What is bariatric or weight loss surgery?

Bariatric surgery, also called weight loss surgery, is a procedure to make the stomach smaller so you feel satisfied with less food. Weight loss surgery is for people who are 100 pounds or more overweight and with a body mass index (BMI) of 40 or greater. Other criteria include not having had success with other weight loss therapies such as diet, exercise and medications.

How do I know if I qualify for weight loss surgery?

You may qualify for weight loss surgery if you are 100 pounds or more overweight and have a BMI of 40 or greater, known in medical terms as morbid obesity. A person with a BMI of 35 or greater and one or more medical conditions such as diabetes, high blood pressure or sleep apnea, among other conditions, may also qualify for weight loss surgery. We follow eligibility and BMI (body mass index) requirements for weight loss surgery established by the National Institutes of Health (NIH). 
Learn more about eligibility requirements or try our online BMI calculator here 

What medical conditions are associated with obesity?

One or more co-morbid conditions often accompany excessive weight of 100 pounds or more and a high BMI. Co-morbid conditions include:

  • Type 2 diabetes
  • High blood pressure
  • High cholesterol
  • Sleep apnea
  • Acid reflux (gastro-esophageal reflux disease GERD)
  • Higher risk for colon, breast and kidney cancer
  • Depression
  • Osteoarthritis
  • Incontinence
  • Reproductive issues in women such as polycystic ovarian syndrome (PCOS), which causes fertility problems

The good news is that weight loss surgery frequently improves or even gets rid of co-morbid conditions. The statistics below refer to patients whose gastric bypass surgery improved or resolved chronic conditions they had prior to surgery:

  • 84 percent of these patients no longer had type 2 diabetes
  • 75 percent of these patients no longer had high blood pressure
  • 95 percent of these patients experienced improved cholesterol health
  • 87 percent of these patients no longer had sleep apnea

Read more about the benefits of weight loss 

Is weight loss surgery right for me?

The decision to undergo weight loss surgery requires much consideration and consultation with a qualified physician, preferably a weight loss surgeon. The benefits of weight loss surgery can be dramatic and life changing. Health problems that often accompany being overweight can be minimized or even disappear after weight loss surgery.

  • One study found gastric bypass surgery reduced the total number of co-morbid conditions of participating patients by 96 percent
  • Weight loss surgery can offer you a whole new outlook on health and life
  • Studies find that weight loss surgery patients feel better, spend more time doing recreational activities and had more self-confidence than they did prior to surgery

What are the risks and realities of weight loss surgery?

First, remember:

  • Weight loss surgery is not cosmetic surgery
  • Weight loss surgery does not remove fat from your body
  • For weight loss surgery to be successful, patients must commit to long-term lifestyle changes including diet and increased physical activity
  • Problems after surgery are rare, but corrective procedures are sometimes needed

Possible risks may include:

  • Bleeding
  • Complications due to anesthesia and medications
  • Deep vein thrombosis
  • Separation of areas that are stitched or stapled together, known as dehiscence
  • Infections
  • Leaks from staple lines
  • Marginal ulcers
  • Pulmonary problems
  • Spleen injury
  • Narrowing of created surgical passage, known as stenosis
  • Death

What is the difference between laparoscopic or minimally invasive surgery and an open procedure?

Open surgery involves a long incision to open the abdomen and operating with "traditional" medical instruments.

Minimally invasive surgery allows the surgeon to perform the same procedure using several small incisions, a fiber-optic camera, video monitor and long-handled instruments.

Why would I have an open procedure?

Your surgeon is the expert in deciding whether an open surgery or a minimally invasive surgery is most appropriate for you. Some patients cannot undergo laparoscopic minimally invasive surgery because of the presence of dense scar tissue from prior surgery. Also, the inability to see organs or bleeding during the operation can cause your surgeon to switch from minimally invasive to open surgery.

If minimally invasive weight loss surgery is not an option for you, know that the highly skilled surgeons at Inova Fair Oaks Hospital perform open procedures using a very small incision and can perform the procedure in as little as 50 minutes.

What bariatric weight loss surgery results might I expect?

Studies show that bariatric surgery can effectively improve and resolve many co-morbid conditions. A review of more than 22,000 bariatric surgery patients showed:

  • Improvement or complete resolution of conditions including type 2 diabetes, hypertension and sleep apnea
  • 61 percent reduction of excess weight

What types of bariatric surgery does Inova offer?

Some common types of bariatric surgery that Inova may offer include:

  • Laparoscopic Gastric Banding
    Lap band (gastric banding) surgery is known as a "restrictive surgical procedure" and involves a silicone band being placed around the uppermost part of the stomach.
  • Gastric Bypass Surgery (Roux-en-Y)
    Roux-en-Y gastric bypass surgery involves partitioning the stomach and connecting a small "pouch" of stomach directly to the small intestine. The smaller stomach pouch restricts the amount of food you can comfortably eat, and the bypass decreases the amount of nutrients and calories absorbed by the body. The Inova Weight Loss team specializes in mini-incision and laparoscopic gastric bypass surgery, which are less invasive than traditional surgery and allow for a faster, more comfortable recovery.
  • Sleeve Gastrectomy
    The sleeve gastrectomy generates weight loss by removing more than 70 percent of the stomach, thereby restricting the amount of food (and therefore calories) that can be eaten and absorbed. A smaller stomach shaped like a "sleeve" is left behind. The surgery is purely restrictive and does not involve bypassing the small intestine.
  • Biliopancreatic Diversion with Duodenal Switch (BPD/DS) 
    BPD/DS is a combined restrictive and malabsorptive procedure that reduces the size of the stomach by 70 percent. The pouch created is a bit larger than with other restrictive procedures. The pouch is connected to the lower part of the small intestine and greatly reduces the absorption of calories and nutrients.

Will I gain the weight back after surgery?

Weight gain after bariatric weight loss surgery is a concern for many new patients.

The good news is that if you follow the guidelines presented to you by your weight loss team, and modify your lifestyle and eating habits permanently, you can achieve and maintain successful weight loss.

Weight loss surgery alone does not guarantee patients long-term success. Keeping the weight off requires ongoing dietary, exercise and behavioral changes. For example, if you consume more food than your stomach pouch is supposed to hold, this can cause the pouch to stretch and can result in weight gain or even more serious medical consequences. After weight loss surgery, it is better to consume frequent small meals (4 to 5 meals per day) rather than eating fewer large meals.

What should I bring to the hospital on the day of my surgery?

A suggested list of items to bring to the hospital on the day of your surgery include:

  • Loose, comfortable clothing, including pants with an elastic waistband or loose dress
  • Cell phone and/personal device
  • Phone/device charger
  • Your personal toiletries
  • Glasses and/or contacts
  • Slippers
  • Insurance card
  • Photo ID