Bariatrics-bob-25018

Frequently asked questions

What happens to all of my excess skin after surgery?

Because most of your fat is stored in the tissue directly beneath the skin, when the fat is gone, the skin will sometimes sag.

The skin will shrink, but not as rapidly as the fat is lost. Six to 12 months after surgery you will see the worst of the sagging skin. Younger patients may have more elastic skin and may not sag as much as older patients.

Some patients may wish to have excessive skin surgically removed by a plastic surgeon, but we recommend waiting 18 to 24 months after surgery, when weight loss has stabilized.

Would eating more food in the postoperative time decrease sagging skin?

Absolutely not! Sagging skin is a function of weight loss. It is important that the rapid weight loss be optimized while the gastric pouch is small.

The situation with your skin should be seen as a cosmetic issue that will ultimately improve and can be treated with plastic surgery if necessary.

What happens to the rest of my stomach after surgery?

In gastric bypass, the remainder of the stomach stays in place and continues to function. With a sleeve gastrectomy, the outside 80 to 85 percent of the stomach is removed.

Is weight-loss surgery reversible?

Technically, yes. But it is highly discouraged. Gastric bypass is considered permanent. It’s impossible to predict if you can reverse a sleeve gastrectromy. If your operation were reversed, you would regain most or all of the weight that you lost. You'd also be at risk for the same complications as when you had the initial surgery.

What is dumping syndrome?

Dumping syndrome is a group of symptoms (gas, diarrhea, cramping) experienced by some patients who have gastric bypass.

Dumping is related to eating sweets and carbohydrates that stimulate the stomach pouch to empty more quickly, causing these highly concentrated foods to be “dumped” into the small intestine. When this type of food enters the small intestine, it moves rapidly through the bowel.

It also causes the release of hormones that can cause dizziness, nausea, fatigue, sweating and diarrhea.

The unpleasant feelings associated with dumping syndrome often influence you to consciously or subconsciously avoid foods high in sugar and carbs. The upside is that this aversion to sweets can speed up your weight loss.

Will I have diarrhea or increased gas after surgery?

You might. Some patients swallow air when they eat. Air is not absorbed by the digestive tract, and it has to go somewhere.

Some people will find themselves burping more than before. For those who don't burp, the air must pass all the way through the digestive system.

This may make the symptoms of irritable bowel syndrome worse, which may lead to diarrhea.

Will I regain weight in the future?

For gastric bypass and sleeve patients, maximum weight loss occurs at approximately 12 to 18 months after surgery. You may continue to lose weight for as long as two years.

After that, weight loss levels off. There is usually a slight regain of around 5 to 10 percent of your weight loss around the two-year mark.

This is typically the maximum weight regain. However, if your weight begins to creep up beyond what you expect, talk to your doctor about what might be causing you to gain weight.

If you return to your old eating habits, it is possible to overcome your bypass operation and experience significant weight gain in the future.

What about pregnancy?

Women should not get pregnant immediately before surgery or until at least 18 months after surgery.

During the period of rapid weight loss, certain nutritional deficiencies may occur which would put the developing baby at risk for malnutrition and birth defects. Plus, female fertility increases as weight is lost, so your chances of becoming pregnant increase in the months right after surgery.

Therefore, women of childbearing age who are having weight loss surgery should use two methods of birth control before surgery and for 18 months after surgery.

After that time, when weight loss and nutritional status have stabilized, there is no restriction on pregnancy.