We offer several approaches to weight loss. Through research we have shown that surgical weight loss is much more effective. Medical weight loss has shown up to 10% weight loss, but with high risk of regaining weight. Surgical weight loss can offer up to 65-75% of your excess body weight lost, depending on which operation you choose and which you qualify for. Typically, the weight loss can be maintained with proper follow-up.

Weight-loss results vary from patient to patient, and the amount of weight you lose depends heavily on your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won’t come off by themselves. Surgery is simply a tool that must be used properly for it to work. It is very important to set achievable weight-loss goals from the beginning. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. Remember that you should lose weight gradually. Losing weight too quickly creates a health risk and can lead to a number of problems. Close follow-up is required to make sure you are achieving the weight loss safely. The main goal is to have weight loss that is maintained and prevents, improves, or resolves health problems connected with severe obesity.

All of the weight loss procedures limits food intake. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well enough or that you are not following the diet rules properly. However, it could also mean that there is a problem, so contact your doctor if it persists. Vomiting should be avoided as much as possible as it can cause the reduced stomach to stretch.

All surgery is performed robotically.  Patients typically spend 24-48 hours in the hospital. It takes most patients about 3-4 weeks to return to work and a month to six weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.

That is not always the case. As a rule, plastic surgery will not be considered for at least 18 months after the operation as, some-times the skin will mold itself around the new body tissue. Give the skin the time it needs to adjust before you decide to have more surgery.

These procedures make you eat less and feel full in two ways—first by reducing the capacity of your stomach and second by increasing the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived. Remember that weight loss surgery is a tool to help you change your eating habits. Occasionally the feeling of being deprived can represent a vitamin or mineral deficiency. This is another reason it is important to follow-up with your Weight Management Team on a routine basis post bariatric surgery.

Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. It is recommended with any weight loss procedure, that you wait approximately 18 months post surgery before trying to become pregnant. At this point your body will be more adapted to handle the stress of bearing a child—significant weight will have been lost, making it easier to carry the weight of a baby. Furthermore, obesity has been linked to stillbirths. Weight loss will benefit not only you, but your child. Children of obese parents become obese 80% of the time.

Yes. All weight loss surgery patients will be required to take life long vitamins. The bariatric surgery procedures limit the amount of food intake and variety of foods consumed.  Acid production is altered which also affects absorption. A bariatric-specific multivitamin is designed to provide the appropriate level of supplementation to support the needs of a bariatric patient as their needs are different from the general population.  Our team will work with you at post op visits for apprpriate supplementation to prevent vitamin/mineral deficiencies. 

You should be able to take prescribed medication, though initially after surgery you may need to use capsules, break big tablets in half or dissolve them in water. The goal is to get you off medications! Always ask the doctor who prescribes your medications. Your surgeon may tell you to avoid taking aspirin and other nonsteroidal anti-inflammatory pain relievers because they may irritate the stomach.

Order only a small amount of food, such a side dish or appetizer. Some restaurants may allow you to order off the children’s menu. Most restaurant serving sizes are enough for two or more! If you are ordering alone- take home at least half or more of the meal. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.

Alcohol is not reocmmended following weight loss surgery.  Research shows that blood alcohol levels peak higher and faster and take longer to return to normal due to altered metabolism after gastric bypass surgery. 

Alcohol is high in calories and low in nutrients, which is why excess calories from alcohol can slow weight loss or even contribute to weight gain.  

Patients with a history of addiction are at higher risk for developing a new addiction. With the dramatic reduction of food consumption after bariatric surgery, some patients may trade their food addiction for other addictive behaviors, including alcohol. 

After your stomach has healed, you may eat most foods that don’t cause you discomfort. However, because you can only eat a little, it is important to include foods full of important vitamins and nutrients as advised by your surgeon and/or dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of “empty calories", the effect of the weight loss surgery will be greatly reduced.

There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fiber. This should not cause you severe problems. If difficulties do arise, check with your doctor. He or she may suggest you take a mild laxative and drink plenty of water for a while. Your needs will vary, but we recommend at least 8 cups or 64 oz of water daily.

Gastric bypass and sleeve patients are typically 1-2 days in the hospital.

Sleeve gastrectomy takes about an hour and a half. Gastric bypass typically takes 2-3 hours. The actual length of the operation depends on many different factors.

On average, people lose between 50–75% of their excess weight at two years. The amount of weight you lose depends on your motivation, how well you adhere to the post-op diet and how much you exercise. Gastric bypass patients tend to lose weight much faster, and the sleeve patients lie somewhere in the middle. All weight loss patients tend to reach the same level of average weight loss after 3-5 years.

You will be prescribed a series of healing diets initially after surgery.  You will start with liquids only and protein shakes  the first two weeks after surgery.  Diet advancement is gradual after the first two weeks thru the following three months post surgery. Your dietitian will work with you on healthy eating, because if you do not change your nutrition patterns you are at risk for weight gain and nutritional deficiencies.

