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Making Your Decision: Weight Loss Surgery
Is weight-loss surgery right for me?
Weight-loss surgery restricts food intake, which
helps lead to weight loss. Losing weight may
improve health conditions such as sleep apnea,
diabetes, heartburn and high blood pressure.
But surgery is only the beginning. Patients must
commit to a new lifestyle. You can expect to follow
rules for nutrition and exercise. Regular check-ups
will be important as well.
As you make your decision, be sure to discuss your
questions or concerns with members of the bariatric
team. We are here to help you.
Who can have weight-loss surgery?
Weight-loss surgery is for people who are morbidly
obese or who are severely obese with other serious
health problems. You may qualify if:
• Your body mass index is between 35 and 39.9
(and you have a weight-related illness such as
diabetes, high blood pressure or high cholesterol)
• Your body mass index is over 40 (without a
weight-related illness)
At your first visit, you will receive a list of tasks
to complete as part of your evaluation. This will
include letters from your doctors, blood tests and a
mental health evaluation.
Based on the results, the bariatric team decides
whether bariatric surgery is the best option for you.
Sometimes, even if you meet all of the criteria, the
team may not recommend surgery because of the
medical or mental health risks to you.
If you are deaf or hard of hearing, please let us know. We provide many free services including
sign language interpreters, oral interpreters, TTYs, telephone amplifiers, note takers and written materials.
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What are the types of weight-loss surgeries?
We do several types of weight-loss surgery.
Sleeve gastrectomy
This surgery removes about 80 percent of the
stomach. This is permanent. The surgeon uses a
stapler to make a thin vertical “sleeve” out of the
stomach. The sleeve is about the size of a banana.
The stomach still works normally and the intestines
are unchanged. This means you still digest and
absorb food. You just eat much less of it.
The surgery takes two hours and you will be in the
hospital overnight.
stomach sleeve
Adjustable gastric banding
A silicone band is wrapped around the top part of
the stomach to create a pouch. The larger part of the
stomach stays below the band, which controls the
opening between the two parts of the stomach. A
smaller opening means the food moves slowly from
the top to the bottom. You stay full longer so you
eat less and lose weight. The band can be adjusted at
our clinic.
The band is connected to a tube that leads to a port
placed under the skin near your stomach. We adjust
the band by adding fluid (salt water) or taking fluid
out with a syringe through the port.
The surgery takes 90 minutes. You will be in the
hospital overnight or may go home the same day.
Recovery time is shorter because the stomach and
intestines are not cut. The band will need to be
replaced at least once in your lifetime.
esophagus
stomach pouch
band
stomach
port
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Gastric bypass
Duodenal switch
A pouch is created from the upper part of the
stomach. The rest of the stomach is closed off, so
food will no longer reach it.
During this surgery, the stomach is made smaller
and part of the small intestines are bypassed.
Therefore, you eat and absorb less food.
Food goes from the stomach pouch into the small
intestines. Because the intestines are shorter, they
will absorb less food and fewer calories.
Surgery takes 3 to 4 hours and you will be in the
hospital 1 to 2 days.
After surgery, your stomach will be able to hold
about 1 ounce of food—the size of two thumbs held
side by side. This leaves you feeling full after only a
few bites. When you eat less food and absorb fewer
calories, you can lose a lot of weight quickly.
Surgery takes 3 hours and you will be in the hospital
1 to 2 days.
new
stomach
duodenum
ileum
Before surgery
What are the risks for surgery?
stomach
jejunum
duodenum
• Breathing problems
•Pneumonia
After surgery
stomach
pouch
Weight-loss surgery does work, but it is a major
surgery with risks. These risks are the same as for
any surgery on the abdomen (belly). Since weightloss patients are obese, problems are more likely.
About 7 to 13 out of 100 patients develop a medical
problem after surgery. Possible problems include:
bypassed
stomach
•Infection
• Bleeding at the incision sites
• Blockage in the GI tract
jejunum
• Leaks at the site where the stomach or intestines
are sewn together
• Blood clots in the legs causing leg pain
jejunum
• Blood clots in the lungs that can cause chest pain
or trouble breathing
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• Nausea and vomiting that does not stop
What side effects might I have after surgery?
• Injury to the organs
• Nausea and vomiting
•Death
• Cramping or bloating
Remember, surgery is both a personal and medical
decision. Our staff can teach you about the risks and
help you measure the benefits. Still, the choice is
yours. You need to understand the risks in order to
make an informed decision.
•Constipation
If you notice a problem in the hospital, be sure to
tell us.
What are the risks of each type of surgery?
Your bariatric team will explain these risks to you.
• Adjustable gastric banding: slipped band;
stretching of the esophagus; injury to organs;
ulcers; tubing kinks; port flips over; leaks in band
that must be replaced or removed; heartburn;
regurgitation and night time coughing.
