Many people struggle to reach or maintain a body weight that makes them feel healthy and confident. And if that sounds like you, you’ve probably tried several diet methods, exercise programs and other lifestyle changes over the years – but haven’t gotten the results you hoped for.
Here’s what you need to know: Your struggle with weight is not your fault. It’s not that you did anything wrong or didn’t try hard enough. Obesity is a disease, and similar to other diseases, people often need expert support to manage and treat it.
That’s where bariatric surgery may be an effective treatment option to help improve your health and overall quality of life.
But what is bariatric surgery and how does it work? Who’s a candidate? Is it really safe? Below, we answer all these questions and more about bariatric surgery benefits, risks, how to qualify and more.
Bariatric surgery is a procedure that helps people lose weight and better manage any medical conditions that may be impacting their health and quality of life. The surgery lowers the weight range the body “protects” when a person tries to lose weight. This triggers changes in metabolism and hunger signals, so lifestyle changes can (finally) make a significant and sustainable impact on body weight and overall health.
How much weight do you lose after bariatric surgery?
People who have bariatric surgery can lose 60-80% of their excess weight within one year. Excess weight are those pounds above your ideal weight and is based upon your height, gender, muscle mass and other factors.
Bariatric surgery weight loss examples
|Possible weight loss
|73 – 98 lbs.
|88 – 118 lbs.
|122 – 163 lbs.
|165 – 220 lbs.
How fast do you lose weight after bariatric surgery?
Weight loss after bariatric surgery is almost immediate. You’ll have noticeable weight loss during the first month as you lose water weight, and your body adjusts to getting fewer calories. Then, you’ll continue to lose weight for at least the next 12 months.
The benefits of bariatric surgery go beyond weight loss
By losing weight with bariatric surgery it may be possible to avoid new weight-related health conditions and reduce symptoms of the ones that you have.
There are many medical conditions that are linked to obesity, including type 2 diabetes, heart disease, stroke, obstructive sleep apnea, liver disease, gallbladder disease, some cancers, cataracts, infertility and polycystic ovary syndrome.
According to the American Society for Metabolic and Bariatric Surgery (ASMBS), most people who had bariatric surgery saw improvements in conditions such as:
|Percent of people who improved
|Type 2 diabetes
|High blood pressure
Other people saw significant improvements in depression, migraines, asthma and acid reflux.
Who’s a candidate for bariatric surgery: It’s not just about weight
Your eligibility for bariatric surgery is largely based on your body mass index (BMI) which is a calculation based on your height and weight. But if you have certain health risks, you may be eligible for bariatric surgery at a lower BMI. You may meet the requirements for bariatric surgery if you:
1. Have a BMI of 40 or higher
2. Have a BMI of 35 or higher with at least one obesity-related medical condition, such as:
- High blood pressure that is consistently above 140/90
- High cholesterol
- Obstructive sleep apnea
- Type 2 diabetes
Do you have to lose weight before bariatric surgery?
Sometimes, but not always. It often depends on a range of factors such as your BMI, overall health and insurance. For example, even if you meet the physical and health requirements, some insurance plans may require that you try other options and make changes before surgery. But the requirements for bariatric surgery can vary based on your insurance plan. So, it can be a good idea to contact your insurance company to understand your coverage before you set an initial consultation with a weight loss specialist.
What can disqualify you from bariatric surgery?
Bariatric surgery isn’t the right option for everyone. These are reasons why your doctor may not recommend bariatric surgery:
Your BMI isn’t high enough
The goal of weight loss surgery is to improve your health and mobility – and help you live longer. Many people with BMIs under 35 don’t have weight-related medical conditions that significantly impact their lives. If they do, they may be able to lose enough weight in a medical weight management program to be comfortable and healthier.
For some people with a BMI under 35, medical weight management may not be enough. That’s why the surgery may be an option for people with a BMI over 35 with weight-related medical conditions.
You’re not ready to make long-term changes
Bariatric surgery isn’t a quick fix. In order to lose and maintain weight loss, you’ll need to make long-term lifestyle changes. The good news is that as part of a medical weight management program, you’ll get guidance and support in making changes that contribute to long-term weight control.
You’re not healthy enough (at least not yet)
Surgery is hard on your body – and there can be complications with anesthesia. Your doctor may not recommend surgery if they’re concerned about poor surgical outcomes. But it’s possible that bariatric surgery may be an option in the future if you’re able to improve your health by losing weight or changing your diet.
You can’t quit smoking
If you smoke, you’re much more likely to have surgical complications. So, you’ll need to quit smoking at least six weeks before surgery. Your primary care doctor can help you quit smoking.
The types of bariatric surgery work differently
There are different types of bariatric surgery, each of which changes your body in a slightly different way. Here are more specifics:
Vertical sleeve gastrectomy (gastric sleeve)
Sleeve gastrectomy procedures are the most common and simplest type of bariatric surgery. Between 60-70% of weight loss surgeries are gastric sleeves.
During a gastric sleeve procedure, about 80% of the stomach is removed, leaving a pouch that’s about the size and shape of a banana. The procedure removes the part of the stomach that makes most of the “hunger hormone,” so people feel less hungry.
With gastric sleeve procedures, there are no changes to the intestines, so food continues to travel through the digestive system in the usual way.