Protein and vitamin deficiencies are a risk after any weight loss operation. You will be required to purchase (out of pocket cost)  protein supplementation and bariatric vitamins following any of the bariatric surgeries.   Chewable, dissolvable and liquid vitamins are easier for some patients and our team will recommend certain formulations of vitamins for each individual patient. Surgery patients will have routine blood work drawn to check vitamin levels several times in the first year and then yearly.

The surgeon performs the  surgery using a robot called the da Vinci Robotic System. Robotic surgery uses small incisions instead of a large abdominal incision and therefore is less invasive than traditional bariatric surgery.  

Most patients go back to work about 3-4 weeks after surgery. We ask anyone doing manual labor or heavy lifting avoid lifting for 4 weeks after surgery to limit the risk of post-op hernia. 

Exercise will help you lose weight. At first, we ask you to walk, or do something physical for thirty minutes per day and gradually increase your exercise as you lose weight. There is no lifting or pullling more than 20 lbs the first four weeks after surgery. The most successful weight loss surgery patients are those that exercise in addition to the caloric restriction provided by surgery.. Our fitness center is available for all patients in our program and we offer Water Aerobics as well. 

One of the reasons weight loss surgery is so successful is because the background hunger so typical of dieting goes away. This is due to decreased levels of Ghrelin (the hunger hormone.) Ghrelin levels initially drop drastically after all weight loss surgery. Patients no longer crave food and sometimes, if you can believe it, have to be reminded to eat!

 All patients that lose a significant amount of weight will experience some hair loss.. This means more hair in the brush or shower drain. You do not go bald. Supplementing with bariatric vitamins and adequate protein intake post surgery are important steps to manage hair loss. It will grow back. Hair loss usually occurs during the first year.

Once your insurance company approves the surgery (the insurance company has from 7-30 days to review all clinical notes before giving a prior authorization approval for your surgery), we can typically get surgery scheduled in approximately 2-3 weeks, but we set a tentative date once your clinical notes are submitted to your insurance company. While waiting for insurance prior authorization, you attend pre-op teaching class and begin your protein replacement diet.

There has been an increase in the number of insurance companies that will cover weight loss surgery. Other companies will continue to follow their lead. Call your insurance company and ask them what their policy is regarding weight loss surgery. 

Once we submit all clinical notes to your insurance company for review-they can take 7-30 days to authorize your bariatric surgery.

The restrictive component of weight loss surgery works by filling a small gastric pouch with food that sends a signal to your brain that you are full and to stop eating. If you drink liquid with your meals, it will flush the solid food out of your pouch and will decrease the success. For best success, you should stop drinking 30 minutes before you eat and not drink for 30 minutes after you eat.

Our program does not recommend any carbonated beverages following weight loss surgery.  Carbonated beverages can cause increase gas production and cause stomach expansion. We ask that patients refrain from drinking all carbonated beverages after surgery to avoid this risk.

Symptoms of vitamin deficiency can include anemia, neurological alterations, skin changes, and other metabolic abnormalities. These cam be difficult to diagnose and may take time to correct. The best way to treat vitamin deficiencies is to prevent them. Vitamins, calcium, and iron supplements should be taken for life after weight loss surgery.  Our team will work with you at office visits for the appropriate vitamin supplementation you need.

Yes. Some medications will need to be crushed or taken in liquid form early after the surgery due to swelling. Eventually you should be able to take most medications normally. Large tablets will need to be cut in half. Extended release or long acting medications, as a general rule, cannot be crushed or cut in two. This will reduce their effectiveness and an immediate release medication will be needed. The goal of surgery, however, is to get you off most medications!

The gastric sleeve is irreversible. The gastric bypass has been reversed with limited success and is a major operation with much higher risks than even a gastric bypass. Patients should think of a gastric bypass as permanent.

Everyone reacts to pain differently. Some patients have discomfort around the keyhole incisions for a few days, some need pain medications.  Occasionally patients experience shoulder discomfort which is related to the gas placed during surgery which irritates the diaphragm nerve that goes to the shoulder. About 5-10% of people experience significant nausea after the general anesthetic. We aggressively treat nausea and pain with medications.

Most patients can drive after 4-5 days or sooner if off all pain medications. The pain level must be low enough so that you would be able to slam on the brakes if needed.

 All patients are provided an education manual, similar to a user’s manual to walk you though the steps in use of your new tool.  This education manual guides you through what portion sizes will look like at regular eating times following surgery.  The dietitian will also work with you before and after surgery to prepare in reductions in serving sizes of foods that you will consume.

We’ll set an initial post-operative appointment approximately 1-2 weeks post op. Generally we then see you again at 6 weeks, 3 months, 6 months, and as needed, then yearly.  

Recent data suggest that 6-30% of patients will have plastic surgery for removal of excess skin. Few patients require skin fold reduction surgery after weight loss. If you are younger it is not so likely as your skin is still fairly elastic and can remodel. For older patients with high BMIs, or if you have recurrent infections in a skin fold it may be required. We usually would wait until at least 18 months from surgery (when your weight loss will have plateaued) and then consider if any skin surgery is needed.

Yes you must be nicotine free to start our program. Cigarettes/Vaping interfere with your lung's ability to exchange oxygen, and nicotine can impair circulation, impeding healing after surgery and increasing the chance of infection.