Frequently Asked Questions

Am I a candidate?

You may be a candidate for weight-loss surgery if you meet the following criteria:

• Body Mass Index (BMI) of 40 or greater (100 pounds or more above "ideal" body weight)
• BMI between 35-40 with significant co-morbidities such as high blood pressure, diabetes, and/or sleep apnea
• Documentation of failure to lose and maintain weight loss with traditional diet programs while supervised by a physician
• Absence of any medical condition that would make the risk of surgery outweigh the benefits
• Absence of any psychological or medical condition that would preclude patient compliance to postoperative recommendations
• Determination to make necessary life-style changes and participate in long-term follow-up care as evidenced by a psychological evaluation

How does it work?

Several different types of bariatric surgery are performed through our program― Roux-en-Y gastric bypass, gastric sleeve resection, adjustable gastric banding, duodenal switch and revisional surgeries.

The Roux-en-Y gastric bypass (CPT 43644) works by creating a small pouch closed off from the rest of the stomach to make you feel fuller faster. It also involves re-routing your small intestines, which makes the food bypass majority of the small intestines. This is both a restrictive and malabsorptive operation. Patients who have the gastric bypass lose an average of 66 percent of their excess body weight in 18 months.

The gastric sleeve resection (CPT 43775) works by removing 80 percent of the stomach, leaving a small pouch the size and shape of the banana. This procedure works through calorie restriction and changes in gastric hormones, and it will cause you to feel fuller faster and longer. Studies have shown that patients who have the gastric sleeve resection lose approximately 60 percent of their excess body weight at 18-24 months post-operatively.

The adjustable gastric band (CPT 43770) works by creating a pouch at the top portion of your stomach to make you feel fuller faster and longer.  This procedure works on calorie restriction alone.  It is the least invasive of the three procedures, but has the slowest rate of weight loss. Patients with the gastric band lose, on average, 1-2 pounds a week. In 24 months, the average patient has lost approximately 46 percent of their excess body weight.

The duodenal switch (CPT 43845) works by reducing the size of the stomach and rerouting the intestines. It is both a restrictive and malabsorptive operation. This procedure is associated with the most risks, so it is selectively offered.

What are the risks and complications?

All of the procedures are available laparoscopically, which means that the surgery is completed using 4-5 small incisions. The potential for complications is moderately high and varies depending upon which procedure you have. Some patients need additional surgery to correct complications such as abdominal and internal hernias, and some patients develop nutritional deficiencies such as anemia and osteoporosis. There are essential lifestyle changes the patient must be absolutely committed to making. People who once ate freely must become very attentive to their diets, eat smaller, more nutritious meals and take vitamin and mineral supplements.

Risks associated with abdominal surgery

Risks are associated with any type of surgery, including abdominal surgery, and these risks are greater for individuals who suffer from obesity. Your weight, age and medical history play a significant role in determining your specific risks. Your surgeon can inform you about your individual weight-loss surgery risks.

• Bleeding
• Infection
• Injury to internal organs
• Hernias
• Bowel obstruction
• Deep vein thrombosis
• Heart attack
• Pulmonary embolism
• Stroke
• Death

What steps do I take to be considered for weight-loss surgery?

• Call your insurance company to see if the procedure you are interested in is a covered benefit under your policy. Unfortunately, if these are excluded on your policy, there is nothing our office can do to get your surgery approved. Feel free to call our office for information about private pay pricing.
• Call the Center for Surgical Weight Control office to sign up to attend an educational seminar. These are presented by the surgeon, who reviews each procedure and the benefits and risks associated with each.
• Talk to your primary care physician. He/she will need to write a referral letter of support for your decision and will help care for you after your weight-loss surgery. Your insurance company will also require office notes from your primary care physician documenting a specific diet and specific exercise that you have attempted for a certain amount of time. Please see the insurance section for more information.
• Obtain a psychological evaluation from a licensed psychologist or psychiatrist.  If you are not sure who to use, you may call the office and we can provide a list of phone numbers.
• Gather copies of the medical records from any past weight-loss surgeries or surgeries you have had on your stomach.

What happens to the excess/loose skin after I lose weight?

After you have weight-loss surgery and successfully lose your excess body weight, you will have some loose skin. Your option for this is plastic surgery. Unfortunately, insurance does not cover the majority of these procedures; only in very rare instances will they even assist in coverage. Although rumors persist about burn centers accepting skin donations for burn patients, we have found this to be untrue. Exercise and intake of the recommended protein is the best option in helping to reduce the amount of excess skin you have. 

The decision to consider weight-loss surgery is one of the most important decisions you may ever make. It will not only impact your life, but the lives of those closest to you. Choosing the right program is equally important. The doctors, nurses, nutritionists and counselors at the Center for Surgical Weight Control are all specially trained and focused on helping you. For more information, please call the patient intake coordinator, Charlotte King, at 304-399-4118.

• Last updated: 04/14/2012
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