Top 10 Bariatric Questions Answered

Kirsty at RealSelf on 8 Sep 2010 at 12:00pm

When you make the decision to go through any form of surgery there are inevitably a thousand questions that pop into your mind. It is also inevitable that these questions will come to you about 30 seconds after you've left the doctors office. This is where provides an invaluable, free service to all of our community members.

RealSelf not only provides a community and support network for our members, but for every cosmetic treatment there is an expert Doctor Q&A. The bariatrics community is no different. Whatever your question there is a surgeon, specialized in bariatrics, who can help. You can also read through many questions from our other community members that our medical experts have already answered.

Below is a list of the top 10 bariatric surgery questions that have been answered by medical experts.

Gastric bypass vs. gastric band – How to choose?
From Richard Bonnor, MD: "The gastric bypass procedure is a restrictive and malabsorptive operation. With the proper nutritional counseling and behavior modification, you can get close to your ideal body weight. This operation can be performed and has excellent results in patients with a BMI >45 and those who have a metabolic condition such as diabetes... The lap band can be an effective operation for the well motivated patient who will exercise routinely and follow good nutritional advice. The band is purely a restrictive procedure and does not change your absorptive capacity, therefore it is much less effective overall. The lap-band is best for patients in the BMI range of 35 to 45... The lap band has a lower risk profile than the bypass but it still has complications."

How much does gastric banding cost?
From Richard Bonnor, MD: "There are nationwide differences in the cost of lap band surgery but one can reasonably expect the cost to be in the range to $ 8500 to $11,000 at this time... An important issue to consider is that cash patients may be exposed to significant costs if there is a complication. Ask about what happens if there is an issue with the lap band in the short term and how that is covered or not covered."

Am I required to see a psychologist before having a gastric bypass?
From Carmen Kavali, MD: "This surgery is very high risk, and the overall success of the surgery depends greatly on you and what you do after your recovery. Insurance companies and bariatric surgeons both need to know that you are stable and capable of understanding the gravity of your situation and your responsibility in the success of your procedure. In addition, you may find the session(s) useful, as many people who struggle with weight issues have psychological issues with food. Look at this 'requirement' as an opportunity!"

What is dumping syndrome?
From Otto Joseph Placik, MD: "Dumping syndrome is commonly caused by rapid entry of undigested food products from the stomach into the small bowel where your body is not prepared for the concentration and rushes to dilute it by "dumping" fluid and electrolytes rapidly into the contents of the intestines. This can cause discomfort and nausea with the rapid expansion and electrolyte imbalances or diarrhea due to the undigested materials."

How many times can a Lap Band be filled?
From Otto Joseph Placik, MD: "The diaphragms on the fill port are intended to be accessed hundreds of times if the proper needles are utilized to avoid damage to the silicone."

Is the Lap Band reversible?
From Mark Pleatman, MD: "The adjustable gastric band is supposed to stay in place for the rest of your life. If it is removed, most patients invariably regain the lost weight rapidly. Reason to remove the band include: slippage, erosion, esophageal dilation or failure to lose weight. If you reach your goal with the band, be happy and leave it as is."

Do I need to buy special weight-management food after my bariatric surgery?
From Carmen Kavali, MD: "No [need for] special weight management food after bariatric surgery but you will have to watch your portions and you will need to learn a lot about nutrition as it relates to the specific type of bariatric surgery you have done. Also, you should expect to need vitamin supplements; again, the exact ones you'll need will be dictated by the type of bariatric surgery you have done. The best way to start to do your homework related to questions like this is to attend a local bariatric surgery informational meeting."

Can I get pregnant after gastric bypass surgery?
From Peter A. Aldea, MD: "As a post-bariatric surgery patient you will have your nutritional status closely monitored and should not be nutritionally depleted. As such you may fall into a higher risk OB group but there are many women having these procedures who are carefully followed before getting pregnant to make sure the babies are well. Ask your bariatric surgeon which OB practices specialize in such patients and you will do well."

Gastroplasty revision - Where to go to get a revision?
From Mark Pleatman, MD: "Start by getting a copy of your original operative report, so your new surgeon will know exactly what was done... If you only had an adjustable gastric band, removal is relatively simple, and can be done laparoscopically; sometimes it can even be done 'through the mouth' with an endoscope... The good news is that this isn't an emergency."

How long should I wait after my bariatric surgery before I get plastic surgery?
From Carmen Kavali, MD: "Once you are within about 15-20 pounds of your goal weight, have plateaued in your weight loss for about 6 months, and are about 18 months out from your bariatric procedure, then you are likely ready for the procedures that will truly showcase all your hard work!"