The following frequently asked weight loss questions may help answer questions you have as you consider whether weight loss surgery is right for you.

Note, it is extremely important that you ask all your weight loss questions. We want you to feel educated and comfortable about your weight loss surgery choices. Call us at (727) 289-7137 with any questions you may have or you can contact us online by completing this form.

Bariatric program FAQs

Our team of doctors and specialists has years of experience in caring for patients through the weight loss surgery journey. This includes visits with a Bariatrician and Dietician. We are committed to your care from beginning to end. From our free bariatric surgery seminars/webinars to caring for you after surgery with in office Fluoroscopy. We are on your side.

Medicare covers bariatric surgery. Our program has been awarded Bariatric Center of Excellence designations with most of the insurance carries, making this a benefit for most. We will assist you in verifying your insurance and obtaining the requirements needed for authorization.

Palms of Pasadena Hospital or Largo Medical Center

All billing inquiries should be directed to the office at 727-289-7137 for immediate assistance. In the event it cannot be resolved at this level, you would directed to our practice support at (888) 422-7720.

General FAQs

Significant weight loss following bariatric surgery can help to improve or even resolve a lot of health conditions related to obesity such as high blood pressure, high cholesterol and sleep apnea.

Activities of everyday life can also be improved following weight-loss surgery. Things like climbing stairs, sitting in a restaurant booth or theater seat, standing for long periods of time, bending over, crossing your legs or playing with children tend to become easier tasks.

Secondary benefit following bariatric surgery is improved feelings of self-worth due to appearance. It should be remembered that bariatric surgery should be undertaken to improve the overall health of a patient and that the cosmetic result is a secondary gain.

After bariatric surgery, you must take vitamins for the rest of your life. They vary based upon procedure and individualized but usually includes at a minimum: Multivitamin, Calcium and B-12. Serious illness can result from non-compliance with your vitamin and mineral guidelines. Mood, energy, and focus can also suffer from a lack of proper vitamins after bariatric surgery. Blood tests are required on a regular basis for your first year and annually after that.

You should be able to take prescribed medication. Most patients are able to continue their medication regimen with making major changes. However, on an individual patient basis, you may need to use capsules, break big tablets in half or dissolve them in water so they do not get stuck in the opening of the stomach inside the band and make you sick. You should always ask the doctor who prescribes the drugs about this.

Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much. Also, remember that drinking with your meal may cause vomiting or allow you to eat more food. This is because the liquid pushes the food out of the small upper stomach pouch making you hungry faster. You will receive a card from our office that may allow you to receive discounts at restaurants.

After your stomach has healed, you diet will transition from liquids to foods high in protein and loaded with vitamins and nutrients. Dietary education will be part of each office visit. We recommended 60 – 80 grams of protein daily.

Alcohol has a high number of calories. Remember, you only have to consume 3,300 calories to gain 1 pound. It also breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.

That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery.

Weight loss surgery does not affect or hamper physical activity including aerobics, stretching and strenuous exercise long term. You will be asked to avoid abdominal crunches and strenuous abdominal exercises for the first month.

There may be some reduction in the volume of your stools, which is normal after a decrease in food intake and fiber. This should not cause you severe problems. If difficulties do arise, let us know as soon as possible.

Hair thinning or loss is anticipated after rapid weight loss. It is temporary. Your calorie intake is much less than the body need and protein intake is marginal. The hair thinning usually occurs anywhere from 3 to 9 months after surgery. You can minimize the loss of hair by taking your vitamins daily and making sure that you consume at least 60 – 80 grams of protein per day. Zinc and Biotin supplements may help as well.

Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular.

Patients are requested to stop smoking at least six weeks prior to surgery. As you probably are aware, smoking can increase everyone’s risk of heart attack, stroke, lung cancer, infections, increase in blood pressure, COPD and other breathing problems. But did you know smoking, when combined with bariatric surgery, complications can increase 3-4x more than those who do not smoke? If need be, your PCP or surgeons will be available to write you a prescription for a smoking cessation aid.

Sleeve Gastrectomy and Gastric Bypass FAQs

Sleeve Gastrectomy patients typically spend 1 night in the hospital and our Gastric Bypass patients are discharged after 2 night. It takes most patients about 1 week to return to work – although we recommend you plan for 1-2 weeks. In the extremely rare case of open surgery of if there are complications, recovery may take longer.

Check-ups are a normal and a very important part of follow-up. Patients will be asked to follow up at 1 month, 3 months, 6 months and 12 months after surgery. After the first year patients should follow up yearly.

The sleeve gastrectomy makes you eat less and feel full in two ways – by reducing the capacity of your stomach and increasing the time it takes food to get through the digestive system. The gastric bypass also has an element of malabsorption.

After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived.

A concern after Gastric Bypass surgery is a condition called the “dumping syndrome” in which there is a discomfort following eating or drinking. The dumping syndrome consists of abdominal pains and cramping. It can produce, diarrhea, sweating, lightheadedness, palpitations, weakness, dizziness, nausea and vomiting. The most common cause is ingesting high amounts of sugar and fat. By being vigilant and educating yourself about how much sugar and fat are generally in certain foods, you can avoid these “attacks”. If you experience dumping syndrome lie down with a cool washcloth to your forehead. Taking a nap may be helpful. The symptoms will pass but this can take several hours.

