FAQs - SALSA

A BMI of 40kg/m2 or above, or a BMI of 35 to 40 kg/m2 with additional medical illnesses or co-morbidities.
Clearance from your physician and all appropriate specialists pertinent to you medical issues.
Demonstrate an understanding of the indications, alternatives, risks, benefits, and limitations of weight loss surgery.
You should have no active problem with alcohol, tobacco or drug abuse.
You should have no medical conditions that directly result in morbid obesity.
You should be able to demonstrate a history of reasonable attempts at weight loss by means other than surgery.

Why would a person choose surgery over the more traditional weight loss methods?

Morbid obesity is in it self considered a life threatening medical condition, as it leads to many other life-threatening medical conditions. Typically, the morbidly obese have tried many diets during their lives with no lasting success. In many cases, medical studies show that morbid obesity is a genetically based problem that cannot be resolved through conventional weight loss methods. The surgical option is considered a permanent procedure and has good long-range results when patients comply with behavioral, nutritional and exercise guidelines.

Most people lose weight rapidly and continue to do so for 18 to 24 months after the procedure, when the weight loss tapers off. Because of this extensive and permanent weight loss, the following are observed:

The chances of dying prematurely from obesity are reduced to approximately the same as the average population.
There is a 95% reduction in obesity-related co-morbid factors such as back pain, diabetes, high blood pressure, urinary leakage, and sleep apnea.
Almost all patients feel more energetic and optimistic, and are able to be more active and mobile. Patients usually enjoy increased energy almost immediately following recovery and can quickly resume an exercise program.

The Roux-en Y is a restrictive procedure combined with a modified gastric bypass that moderately limits calorie and nutrient absorption and may lead to healthier food choices. Laparoscopic Adjustable Gastric Banding is considered a restrictive procedure but probably works more by stimulating the nerves that promote a feeling of satisfaction or “fullness”.

We choose not to perform extensive Malabsorptive procedures, such as Duodenal Switch and Biliopancreatic Diversion. These procedures are available at some centers in California and other states.

As with any surgery there are risks of complications including anesthesia reactions, drug reactions, hemorrhage, infection, organ injury, conversion to open surgery, and even death.

Generally, our patients remain in the hospital for two nights following surgery. We feel this allows our patients adequate time to rest and recover from the anesthesia. If there are any problems, they are most likely to occur 24-48 hours following surgery, and we prefer to have you monitored in a hospital setting.

The Roux-en-Y procedure usually takes about 45-60 minutes, but can vary depending on the size of the patient. Additional procedures, such as gallbladder removal, hernia repair, or liver biopsy will require additional time.

Each incision is only about 2 mm ( - ) to 12 mm ( ---- ) long.
The actual number of incisions can vary.

After surgery, eating will progress from a liquid diet, to a pureed diet, to a soft diet, and then to a regular diet. The length of time for each eating phase will be determined on an individual basis by the surgeon.

The food intake is limited to one or two ounces per scheduled meal immediately after surgery so that the stomach can heal properly. Later, the quantity of food that can be eaten increases.

We have never had a patient who reported feeling hungry after surgery. On the contrary, most of our patients say they have never before felt "full", and energy levels almost always increase following gastric bypass surgery. Remember, most of the food you eat now is converted into the fuel that you need just to maintain and move the 100 or more extra pounds that are on you. As your weight decreases, your calorie (food) requirements decrease.

Patients generally lose 60 to 75 percent of their excess weight within the first 6 to 9 months after surgery. After that, weight loss continues until about 18 months post-surgery when the patient usually achieves his/her goal weight. Weight loss is highly variable. Patients who weigh more at the time of surgery, statistically lose less overall. There will be periods of rapid weight loss, slow weight loss, no weight loss, and even periods of weight gain.

Women do have babies after having the surgery. It is recommended that you do not get pregnant for at least one year --- or even better, two years --- after surgery. Once you are pregnant, you will need to carefully watch your dietary program to make sure you and your baby are well nourished.

You can return within two to six weeks, in most cases, depending on the amount of physical activity your job requires, and the effect of any postoperative complications that may occur.

Most medical insurance plans do cover part of the procedure. We will assist you in obtaining required insurance authorizations and clearances. Your surgery will not be booked until we receive verification from your insurance that they will cover this procedure.