• Sleeve gastrectomy: Leaks at the staple line;
narrowing of stomach, esophagus or intestines
(stricture); injury to other organs; heatburn and
ulcers.
• Gastric bypass: Leaks at the staple line; narrowing
of new stomach or esophagus (stricture); fewer
vitamins and minerals absorbed; ulcer (more likely
if you smoke or use NSAIDs); low blood sugars
(without diabetes); anemia; trouble accessing the
lower stomach and duodenum (important if you
develop gallbladder problems).
• Duodenal switch: Leaks at the staple line;
narrowing of the stomach, esophagus or
intestines (stricture); more bowel movements (at
least 5 times a day) that may be loose with badsmelling gas; anemia; severe vitamin and protein
deficiencies. For example, a severe vitamin A
deficiency could cause changes to your vision and
problems seeing at night.
• Dehydration (not getting enough fluids)
•Diarrhea
• Dumping syndrome (with gastric bypass)
• Hair loss
•Heartburn
•Scarring
• Excess skin
• Lactose intolerance (with gastric bypass)
• Extreme tiredness
• Gallstones during the first 6 months after surgery
due to rapid weight loss
• Weight regain after weight loss if changes in
eating, exercise or medicines
If you notice a problem at home, call our nurse at
612-626-6666. We can help with these side effects.
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What happens in the hospital?
Day of surgery
You will come to the hospital two hours before
surgery.
A doctor will talk to you about medicines that will
help block pain. He or she will give you medicine
that lets you sleep through surgery. You will also
meet with the pain medicine team 3 weeks before
surgery.
Your surgeon will begin surgery by making several
small cuts in your belly. Before surgery, he or she can
show you where these cuts might be. Strips of tape
or glue will close these cuts once surgery is done. You
may have stitches under the skin.
If a problem occurs during surgery, we may stop or
change the surgery for your safety.
After surgery
When you wake up after surgery, you MAY have:
• An IV tube (line in a vein) in your arm. This will
put fluid and medicine into your veins.
• A pump to control the amount of pain medicine
you receive. When you push the button, it
pumps medicine into your body. Visitors may
not touch this pump.
• A drain in your belly. This removes body fluids
that may build up after the surgery. The drain is
not used with adjustable band surgery.
• Pneumo boots (special leg wraps) on your legs.
These help your blood flow.
• A clip on your finger to measure the oxygen in
your blood.
• A catheter (long, thin tube) in your bladder. This
drains your urine.
Once you get to your hospital room, we will help
you walk, which helps prevent blood clots. To help
prevent pneumonia, we will have you take deep
breaths at regular times.
After surgery, you will begin a clear liquid diet of
gelatin, fruit juice and broth. Once you are taking
enough fluids, you can go home.
Most patients go home the day after surgery.
At home
When you go home, it is important to follow your
doctor’s orders. Here are some things to know.
• Plan on being away from work 2 days before
surgery and 2 to 6 weeks after surgery. Your
return to work or school will depend on your job
or school activities.
• You cannot lift more than 10 pounds for 6 weeks
after surgery.
• Take your pain medicine as advised. No driving
or using machinery until you have stopped taking
narcotic pain medicines.
• You will do deep-breathing exercises for the first
week.
• Increase your activity as you are able. This will
help you:
– Gain strength, so you can go back to work.
– Improve the blood flow in your legs.
– Prevent blood clots and pneumonia.
• Your dietitian will advise you about your diet and
supplements. You will start supplements at one
month.
• Do not plan to fly or take a road trip for at least
1 to 3 months after surgery. You can travel when
your care team says it is safe to do so.
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What problems could occur after surgery?
Minor problems are common after weightloss surgery. Please let us know if you have any
problems. They may include:
• Hair loss. This is due to the huge weight loss. It
tends to happen between two and nine months
after surgery. It only lasts a short while and your
hair will grow back.
• Dumping syndrome (gastric bypass). This can
happen if you eat too much sugar (carbohydrate)
or too large a meal. Effects can include nausea,
weakness, sweating, fainting and diarrhea after
eating.
• Dehydration (too little fluid in the body).
Symptoms are feeling tired, low fever, headache,
muscle cramps, dizziness, belly aches, nausea and
vomiting. It is important to sip 48 to 64 ounces
of fluid each day.
• Blockage. If you do not chew your food well
enough, you may regurgitate (bring back up to
the mouth) your food or feel some pain. Pain in
your belly (abdomen) is a sign we should check
to see if you have a blockage or constipation.
• Scarring. The stomach can scar and narrow where
it connects to the intestine or where there is a
band. This will cause vomiting. We can usually
fix this problem in an outpatient procedure.
