Frequently Asked Questions (FAQ)

Metabolic/bariatric surgery is the most effective and long-lasting treatment for severe obesity. Surgery results in significant weight loss and the improvement, prevention or resolution of many related diseases including type 2 diabetes, heart disease, hypertension, sleep apnea and certain cancers.

Patients may lose as much as 60% of excess weight six months after surgery, and 77% of excess weight as early as 12 months after surgery. On average, five years after surgery, patients maintain 50% of their excess weight loss.

The majority of bariatric surgery patients with obesity-related diseases, such diabetes, dyslipidemia, hypertension, and obstructive sleep apnea also experience remission post-surgery. Learn more about bariatric surgery from these videos from the ASMBS.

While a very small number of patients regain their weight, the vast majority lose significant weight and keep this weight off. In fact, more than 95% of patients will successfully lose half of their extra body weight or more after surgery for weight loss.

Every story is different. Discover how a US Navy Veteran, a Stanford University nurse, and a former NFL linebacker use weight loss surgery to overcome their struggle with obesity here watch these testimonials.

Weight loss surgery is very safe. In fact, studies show bariatric surgery may reduce a patient’s risk of premature death by 30-50%.

A recent study of 209,116 patients found the risk of death from weight loss surgery was 0.16%, or approximately 1 in 600. Of course, there are risks to any surgical procedure. This rate is considerably less than most other surgeries in America including gallbladder surgery, appendectomy and knee replacement.

To learn more about weight loss risks and the evolution of bariatric surgery, check out the videos on this page.

Yes, you should expect your lifestyle habits to change prior to surgery. In fact, many insurance companies require patients to be a part of a weight loss program before they can qualify to have the surgery. This diet focuses on food education and can range anywhere from three to six months prior to surgery.

Even if a diet is not required by your insurance company, you’ll still be required to be on a special pre-operative diet plan created by your Total Medical dietitian for 10 days prior to surgery. This will help shrink your liver and make more room in your abdomen for your surgeon during the procedure, making surgery safer for you.

At Total Medical Weight Loss, our in-house dietician, Dr. Casey Olsen, will collaborate with you to create an individualized meal plan as part of your surgical weight loss journey.

No. Usually patients gain their appetite back in some form 6-18 months after surgery. However, your appetite will be weaker and easier to satisfy than before.

This doesn’t mean you should eat whatever and whenever you want. Healthy food choices are important to maintain the best results. That said, most patients still enjoy tasty food and occasional treats, even after the procedure. Your in-house dietitian Dr. Casey Olsen, will collaborate with you to create an individualized meal plan as part of your surgical weight loss journey.

The solution to obesity isn’t as simple as eat less, exercise more. In fact, The National Institutes of Health (NIH) Expert Panel stated that, without surgery, long-term weight loss is nearly impossible for those affected by severe obesity. Studies show little long-term success with diet and exercise alone.

That’s because other factors, such as food availability and genetics, play a role in obesity, and these factors don’t change even with the best diet or workout regimen.

Weight loss procedures, unlike diet and exercise alone, cause biological changes that help reduce food intake. Energy intake is decreased with surgery by restricting stomach size and limiting absorption. In addition, weight loss surgery changes the production of certain gut hormones that communicate with the brain to reduce hunger, decrease appetite, and enhance the feeling of being full. In these ways, weight loss surgery, unlike dieting, produces long-term weight loss. Learn all about about bariatric weight loss here.

Most patients report some pain after surgery, though it depends on the specific person and the type of procedure they had. Most patients simply take oral pain medications for a few days after surgery. Pain does not tend to be a major issue during weight loss surgery recovery.

Most patients return to work within one to two weeks following the procedure.

Some patients choose to have plastic surgery following their weight loss procedure to help tighten loose skin or make other cosmetic changes. Whether you choose to seek plastic surgery is up to you and your surgeon.

Some hair loss is common between 3 and 6 months following surgery but is almost always temporary.

The reasons behind post-op hair loss are not totally understood. Even if you take all recommended supplements and meet protein requirements, you may notice hair loss until all the follicles come back. Adequate intake of protein, vitamins, and minerals will help to ensure hair regrowth, and avoid longer term thinning.

