Reviewing options with a patient

How We Can Help

Surgery should be viewed as a method for alleviating a debilitating chronic disease. Morbid Obesity is a complicated chronic disease. It is usually not solved simply by eating less and exercising more. Most people who are able to loose weight this way often regain the lost weight within one year.

Surgery for Morbid Obesity has been proven to help patients remain at healthier weights for longer periods of time. In most cases the minimum qualification to be considered a candidate for a bariatric operation is a Body Mass Index, or BMI, of 40 or greater. Occasionally, someone will be considered  a candidate if the BMI is between 35 and 40 if there are also obesity related health conditions present, such as Obstructive Sleep Apnea, Diabetes and high blood pressure.

Surgery alone will not sustain weight loss. Our patients who have the most success with weight loss are committed to a long-term strategy of working with the experts on our Bariatric Surgery team before, during and after surgery.  Our multi-disciplinary team is committed to your long term success.  We will help you with weight loss before surgery.  We will set up visits with our nutritionists to help you set and reach your goals for healthy eating and sustained weight loss before and after surgery.  We will help you find a support group near your home, and we will continue to see you for regular follow up visits in our office.
Expand all

Surgery Options

Roux-en-Y Gastric Bypass Gastric Sleeve

Roux-en-Y Gastric Bypass

Gastric Sleeve

How is the surgery done?

A small 15-30 ml gastric pouch is connected to the small intestine bypassing the stomach allowing food and digestive juices to be separated for 3 to 4 feet.

A thin tube of stomach is made. The other, larger part of the stomach is completely removed.

The sleeve typically holds 50-150 ml and is about the size of a banana.

How does this surgery help?

Significantly reduces the amount of food that can be eaten at a meal.

Some "malabsorption" will occur because of the bypassed portion of the small intestine.

"Dumping Syndrome" may be experienced if the wrong foods such as sugar or fats are eaten.

Moderately limits the amount of food that can be eaten at a meal.

Food goes through the digestive tract in the normal manner, so there is no "malabsoprtion."

No future adjustments have to be made.

What type of surgical approach is used?

Laparoscopic (i.e. minimally invasive) in which 6 small (5-10 mm) cuts are used.

-Or-

Open approach in which a traditional mid-line abdominal cut is used.

Laparoscopic (i.e. minimally invasive) in which 6 small (5-10 mm) cuts are used.

-Or-

Open approach in which a traditional mid-line abdominal cut is used.

How much weight can I expect to lose?

The average weight loss is 65% of the excess (based on your starting weight).

In clinical studies, patients have lost an average of 55% of the excess weight.

What diet and lifestyle changes are required?

Patients must consume less than 800 calories per day in the first 12-18 months; 1000-1200 calories thereafter.

Must include 3 small high protein meals per day.

No drinking with meals.

Must avoid sugar and fats to prevent "Dumping Syndrome."

Vitamin deficiency/protein deficiency are usually preventable with proper diet, follow-up and supplements.

Must exercise (e.g. walk 10,000 steps per day using pedometer).

Patients must consume less than 800 calories per day in the first 18-36 months; 1000-1200 calories thereafter.

No drinking with meals (can drink 30 minutes before and 45 minutes after a meal).

Must include 3 small high protein meals per day ~ approximately 1/2 cup.

Must avoid concentrated sweets and high fat foods.

Vitamin deficiency/protein deficiency are usually preventable with proper diet, follow-up and supplements.

Must exercise (e.g. walk 10,000 steps per day using a pedometer).

What lifetime nutritional supplements will I need?

Multivitamin
Calcium
Vitamin B12
Iron

Multivitamin
Calcium
Vitamin B12

How quickly will I lose the extra weight?

Patients will experience rapid weight loss in the first few months.

Around the one to one and a half year mark the weight loss will plateau.

The weight loss is often followed by some weight regain and stabilization depending on patient compliance with diet and exercise.

Patients will experience greater weight loss than with the band and slightly slower weight loss than with the gastric bypass.