• Nausea and vomiting (throwing up). This
What kind of follow-up care will I need?
may occur if you eat or drink too fast. It is very
important to chew your food well, take very small
Call 612-626-6666 to schedule a clinic visit.
bites and eat slowly. (A meal should take you 30
minutes.) If you have stomach banding, vomiting
In the first year after surgery: Clinic visits at
could cause your band to move. This may lead to
1 week, 1 month, 3 months, 6 months and 12
a larger stomach and other problems.
months from your surgery date. You will meet
with the surgeon one or two times and see a nurse
• Heartburn. You may have heartburn if you use
practitioner or physician assistant at other visits.
a straw, drink carbonated fluids (like soda pop),
chew gum, suck on hard candy, or eat gassy or
For the next 4 years: Clinic visits every 6 months.
greasy foods that have strong flavors. You should
After five years: Clinic visits once a year.
also be upright for 30 minutes to an hour after
eating or take a short walk after meals. Try not to
Lab tests: at 3 months and every year for life. The
eat for at least two hours before your bedtime.
labs can be done before or after your yearly visit.
• Diarrhea. This can occur if:
– You eat too quickly or too much at one time.
– You eat too much sugar (carbohydrate).
– You become lactose intolerant. (Lactose is
found in milk. In some people, it causes
diarrhea, gas and bloating.)
To control diarrhea, try to figure out what food
causes it or if you are eating too fast. Try adding
soluble fiber to your diet. You can buy Benefiber at
the drug store.
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What will insurance cover?
If I don’t have surgery, what are other options?
Your insurance company must authorize the
bariatric surgery before we can schedule it.
Insurance plans and coverage vary, so you will need
to find out if you qualify for coverage. You will
also need to know your out-of-pocket costs, copayments and deductibles for clinic visits and labs.
Weight management. Our specialists (doctors who
understand how hormones affect the body) can help
you lose weight, using diet, exercise and medicine.
You must take vitamins for the rest of your life
after bariatric surgery. Costs can vary from $20 to
over $100 dollars per month and are not typically
covered by insurance.
Counseling. Counselors can help you learn to
change your thinking and behavior related to eating
and exercise.
The University of Minnesota Health clinics are
hospital-based clinics. Health insurance billing
rules require that services provided in our clinics
are billed as “outpatient hospital.” This may
increase your out-of-pocket cost when compared to
community-based clinics.
You will receive two separate bills: One for the
doctor’s services and the other for the clinic and
equipment.
Band adjustments and X-rays may or may not be
covered by your insurance. The doctor’s fee for band
adjustments could range from $150 to $350.
Lab tests may or may not be covered by your
insurance. The costs for these tests could range from
$200 to $2,500.
What else do I need to do?
Surgery is only a tool. You are the key to your
success. You should attend regular support groups,
at least during the first year.
It is important that you see us when you are supposed
to and tell us when things are not going well. We can
help if your weight loss does not go as planned or if
you are afraid of falling back into old habits.
If you want to succeed at weight loss, you must
make lifelong changes in your eating and behavior.
You make it happen!
Nutrition education. Our dietitians can set up a
diet and exercise plan for you.
Food and exercise log. Programs such as www.
sparkpeople.com, show you how to track daily
exercise and the food you eat.
Diet programs. Weight Watchers or Medifast
are examples of programs that help you focus on
healthy eating.
Before surgery phone numbers
• To schedule surgery or ask insurance questions,
call our scheduler: 612-624-6102.
• For nurse advice, call our nurse coordinator: 612625-1124.
• To schedule or change appointments,
Call Center: 612-626-6666.
After surgery phone numbers
• (7:30 a.m. to 4:30 p.m. Monday through Friday)
Appointments or nurse advice, call 612-626-6666.
• (After 5 p.m. Monday through Friday and on
weekends): Call the doctor on call for bariatric
surgery at 612-273-3000.
To contact staff, you may use My Chart, a secure
online system. Call 612-884-0718 to sign up.
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Resources
The New U Support Group for Weight Loss
First Wednesday of the month, 6:30 p.m. to 8 p.m.
University of Minnesota Medical Center
East Building – Brennan Center
2450 Riverside Avenue, Minneapolis, MN 55454
For directions and information on upcoming
speakers, call 612-624-1089 or email hadl0052@
umn.edu.
UMP Weight loss surgery: http://www.umnwls.org
ASMBS Benefits of Bariatric Surgery:
http://asmbs.org/benefits-of-bariatric-surgery
Weight-control Information Network:
win.niddk.nih.gov/index.htm
www.fairview.org
For informational purposes only. Not to replace the advice of your health care provider.
Copyright © 2005 Fairview Health Services. All rights reserved. SMARTworks 521979 – REV 08/15.