surgery for weight loss compared to most other surgeries: This is a completely elective operation that you do not need to have in order to survive.


You may benefit tremendously from weight loss surgery however, and many of your medical problems may get better after surgery, but you do not need to have this operation. As with any surgical procedure there is a risk of dying. Please think about this and discuss it with your family. This is not something to be taken lightly.

Risks of weight loss surgery include:

  • Excessive bleeding from any one of several places we need to cut in order to do the operation. You may require a second operation and / or a blood transfusion if this occurs.
  • A blood clot can form in your legs and possibly travel to your lungs. If this happens, it can sometimes be fatal.
  • Infection can occur at any number of sites after the operation. This could require a second procedure.
  • Hernias can occur at one of several locations which may require another operation to fix.
  • This can occur even many years after the operation.
  • Conversion to open: It is possible that we will not be able to complete your operation with the laparoscope. In that case, you will need a larger incision and this will result in a longer hospital stay and recovery.
  • Strictures are a narrowing of the connections we make. They can occur at anytime after the operation and prevent food from passing easily. Strictures can usually be treated by dilating the connection, but sometimes require another operation.
  • Vitamin and nutrient deficiencies can be serious and cause permanent damage. The operation makes it possible to become deficient in several important minerals and vitamins. It is therefore critical that you take the recommended supplements every day.
  • Failure of Weight Loss: You may not loose all the weight you expect, or you may gain some weight back. This often depends tremendously on your compliance.
  • Loose skin is quite common after the operation. Many patients will desire plastic surgery.These procedures are often not covered by insurance.
  • Psychiatric Disorders: The stress related to undergoing such a drastic life change may worsen pre-existing depression, anxiety or other psychological problems. Sometimes patients get depression or anxiety for the first time after the procedure.

Additional risks with gastric bypass and sleeve gastrectomy surgeries include:

  • Leaks can occur from one of the internal incision sites (staples/suture sites) and almost always require a second operation with the placement of temporary drainage tubes and a feeding tube, as well as a prolonged recovery.
  • Ulcers can form due to the decrease size of the newly created stomach pouch, causing pain and/or bleeding. These can usually be treated with anti-ulcer medications, but some patients will require another operation to treat the ulcer. Aspirin and pain-relievers like Motrin, Aleve, Celebrex, and other non-steroidal anti-inflammatory drugs (NSAIDs) cause ulcers and should never be taken after gastric bypass or sleeve gastrectomy surgeries. Alcohol and smoking can also cause ulcers and must be avoided.
  • Kidney stones can also occur primarily after gastric bypass surgery, but can usually be prevented by drinking plenty of fluids (preferably water) each and every day.

There are also other complications that are not listed above which can occur after weight loss surgery. We will do all that is possible to prevent and/or minimize the chances of any of these complications from occurring. However, it is critical that you follow-up with our team and primary care physician for the rest of your life so that if these problems do occur, they can be treated early and with minimal discomfort or inconvenience on your part.

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Patient Stories

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