Roux-en-Y gastric bypass
Gastric bypass is the second most common type of bariatric surgeries. This procedure changes both the stomach and the intestines.
The first step of the surgery is to separate the top and the bottom of the stomach. The top part will be an egg-sized pouch for food. The rest of the stomach is bypassed and will no longer be used to store or digest food. The other part of the surgery is reorganizing the digestive tract so that food doesn’t go through the upper part of your small intestines.
Gastric bypass works because it sparks changes in your metabolism and hormones that can help you successfully lose weight with lifestyle changes, even if you’ve experienced weight loss plateaus in the past.
Other types of bariatric surgeries and procedures
Most bariatric surgeries are either gastric sleeve or gastric bypass procedures. While unlikely, it’s possible that one of the following procedures may be recommended:
- Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) – This procedure starts with a sleeve gastrectomy, but it’s different from a normal sleeve gastrectomy because it also shortens your digestive tract.
- Biliopancreatic diversion with duodenal switch (BPD/DS) – This procedure creates a gastric sleeve, but also rearranges your digestive tract, allowing your food to bypass about 75% of your small intestines.
The potential risks of bariatric surgery
Like all surgeries, bariatric surgery comes with risks – both in the short term and the long term.
But the risk of living with obesity is usually greater. Being obese greatly increases your chance of medical conditions that impact your quality of life and longevity. The ASMBS notes that when people who are very overweight get weight loss surgery, it can reduce the chance of premature death by 30-50%.
Possible post-bariatric surgery complications
Doctors have been performing bariatric surgeries for over 50 years. Over time, the surgery has become safer, and bariatric surgery is about as safe as procedures for gallbladder removal or hip replacement.
Certain types of bariatric surgery can be safer than others. For example, there are fewer surgical complications with a gastric sleeve procedure because it only changes your stomach.
Surgical complications of bariatric surgery can include excessive bleeding, blood clots, infection, reactions to anesthesia, breathing problems and leaks in your digestive system.
Bariatric surgery changes how your digestive system works. In some people, this can cause bothersome symptoms that don’t go away, including bowel obstruction, hernias, gallstones, ulcers, acid reflux, malnutrition and the tendency toward low blood sugar. You may also have dumping syndrome, which leads to diarrhea, flushing, lightheadedness, nausea or vomiting.
It’s also possible that you may need another bariatric procedure or a revision of your first surgery.
The cost of bariatric surgery depends on hospital stay and more
The cost of bariatric surgery can depend on a range of factors, but the average cost can be somewhere between $25,000 and $35,000 before insurance. Your out-of-pocket cost will depend on where you have the surgery, how long you stay in the hospital and the type of surgery you have (gastric bypass tends to cost more).
Is bariatric surgery covered by insurance?
Coverage for bariatric surgery depends on your insurance and your health. Most of the time, insurance plans cover some bariatric surgery costs for at least some patients. But there usually are strict guidelines in terms of weight, other health factors and the treatments you need to try first.
You’ll want to check with your insurance company to see if you qualify and how much they’ll cover. It can be a good idea to get a written estimate of your costs before you get surgery.
If you have HealthPartners insurance, check your insurance coverage.
Life after bariatric surgery
There will be a lot of changes to your body in the days, weeks and months after surgery. But we’ll be with you every step of the way.
During the first year after surgery, you’ll come back for a lot of visits. This is so your care team can track your weight loss and offer guidance to help you meet your goals. There are also bariatric surgery support groups where you can share your progress and learn from others’ experiences.
Bariatric surgery recovery takes time
Healing time depends on the type of surgery you have. Recovering from surgery can take anywhere from three days to six weeks or more. You may have discomfort after the procedure, but pain levels can usually be managed with medications. Here are some things to expect:
- Hospital stay – It’s typical to spend one night in the hospital, but you may also need to stay in the hospital a few days. It’s also possible that you may be able to go home on the day of your surgery.
- Work – You may be back to work in a few days, but it can take two weeks or more, depending on the type of job you have.
- Activities and exercise – You may have no activity restrictions, or your doctor may recommend that you slowly transition back to regular activities and exercises.
- Eating – You will likely be on a liquid diet for a couple of weeks while your stomach and digestive system heal. Stages of a post-bariatric surgery diet include liquid diet, pureed diet, soft food and then the stabilization diet. Depending on the type of surgery you have, it can take months before you get to a stabilization diet.
Weight gain after bariatric surgery is common, but manageable
After bariatric surgery, you’ll likely lose a great deal of weight in a short amount of time. But it’s possible that you may gain back some of the weight within a few years of surgery – though it’s usually less than 20% of the weight you lost.
The best way to minimize weight gain after bariatric surgery tends to be through diet and exercise. This is why there’s such a big emphasis on building new lifestyle habits before surgery. By building habits beforehand, there’s a better chance you’ll maintain positive eating habits and exercise routines after bariatric surgery.
Questions about bariatric surgery? We can help
If you wonder if bariatric surgery could help you lose weight and get healthy, make an appointment at the Park Nicollet Bariatric Surgery and Weight Center.
If you qualify for bariatric surgery, we’ll help you prepare and will support you after bariatric surgery. And if bariatric surgery isn’t an option, there are other ways we can help you lose weight without surgery.
Choosing to work with a weight loss center means that you’re taking charge of your health and addressing a chronic disease with every available tool to have the best chance of feeling your best for a quality, healthy life.