After struggling with a weight problem for years, some individuals reach a point where dramatic measures seem to be necessary.

Weight loss surgery is therefore at times a realistic option for obese persons who have tried every diet and weight loss system available, yet still can’t take off the pounds.

Types of Weight Loss Surgery

• Restrictive procedures that make the stomach smaller in order to limit the amount of food consumed.
• Malabsorptive techniques that reduce the amount of intestine that coming into contact with food so that fewer calories are absorbed by the body.
• Combination operations that use both restriction and malabsorption to achieve weight loss.

How much does Weight Loss Surgery cost?

The average cost for a gastric bypass procedure ranges from $18,000 to $35,000, The average cost for an adjustable gastric banding with Lap-Band procedure ranges from $17,000 to $30,000.

Other kinds of weight loss surgery including gastric sleeve surgery and duodenal switch surgery cost roughly the same as gastric bypass and gastric banding. There are also promising new and minimally invasive bariatric surgeries on the horizon, but the cost is yet-to-be-determined for these new weight loss surgery procedures.

After the main weight loss surgery procedure, a bariatric surgery diet must be adhered to. It’s also likely that additional surgical procedures such as liposuction, breast augmentation or reduction and tummy tuck will be necessary. These follow-up cosmetic procedures usually take place one or two years after bariatric surgery is completed.

Does Insurance cover Weight Loss Surgery?

Health insurance including Medicare and, in some localities, Medicaid, are starting to cover some or all of the costs of weight loss surgery. It is necessary to establish for your doctor to classify it as a medical necessity as defined by the National Institutes of Health requirements.

If your doctor provides the insurance company with medical documentation that you have a B.M.I. (body mass index) over 40 and that the surgery is medically necessary to treat morbid obesity, the insurance company will probably cover the majority of the cost of the surgery. Your doctor must also state that other weight loss methods have failed and therefore bariatric surgery appears to be the only remaining option.

You may qualify for insurance coverage of weight loss surgery if you fall under one or more of the following categories:

• A BMI of 40 or higher.
• A BMI of 35 or higher with serious obesity-related health problems, including diabetes, heart disease, high blood pressure or severe sleep apnea.
• Women who are more than 80 pounds overweight.
• Men who are more than 100 pounds overweight.
• Both men and women who have been overweight for at least five years.

Weight Loss Surgery Success Rates

The success of weight loss surgery varies by the individual and the type of procedure performed. Lap band and gastric bypass surgery have mixed success rates, while the duodenal switch appears to provide the most successful long-term weight loss (see chart above).

One of the best ways to educate yourself is to post your questions on various weight loss surgery forums and get feedback from others who may have a similar problem or already have undergone bariatric surgery. Take your time and make sure you choose the right bariatric doctor and understand all the weight loss surgery options available.

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The surgical procedure known as bariatric gastric bypass is a way to achieve major – and hopefully permanent – weight loss. It is also a potential remedy for type 2 diabetes and other health conditions related to morbid obesity. Statistics show that gastric bypass surgery can help people as much as 90 percent of their excess body weight.

This operation works by modifying the stomach to limit food intake and suppress appetite. If you have an obesity-related medical condition, you may be able to lose weight and improve your overall health by undergoing bariatric gastric bypass surgery.

Gastric bypass surgery helps you lose weight by changing how your stomach and small intestine digest the food you eat. After the surgery, your stomach will be smaller, so that you will feel full even though you are eating less food.

Moreover, the food you eat will no longer go into certain areas of your stomach and small intestine. Since your stomach and intestines aren’t completely digesting the food, your body will not absorb all the calories.

Gastric bypass can be done in two ways. The first way is for your surgeon to make a large incision in your belly. Your surgeon will then reach inside and perform  the bypass by directly moving around your stomach, small intestine, and other organs.

The second way to do bariatric gastric bypass is to use a tiny camera, or laparoscope. This is called laparoscopic bariatric surgery. First, the surgeon will make several small incisions in your belly. Then he or she will pass the laparoscope through one of these incisions.

The laparoscopic stomach camera will be connected to a video monitor in the operating room, and your bariatric surgeon will look at the monitor to see inside your belly. Using thin surgical instruments, the doctor will then perform the gastric bypass.

Gastric Bypass Surgery: The Basics

There are two basic steps involved for each type of gastric bypass:

• Step One: This reduces your stomach size. Your bariatric doctor will use staples to separate your stomach into a small upper section and a larger bottom section. The top section of the stomach is called the “pouch” and this is where the food you eat goes. This pouch is about the size of a golf ball. It holds only about 1 ounce of food.
• Step Two: This is the bypass itself. Your gastric surgeon will connect the jejunum, which is a part of your small intestine, to a small hole in your pouch. The jejunum is located farther down from where the stomach normally attaches to the small intestine. Food consumed will now move from the pouch into this new opening into the small intestine.