  • Leaks are usually associated with a staple line disruption internally. An initial symptom is sustained rapid heart rate. Other associated symptoms can be fever, elevated white blood count (lab work) and pain. Diagnosis of leaks can be made radiologically and/or endoscopically.
  • Stomal Stenosis are usually late complications. With the Gastric Bypass it is described as a narrowing of the outlet of the stomach pouch. With the Sleeve Gastrectomy it is described as a narrowing or stricture in the sleeve portion of the stomach. Difficulty keeping food down is patients’ chief complaint. This condition may require dilation and possible surgery.
  • Bowel obstruction due to a blockage from adhesions (scar tissue) can occur as it can after any abdominal operation, trauma, or intra-abdominal infection.

Adjustable gastric banding FAQs

If adjustable gastric banding surgery is performed laparoscopically, patients typically spend less than 24 hours in the hospital or just a few hours in an outpatient surgery center. It takes most patients a few days to return to work – although we recommend you plan for up to a week. In the extremely rare case of open surgery or if there are complications, recovery may take longer.

Weight-loss results vary from patient to patient, and the amount of weight you may lose depends on several things. The band needs to have the right amount of tightness or restriction, and you need to be committed to your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won’t come off by themselves. It is very important to set achievable weight-loss goals from the beginning. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. Remember that you will lose weight gradually. Your main goal is to have weight loss that prevents, improves, or resolves health problems associated with severe obesity.

Check-ups are a normal and a very important part of follow-up which will be individualized to the type of surgery and patient. Everyone is seen approximately two weeks after surgery, six weeks post op and then every two to three months during the acute weight loss phase.

Your body needs to become used to varying levels of tightness. For some patients the band may become tighter over the first one to two weeks following an adjustment. Also things such as stress and menstrual cycles can alter the perceived tightness of the band.

You must remember that adjusting the band is a process and one adjustment will not fulfill the desired level of tightness for most patients.

Most adjustments can be performed in the office. A fine needle is passed through the skin and into the access port to add or remove saline. This process most often takes only a few minutes. Most patients say it is nearly painless. You will be asked to drink some water to assess the tightness of the band.

There are no restrictions based on the access port. It is placed under the skin in the abdominal wall, and once the incisions have healed it should not cause discomfort or limit your movements or any physical exercise. The only sensation you may have from the port is when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.

Although the adjustable gastric band is not meant to be removed, it can be. In most cases this can be done laparoscopically. The stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight or even gain more. The goal is to leave the band in place for as long as it lasts.

This is a fairly common feeling, especially for people with bands that are tight or in the time period shortly following an adjustment. During the day the water content in the body changes and this may cause the band to feel “tighter” some of the time. Some women have also noticed that the adjustable gastric band feels tighter during menstruation.

One of the major advantages of the adjustable gastric band system is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline. Any vomiting, even if not caused by your adjustable gastric band, can harm your stomach and band. You will need to be seen for deflation of your adjustable gastric band if vomiting occurs.

Adjustable gastric banding system limits food intake. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well or that you are not following the diet rules properly. However, it could also mean that there is a problem with over tightening of the band or the position of the band (slippage) so you should contact us if this problem persists. Vomiting should be avoided as much as possible. It can cause the small stomach pouch to stretch. It can also lead to slippage of part of the stomach through the band, which would reduce the success of the operation. In some cases, it would also require another operation.

If the band is feeling too tight, foods are getting stuck or you are experiencing vomiting then you should be seen fairly quickly. If you are able to drink liquids without vomiting then this is not an urgent matter. If you are unable to tolerate liquids then the band should be deflated. We will make arrangements to see you in the office (during business hours) or in the emergency room (after hours). Again, if you are tolerating liquids it is okay to maintain on a liquid diet and follow up with our office the next day.

If foods are becoming routinely "stuck" then deflation should be carried out, even if this issue resolves on its own. If you are unable to tolerate solid foods, then you will likely eat moister, "mushier" foods that will lead to greater calorie intake and weight gain.

  • Port problems such as port leak or malposition usually require an outpatient procedure, under sedation anesthesia to reposition or replace the port.
  • Band slippage occurs when the band slips to a lower position on the stomach and the stomach that is normally situated below the band protrudes up through the band. This would require an additional procedure under general anesthesia to reposition the band around the stomach or potentially remove the band.
  • Band erosion occurs when the band eats through the layers of the stomach to end up on the inner lining of the stomach. This would allow the band to be seen by an upper endoscopy, where a small scope can be passed through the mouth, down the esophagus and into the stomach. Once this diagnosis has been made the band must be removed, usually laparoscopically, and the hole created by the band erosion is sewn shut.

The band should be deflated before any surgery on the abdominal cavity, which requires general anesthesia, for several reasons. First, with most of these cases a tube called the nasogastric tube will be required during the operation to aspirate gastric juices from the stomach. This tube is placed via the patient's nose or mouth and down the esophagus into the stomach. If the band is tight around the stomach then there is a risk that the tube may puncture a hole into the stomach as it passes through the band. Secondly, during surgery, IV fluids are typically given in large volumes. This causes swelling throughout the body, including the stomach, making the band feel tighter than it actually is. This could lead to nausea and vomiting. Also, some patients have a predisposition to postoperative nausea and vomiting, which could worsen with a tight band.