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Ask The Expert: Dr. Nick Answers 10 FAQ About Weight Loss Surgery

Oct 16, 2014

Have you been considering weight loss surgery to help you reach your weight loss goals and live a healthier lifestyle? If you’ve given any thought to weight loss surgery, you probably have some questions about the procedures available.

Here are answers to 10 frequently asked questions about bariatric surgery from Dr. Nick:

How do I know if weight loss surgery is right for me?  

Weight loss surgery is not for everyone, but it might be right for you. At the Nicholson Clinic, our qualifications for a LAP-BAND/REALIZE™ band, gastric bypass surgery, or gastric sleeve are as follows:

  • A body mass index (BMI) of 30 or more (which translates to about 100 pounds overweight for men and 80 pounds overweight for women).
  • BMI of 30 or more, accompanied by a co-morbidity, such as type 2 diabetes, hypertension, GERD, sleep apnea, joint disease.
  • History of obesity.
  • Evaluation with a clinic psychologist. The Nicholson Clinic has referrals and partners available to help meet this requirement.

In addition to the qualifications listed above, it is also beneficial that the patient have a thorough understanding of the weight loss procedure chosen and the lifestyle changes that are necessary for it to be successful. The Nicholson Clinic provides these educational services to all prospective patients.

How does weight loss surgery work

How your weight loss surgery helps you lose weight is dependent on the type of surgery you have. There are two basic types of bariatric surgery: restrictive surgeries (like gastric sleeve and LAP-BAND) and malabsorptive surgeries (like gastric bypass), and the mechanisms resulting in weight loss are different in each.

  • Restrictive surgeries reduce the capacity of the stomach, limiting the amount of food a person can eat. The goal is to help the patient feel satiated with smaller amounts of food. The reduced caloric intake naturally results in weight loss. During gastric sleeve, for example, a large part of the stomach is divided and vertically removed. The remaining stomach, now reduced to about 25 percent of its original size, is shaped like a banana and resembles a tube or sleeve, and the amount of food volume that can be comfortably ingested is reduced.
  • Malabsorptive surgeries alter the way the digestive system absorbs food. During gastric bypass, for example, the stomach is made smaller by creating a pouch at the top of the stomach. The smaller stomach is then connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine. The result is that the patient will feel full more quickly than when the stomach was its original size, resulting in reduced caloric intake and consequently, weight loss.

How can weight loss surgery affect my overall health?

There are a number of obesity-related medical problems that can be greatly improved or even eliminated with weight loss surgery. These conditions include:

  • Obstructive sleep apnea
  • Type 2 diabetes
  • Gastroesophageal reflux disease (GERD)
  • High cholesterol
  • Degenerative joint disease or orthopedic problems
  • High blood pressure
  • Asthma
  • Urinary incontinence

What are the risks of weight loss surgery?

Each weight loss procedure has its own specific risks that your doctor will go over with you while addressing your personal health and medical conditions.

How much weight will I lose with weight loss surgery?

The amount of weight that you lose and the amount of time it takes to lose the weight depends on a number of factors including the type of weight loss surgery that you choose and how committed you are to maintaining a healthy lifestyle after the surgery.

With LAP-BAND band surgery, an average patient loses 36 to 40 percent excess body weight within one year with an average of 60 to 65 percent excess weight loss three to five years post surgery.

With gastric bypass, an average patient experiences 70 percent to 80 percent excess weight loss at one year.

With sleeve gastrectomy or gastric sleeve surgery, weight loss falls in between the LAP-BAND and gastric bypass.


Will my insurance cover my weight loss surgery?

Most insurance companies at least partially cover weight loss surgery if it is considered medically necessary and the patient meets the requirements. Nicholson Clinic has a team of insurance specialists to help you navigate the process, minimize your out of pocket expense, and maximize coverage for your procedure.

Will I have to have plastic surgery after weight loss surgery

Losing an excessive amount of weight often means that weight loss surgery patients are left with excess, saggy skin, which can be both uncomfortable and unsightly. Plastic surgery is available to remove this excess skin and in many cases, Nicholson Clinic is able to find ways to have your insurance company help cover at least a portion of this surgery.

Can I get pregnant after weight loss surgery?

The Nicholson Clinic recommends that patients refrain from getting pregnant for at least one year following surgery. During this time, you will be losing weight very rapidly and such weight loss can be harmful for a pregnancy. After the first year, when you have returned to a regular diet – and are at a healthier weight – you have a much better chance for a healthy pregnancy.

What is the difference between bariatric surgery and weight loss surgery?

“Bariatric surgery” is medical terminology for weight loss surgery. It does not separate out any of the different types of surgery; it is the generic term for weight loss surgery.

What are the differences between LAP-BAND and Gastric Sleeve?

The main difference between a lap band and a sleeve gastrectomy lies in their mechanism of action. A lap band is strictly a portion control only operation, as opposed to a sleeve gastrectomy that's more of a portion control than appetite suppression operation.

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