The Skinny on Bariatric Surgery
UT Southwestern Medical Center’s Bariatric Surgery Program has a long history of treating obesity. In fact, the first laparoscopic gastric bypass operation in the state of Texas and the first gastric banding procedure in North Texas were both performed at UT Southwestern. And many bariatric surgery providers in North Texas received their training at UT Southwestern.
Who better to ask all those things you’ve always wanted to know about bariatric surgery?
Will bariatric surgery really help me lose weight?
Bariatric surgery can be a very effective way to lose weight for patients who haven’t been successful with diets. There are several types of bariatric surgeries, but none work without a substantial degree of effort on your part. The most important thing for a prospective patient to understand is that these operations only work to help you comply with your diet; they don’t replace the need to actively work at managing the amount and type of food you eat.
Who is a good candidate for bariatric surgery?
Bariatric surgery is mostly for people with a body mass index (BMI) above 35. Generally speaking, a person with normal weight will have a BMI of between 18 and 25; an overweight person will have a BMI of between 25 and 30; and an obese person will have a BMI of 30 or greater. Bariatric surgery is generally for people who are a lot overweight, not just a little heavy.
Is bariatric surgery typically covered by insurance?
Most insurance companies will cover the procedure if the patient’s BMI is 40 or greater (which is approximately 100 pounds overweight), or the patient’s BMI is 35 or greater and they have at least one comorbidity (additional disease or disorder). Some insurance companies require documentation of participation in a weight-loss program prior to authorizing bariatric surgery. On a cash basis, the cost can range from $13,000 to $20,000 depending on the type of procedure, whether it’s inpatient or outpatient surgery, the amount of insurance coverage, deductibles, self-pay discounts, etc. A company called Chase Health Advance offers financing options for medical procedures.
Is bariatric surgery risky?
Different types of bariatric surgeries result in different degrees of weight loss, and they pose different risks. Generally speaking, there’s a corresponding relationship between the operation’s success in generating weight loss and the procedure’s risks. In other words, the most effective procedures also carry the greatest risks.
Which bariatric surgical procedure is most effective?
The Roux-en-Y gastric bypass is the most effective operation for inducing weight loss. This operation involves stapling the stomach closed below the esophagus, creating a much smaller stomach, and then bypassing the remaining stomach straight to the small intestines. This operation causes patients to eat less and is very effective in reducing ingestion of fattening foods such as sugars. After the operation, people will feel ill if they eat highly fattening foods, thus reducing their desire for them.
How much weight can a patient expect to lose with the Roux-en-Y gastric bypass?
Although the risks of most short- and long-term complications from this operation are greater than for any other bariatric procedure, it’s the most effective procedure in causing weight loss, and the weight loss induced is the most long lasting. A patient can reasonably expect to lose one-third of their total body weight from this procedure within a year of the operation.
What are lap band procedures?
Laparoscopic banding procedures have become very popular in recent years. These operations involve entering the abdomen through a series of small incisions and placing an inflatable balloon-type device around the upper portion of the stomach. This device is connected to another device placed underneath the skin that allows physicians to inflate or deflate the band, enabling them to restrict the amount of food traveling through the stomach. Complications are rare for this procedure.
What about results with the lap band?
Weight loss tends to be less than experienced in gastric bypass and may take as long as five years for patients to lose their desired weight. Success for this procedure is highly dependent on a patient’s compliance with their diet. Patients who’ve had laparoscopic banding operations need frequent visits with their physicians and dietitians to maintain a rigorous diet.
What is a gastric sleeve?
The gastric sleeve operation involves removing part of the stomach, which results in a much smaller organ that restricts the passage of food. The theory behind the gastric sleeve is that the portion of the stomach that’s removed is the part that produces a hormone called ghrelin that causes people to become hungry. By removing this hormone, hunger is reduced and weight is lost.
Is the gastric sleeve effective?
The gastric sleeve operation is new, and there’s no adequate long-term follow-up data to support its use. The operation has promise, but it needs to be subject to controlled clinical trials. Most insurance companies don’t cover the gastric sleeve. Our surgeons are proficient in this operation and can perform it if patients desire; however, we prefer the gastric bypass or laparoscopic banding operation.
How do you determine which bariatric procedure is appropriate for each patient?
The type of surgery that’s best for you will be determined by a team of bariatric specialists that includes a bariatric surgeon, psychiatrist, dietitian, and nurse practitioners. They consider each patient individually, taking into account the patient’s physical condition and ability to exercise, diet, eating habits, lifestyle, emotional issues, etc. The team guides each patient in making an informed decision.
How long does it take to recover from bariatric surgery?
Each patient is different, but generally speaking, lap band surgery requires a one-night hospital stay and the patient is usually able to go back to work in a week; for gastric sleeve surgery, two nights in the hospital are usually required, and the patient can return to work in a week; for gastric bypass, count on two nights in the hospital and 10 days to two weeks before returning to work.
Are patient follow-up visits typically required after bariatric surgery?
Each type of bariatric surgery requires a series of follow-up visits after the procedure, which are spread out over weeks and months for the first year. After the first year, annual check-up visits are recommended following gastric bypass surgery, while check-up visits every one to two years are recommended following lap band and gastric sleeve surgery.
Is bariatric surgery reversible?
Lap band surgery is reversible, but gastric bypass and gastric sleeve surgeries are not.
Are UT Southwestern doctors more familiar with one type of procedure than another?
Our surgeons have a great deal of knowledge regarding all these surgical options and would be happy to discuss them with you during a consultation at UT Southwestern.