- What should I expect during my initial evaluation with the Penn Metabolic & Bariatric Surgery Program?
During the initial evaluation, you will meet with the surgeon, nurse and nutritionist, and undergo a complete history, physical exam, and nutrition screening. You will also discuss what to expect from surgery. This entire process takes about one to two hours.
- What do I do after the initial screening and prior to surgery?
In the weeks prior to surgery you will:
- attend a nutrition class
- have a psychological evaluation
- see your primary doctor, a cardiologist, and possibly a pulmonologist to get medical clearance for surgery
- obtain a few medical studies (these will be tailored to your individual health problems and will be explained when you meet with the surgeon)
- How much time passes between the initial visit and surgery?
On average, the time between your initial visit with the Penn Metabolic & Bariatric Surgery Program and surgery is six to eight weeks. This timeframe can vary depending upon the insurance company and the rate at which medical clearances are obtained.
- Whom do I contact with questions before surgery?
Individuals interested in scheduling an appointment with the Penn Metabolic & Bariatric Surgery Program should call 800-789-PENN (7366). Patients already enrolled in the Metabolic and Bariatric Surgery Program should call their surgeon’s office directly.
- Will I only be able to eat tiny amounts for the rest of my life? Will I be able to eat regular food?
Following surgery, your meals will likely only consist of two to four tablespoons of food. As you advance your diet, you should be eating “regular” food within six to eight weeks of surgery.
- How do I get my protein when I eat such small amounts?
Protein plays an important role in both the healing and weight loss process following surgery. Since you are limited in your food intake, it is recommended that you incorporate high protein drinks that are low in fat and sugar into your diet. You may also add protein powder to liquids or certain foods. As you are able to eat more and increase the variety in your diet, you should rely on high protein foods to help meet your protein goal as outlined by the nutrition team.
- Do I have to take vitamin and mineral supplements for the rest of my life?
To prevent nutritional deficiencies due to malabsorption and a limited dietary intake, most people who have had weight loss surgery are required to take a multivitamin, calcium and vitamin B12 supplement for the rest of their lives. Other vitamin and mineral supplements may also be needed and will be determined on a case-by-case basis.
- What is dumping syndrome and how do I know if I have it? Are there ways to avoid it?
Dumping syndrome happens when foods or drinks that are high in sugar rapidly enter – or dump into – the small intestine. Following gastric bypass surgery, people are particularly sensitive to sugar, making dumping syndrome a concern.
Dumping is not dangerous but it can cause nausea, dizziness, sweatiness, heart palpitations, stomach cramps, and diarrhea. Over time, as the pouch and small intestine learn to work better together, incidents of dumping will decrease.
To avoid dumping syndrome, patients who have had gastric bypass should avoid foods that have sugar – in any form – listed as one of the first three ingredients. Some other names for sugar include:
- sucrose glucose
- corn syrup maltose
- lactose fruit sugar
- dextrose honey
People who have undergone gastric bypass surgery should also avoid eating and drinking at the same time as this can also cause dumping syndrome.
- Will I lose all of my hair? How do I keep it from falling out?
Hair loss after bariatric surgery is common and tends to happen three to five months post-operation. It is generally caused by poor protein intake, but can be stopped if you commit to consuming a protein-rich diet, particularly right after surgery.
- How much will the procedure cost?
Procedure costs depend upon the patient, the surgery and any post-operative difficulties that may occur. In many cases, insurance companies will cover the cost of the surgery since morbid obesity can be a life-threatening condition. You should speak with your insurance company to confirm that the surgery and any related expenses are covered.
- How long will I be in the hospital?
On average, a patient who experiences no post-operative complications will stay in the hospital for four to seven days. This stay may be extended should complications occur. Patients can usually return to work four to six weeks after surgery, but should not do any heavy lifting or heavy manual labor for an extended period of time.
- How much weight can I expect to lose?
Each person’s weight loss progress is different. On average, a loss of approximately 30 percent of starting weight is expected. Most of this loss is experienced during the first few months following surgery. Weight loss usually continues for about 12 to 18 months after surgery. Healthy eating habits and exercise are critical for continued success.
- Are there any side effects?
Side effects vary and are difficult to predict prior to surgery. Some people report problems such as diarrhea, excessive gas, and vomiting. Most side effects can be minimized with changes in the diet. Malnutrition is rare with the current procedures although vitamin and mineral supplementation is essential. All patients are required to take specific supplements for life because the procedure creates changes in nutrient absorption and restricts volume intake.
- Can I get pregnant after weight loss surgery?
It is very important that you do not get pregnant for at least 12 to 18 months after any type of weight loss procedure. You must use a reliable method of birth control throughout this time period. Once your weight has stabilized and the appropriate months have passed, you can become pregnant. It is important, however, to be monitored closely by an obstetrician and nutrition expert familiar with your weight loss surgery.
- Are there any medications that I must avoid?
Some medications may cause ulcers in your pouch and should therefore be avoided. These include any type of non-steroidal, anti-inflammatory drugs (NSAIDs) such as Advil, aspirin, Excedrin, Motrin, Aleve, ibuprofen, as well as Pepto-Bismol. If you are unsure about whether a medication is safe for you to take, contact the prescribing physician and/or your surgeon.
- Is it true that some people regain some of the weight that they lose following the surgery?
In some cases, people who consume foods that are high in fat or sugar will regain weight or experience minimal weight loss following gastric bypass surgery. Therefore, to achieve optimal weight loss results, you must follow the nutritional guidelines as a part of your new lifestyle. Foods you should avoid include:
- Milk shakes and malt drinks
- Cakes and other pastries
- Fried foods
- Chips and other high fat snack foods
- Soft drinks
- Ice cream