When food travels this way, it “bypasses” the lower part of your stomach and the first section of the small intestine. As a result, your body will now absorb fewer calories.

Gastric Bypass: What are the Risks?

Gastric bypass surgery usually takes about 4 hours, and is followed by several days of recovery in the hospital. A liquid diet starts almost immediately after the surgery, with a gradual transition to solid foods.

Be aware that this type of weight loss surgery can increase the risk of gallstones. Your bariatric physician may also recommend that you have surgery to remove your gallbladder before your gastric bypass surgery.

Be sure to consider all your options and educate yourself thoroughly before making the decision to have bariatric gastric bypass. It is major surgery, it is expensive, and it requires a commitment to major dietary and lifestyle changes in order to be successful over the long-term.

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A bariatric doctor specializes in problems of the stomach and digestive system. The best bariatric doctors belong to The American Society of Bariatric Physicians (ASBP), which is the name of the medical professional association for physicians who treat and manage overweight and obese patients and their related conditions.

The American Society of Bariatric Physicians is the primary source for clinical education and training for the non-surgical medical management of obesity. An obesity program should be supervised by a physician who is a member of the ASBP and who has completed specialized training in bariatric medicine.

If you have already know which kind of bariatric procedure you wish to have, then it’s important to find bariatric doctors who are experts in that particular procedure. Don’t allow a general doctor to make the decision for you.

How to Find a Qualified Bariatric Physician

Make sure you do some fact-finding on your own because unfortunately, bariatric physicians need to make money just like anyone else. They will of course try to persuade you to have surgery in their own clinic!

For example, if you search for bariatric doctors in Atlanta, you’ll probably read that it’s the best place to have the surgery done because of the warm weather. The most important thing is to find a bariatric surgeon with an outstanding reputation to perform your bariatric surgery. Don’t be afraid to travel to another city or another state to find the best gastric surgeon.

Also, don’t get sucked in by the fit, attractive men and women on the covers of brochures for certain bariatric clinics. Often, these are models and not real people who have actually had weight loss surgery.

Qualified weight loss doctors have received many hours of specialized training in bariatric medicine in order to help individuals suffering from obesity. This chronic disease can be treated with a comprehensive program of diet and nutrition, as well as exercise and lifestyle changes.

Medical Weight Loss Programs

Before proceeding with obesity surgery, problems such as such as emotional eating, binge eating, negative body image, low self esteem and lack of self control should be treated with behaviorial counseling. A medical weight loss program should be structured to help one maintain weight loss for the long-term.

Research your bariatric surgeon’s background. Weight loss surgery success rates are usually dependent on the doctor’s experience level and past track-record. Your surgery will be more likely to succeed if you choose a doctor who has performed hundreds of bariatric surgeries already.

Be straightforward and honest about your own medical history. Don’t talk yourself into bariatric surgery! It’s not a decision that should be taken lightly. Your doctor may be able to offer an alternative to surgery.

Discuss with your weight loss doctor your expectations for eating habits and weight loss after the surgery. Make sure you have information on bariatric surgery diets so that you understand what you can and cannot eat.

Understand the Risks of Bariatric Surgery

Be aware of potential side effects. Complications that are common with bariatric gastric bypass surgery include infection, internal bleeding, blood clots, bowel obstruction and anesthesia-related problems. Even successful surgery can have unwanted side effects such as loose skin, gallstones, vitamin deficiency and “dumping syndrome.”

Be clear on the cost of weight loss surgery and your payment options. Weight loss surgery may be covered by insurance as a medical need, but make sure you confirm this. Bariatric procedures are quite expensive, and your physician might have some type of payment plan or financial assistance to help you defray the cost of the surgery.

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After bariatric surgery, you will be forced change your diet and lifestyle in order to support rapid weight reduction. Proper nutrition is vital to maintain lean body mass, stay hydrated, and keep your skin elastic.

Your nutrition goals after bariatric surgery should be as follows:

• Adopt proper eating habits to promote weight loss while maintaining your health.

• Eat enough protein to minimize loss of lean body mass and promote healing from the surgery.

• Drink enough fluids to stay hydrated.

• Take vitamins and mineral supplements to compensate for your reduced food intake.

Post-Op Bariatric Surgery Diet

Most weight loss surgery patients will be put on a liquid-only meal plan for two to three weeks after they leave the hospital. Patients then graduate to soft foods for the next six to eight weeks and eventually transition to regular foods over the next six to nine months.

Starting on the day you go home from the hospital, you should drink two ounces of high-protein liquid nutritional supplement every hour throughout the day. This must be a nutritionally-complete liquid that can pass through a standard strainer.

In addition to this nutritionally-complete liquid, you should attempt to consume two ounces of water or non-carbonated low calorie liquid every 15 minutes, for a total of eight fluid ounces per waking hour.