You can return to physical activity immediately. You’ll start with short, easy walks while you’re recovering in the hospital. Once you’re back at home, the key is to start slowly, listen to your body and follow the advice of your surgeon. We recommend only “low-impact” exercise for your first month post-op.

For a majority of patients, regular, modest exercise is pivotal in their stress and appetite control.

Additionally, as you age, a lack of physical activity can be detrimental to your bone health and muscle tone. Weekly exercise can help ensure your bones and muscles are healthy for many years to come.

Many people think of exercise as intense or painful, but in reality, moderate exercise is more useful for your long term success. Work with your surgeon to find the activities that work best for you. There is no “one size fits all” approach, rather you should expect to learn and change as you go.

Yes, you will likely need to take a multivitamin for the rest of your life.

Additionally, your doctor may prescribe higher doses of certain vitamins or minerals, such as Iron, Calcium, and Vitamin D. It is recommended to continue yearly blood work and lab checks. Talk to your Total Medical team about how to qualify for free vitamins.

Many patients are able to reduce their overall number of medications, but it depends solely on the purpose of the medication and the current state of your health. Never go off of any medication without first consulting with your physician.

It is rare to develop health problems from vitamin deficiency, as long as you take the appropriate vitamins,

Weight loss surgery can lead to reduced amounts of vitamins and minerals because patients eat less and may absorb less in the intestines. Weight loss surgeries have different effects on vitamins and minerals based on how much change in absorption they cause.

Deficiencies in vitamins, minerals, and protein can negatively affect health causing:

• fatigue (feeling tired)
• anemia (low levels of red blood cells that carry oxygen through your body)
• bone and muscle loss
• impaired night vision
• low immunity (your body’s ability to stay healthy)
• loss of nerve function (can affect your senses such as touch, taste, and smell)
• mental function deficits (changes how clearly you think)

Fortunately, nutrient deficiencies following surgery can be easily avoided with a good diet and the use of supplements including vitamins, minerals, and protein.

Most women are much more fertile after surgery, even with moderate weight loss. However, we advise waiting 12-18 months after surgery before getting pregnant.

Note: Birth control pills do not work as well in patients who are overweight, and are therefore an unreliable form of family planning when your weight is changing. For this reason, if you do not wish to become pregnant, talk to your Total Medical team and your OBGYN about an IUD or use condoms with spermicide. Additionally, menstrual periods can be very irregular in patients post-op, so you can get pregnant when you least expect it.

Yes. Following surgery, there is much less risk of experiencing problems during both pregnancy and childbirth. Fewer miscarriages and stillbirths are reported in patients following weight loss surgery than in women with obesity who have not had surgery.

Furthermore, children born after their mother’s surgery are at less of a risk of being affected by obesity later, due to activation of certain genes during fetal growth. Lastly, the risk of a C-section is reduced by the procedure as well.

Your relationships with friends and family may indeed change after weight loss surgery. For many people, food and drink are the basis for socializing. After weight loss surgery, you must find other ways to socialize that aren’t focused on food.

Additionally, as you lose weight, your results will be obvious. People will notice, and ask you about your appearance. The team at Total Medical will work with you to prepare for every step of your weight loss journey. We can help you prepare for these questions ahead of time — and consider how you want to answer them.

“Food addiction” as a cause of obesity is extremely rare.

Although some people with obesity have eating disorders, such as binge eating disorder syndrome, most people have obesity caused by many factors. When treating addiction, such as alcohol and drugs, one of the first steps is to stop using drugs or alcohol. This does not work with obesity as we need to eat to live.

Weight gain generally occurs when the amount of food eaten is greater than the number of calories burned. However, there are other conditions that affect weight gain that do not involve diet or exercise at all, such as:

• Poor sleeping habits
• Eating foods that may increase body fat (sugar, high fructose corn syrup, trans fat, processed meats and processed grains)
• Low intake of fat-fighting foods (fruits, vegetables, legumes, nuts, seeds, quality protein)
• Stress and mental distress
• Many types of medications
• Pollutants