The weight loss is often followed by some weight regain and stabilization depending on patient compliance with diet and exercise.

How long will I be in the operating room?

70 minutes (Avg.)

60-75 minutes (Avg.)

How long will I need to stay in the hospital?

2 days (48 hrs.)

2 days (48 hrs.)

When can I return to work?

Not until your surgeon says it is ok but some patients can return to desk jobs within 2 weeks of surgery.

Not until your surgeon says it is ok but some patients can return to desk jobs within 2 weeks of surgery.

When is my first follow up with my surgeon?

1-2 weeks after surgery.

1-2 weeks after surgery.

Where is the surgery performed?

University Hospital at SUNY Upstate Medical University.

University Hospital at SUNY Upstate Medical University.

How long must I wait to have surgery?

Most patients average 3 to 6 months of preoperative training and preparation.

Most patients average 3 to 6 months of preoperative training and preparation.

Who pays for the surgery?

Your insurance (provided your insurance carrier approves the surgery).

Your insurance (provided your insurance carrier approves the surgery).

Is the operation reversible?

It is not recommended except in very unusual circumstances.

Weight regain is almost a certainty.

NO Since the part of the stomach that is detached is removed, the operation is not reversible.

What operation is best for me?

Most effective for patients with a BMI of >=35 (with comorbidity) or >40 especially those with a "sweet-tooth."

It takes away the hunger and produces 10-15% more weight loss then Adjustable Gastric Banding.

It is considered the "Gold Standard Procedure" for weight loss in North America.

Most effective for patients with a BMI of >=35 (with comorbidity) or >40

You and your physician will discuss the options and after being informed on the risks and benefits of each procedure, you will ultimately make the decision.

Life After Surgery

During Bariatric Surgery the size of the stomach is drastically reduced. This smaller stomach only allows the person to consume 3 to 4 tablespoons of food during a meal.   With gastric bypass surgery the digestive tract below the stomach is also altered. After leaving the small stomach pouch, food is re-routed to bypass some of the small intestine. This means a smaller amount of calories and nutrients are absorbed during digestion.

The modifications made to your gastrointestinal tract will require permanent changes in your eating habits. You may hear of other patients being given different guidelines following their weight loss surgery. It is important to remember that every surgeon does not perform the exact same weight loss surgery procedure and that the dietary guidelines will be different for each type of procedure. What is most important is that you strictly adhere to your surgeon's recommended guidelines.

The following are some of the generally accepted dietary guidelines a weight loss surgery patient may encounter:

  • When you start eating solid food it is essential that you chew thoroughly. You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.
  • Don't drink fluids while eating. They will make you feel full before you have consumed enough food.
  • Omit desserts and other items with sugar listed as one of the first three ingredients.
  • Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.
  • Avoid alcohol.
  • Limit snacking between meals.

An example of a menu plan can be found here:PDF Icon

Follow up appointmentsExternal Icon after bariatric surgery are critical. When you are losing weight, you will be asked to follow up frequently. We ask patients to come back to clinic at 2 weeks, 6 weeks, 3/6/9/12/18 months and then  you will need periodic checks for anemia (low red blood cell count) and Vitamin B12, folate and iron levels yearly for the rest of your life.

Birth Control and Pregnancy

It is strongly advised that women of childbearing age use the most effective forms of birth control during the first 16 to 24 months after weight loss surgery. The added demands pregnancy places on your body and the potential for fetal damage make this a most important requirementExternal Icon.

Support Groups

The use of support groups has provided weight loss surgery patients an excellent opportunity to discuss their various personal and professional issues. Most learn, for example, that weight loss surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on their emotional well-being. Our program has support groups in place to assist you with short-term and long-term questions and needs. Most bariatric surgeons who frequently perform weight loss surgery will tell you that ongoing post-surgical support helps produce the greatest level of success for their patients.

To see list of local support groups, when and where each meets go to our Local Support Groups.

Top