Depending on your individual medical history and the type of gastric bypass surgery, many bariatric doctors will recommend that you take a daily multivitamin and mineral supplement as well.

Bariatric Surgery Diet Precautions

• The most important thing is to drink enough liquids to prevent dehydration. Protein consumption is less important in this early stage. You must drink a total of six to eight cups of liquids per day to avoid becoming dehydrated.
• Drink slowly, and don’t rush it. Over a period of several days, you will become accustomed to consuming the necessary liquids.
• Do not start solid foods until you have your three week follow-up visit with your doctor and bariatric surgery dietitian.
• Three weeks after surgery you will follow-up with your surgeon back at the clinic and learn how to successfully incorporate soft solid foods into your bariatric diet menu.
• Soft and easily-digestible foods will be gradually incorporated into your meal plan over the course of the next 6 to 8 weeks. During this time you must continue to focus on high protein foods and stay away from foods that are high in fat, sugar, or fiber.

Consider Taking Vitamin Supplements

Protein is vital to support healing and maintain muscle mass after weight loss surgery. It may also help reduce hair loss that may come with rapid weight loss. Try to consume 40 to 60 grams or more of protein per day.

You may still need to get some of your protein from vitamin supplements until you are able to consume enough solid food to meet your nutritional needs.

Remember that you will not be able to eat a large volume of food at one time. Be prepared to eat small meals four to six times a day.

It is important that you recognize when you are full. Signs of fullness are pressure, tightness, or heaviness in the center of your abdomen just below your breast bone.

A feeling of nausea, regurgitation or heartburn is a sign that too much food has been consumed or that the food was eaten too rapidly!

After 10 to 12 weeks, you should ready to go from soft solids to regular foods. Eventually, you will probably be able to eat many of the foods you were eating before bariatric surgery, but in much smaller amounts.

Try to make healthy food choices that include lean meat or vegetable protein, low-fat dairy products and fresh fruit and vegetables. Do your best to avoid junk foods that are typically high in fat and sugar. Patience is key as you oh-so-gradually return to normal eating habits.

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For obese individuals who have decided to undergo weight loss surgery, a new technique known as laparoscopic bariatric surgery is now available.

This minimally invasive laparoscopic bariatric surgical procedure involves a bypass of a portion of the stomach. Options include laparoscopic isolated gastric bypass, adjustable gastric band, Roux-en-Y and sleeve gastrectomy.

Using a laparoscope, four to six small openings approximately one-half to one inch long are made in the patient’s abdomen. These openings allow the bariatric surgeon to pass a light, a camera, and some surgical instruments into the abdomen.

Next, the abdomen is inflated with carbon dioxide gas in order to allow the surgeon to get a better view of the inside of the stomach and its internal structures. Surgical instruments about the size of a pencil are then placed into the abdomen to perform the surgery.

In a Roux-en-Y gastric bypass, more than 95 percent of the stomach is bypassed and only a small portion remains functional. A  related bariatric procedure known as a sleeve gastrectomy involves the removal of roughly 70% of the stomach by bypassing the intestines.

Adjustable Gastric Band Procedure

In an adjustable gastric band procedure, the stomach is restricted by the placement of the gastric band, which can be adjusted after surgery for further weight loss.

A gastric band device is inserted through very small incisions in the abdomen and then placed around the upper part of the stomach. The resulting pouch (sometimes called the “new stomach”) dramatically reduces the digestive capacity of the stomach.

The band has a balloon on the inside that is adjustable in order to reduce stoma size. This prolongs the period of fullness, and reduces food consumption.

This weight loss surgery is performed under general anesthesia and takes from 30 minutes to an hour to complete. The band is fitted around the uppermost section of the stomach, forming a very small pouch.

The pouch is designed so that it can be inflated or deflated at any time after the operation. With the support of a bariatric surgery diet, this helps the patient continue to lose weight until their weight-loss goals are achieved.

Minimally invasive bariatric surgery has been performed since the mid-1990′s. The overall results after laparoscopic weight loss surgery appear to be equal to open bariatric procedures.

Laparoscopic Bariatric Surgery Candidates

Not all patients are suitable for laparoscopic weight reduction surgery, so an open bariatric weight loss procedure is sometimes necessary.

These days, almost all bariatric operations can be performed using laparoscopic techniques. Currently, bariatric surgical procedures are the most effective way to achieve significant, sustained weight loss for the morbidly obese.

The treatment of obesity through surgery is often more successful than fad diets, meal supplements and shape-up-in-a-hurry exercise programs. Acupuncture to lose weight may or may not be effective in cases of morbid obesity, but is certainly worth trying.

When performed by properly trained surgeons, bariatric surgery performed via laparoscope appears to speed recovery and helps patients return to a normal, productive life sooner than with open surgical procedures.

Nevertheless, when considering weight loss surgery, be sure to research the background and qualifications of your bariatric doctor thoroughly. It is not a decision to be taken lightly.

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