A:It depends on the surgery you have. For the sleeve gastrectomy or omega loop (mini) bypass you should consider being off work for two to three weeks.  If you have a desk job, you are likely to be able to return to work at around two weeks.  If your job is physically demanding and requires heavy lifting or physical activity, a longer period off work may be necessary.  If there are questions please contact the office to discuss.

A:Walking is encouraged early post-surgery and, thereafter, on a regular basis to increase your physical activity level.  Aerobic activities such as brisk walking, stationary biking, elliptical machines, etc. may be engaged two weeks after surgery and are limited generally by the degree of discomfort that these activities cause.  You may engage in swimming once your surgeon has determined that the wounds are fully healed. Activities that are more strenuous or that involve lifting weights are generally discouraged for three to four weeks after surgery and given clearance by the surgeon.

A: If sleeve gastrectomy  is performed patients spend approximately 72 hours in hospital and are off work for two weeks in total.  If a Roux-en Y or Omega Loop (Mini) bypass is performed, patients typically spend three to four days in the hospital.  It takes most patients about a week or so to return to work and a month to six weeks to resume exercising.  In the case of open surgery or if there are complications, recovery may take longer.

A:The general answer to this is yes.  Most of the commonly performed abdominal operations such as C-section, gall bladder surgery, appendectomy, tubal ligation, hysterectomy and minor hernia repair of the belly button rarely impact the ability to have weight loss surgery.  However, if you have had prior surgery for hiatal hernia or reflux, intestinal surgery involving removal of a portion of the small intestine or colon, or have had a major hernia repair with a large mesh, it could impact the type of surgery you can have or the ability to do it laparoscopically through small incisions.  It is important to recall all prior surgeries and let the doctor and office staff know about them during the evaluation process.  If you have had a major abdominal surgery, it is very helpful if you can obtain the operative reports as well.

A:Yes, weight loss surgery has been shown to improve or cause remission of type 2 diabetes.  There is evidence that procedures such as gastric bypass, sleeve gastrectomy and omega loop (mini) bypass work through pathways such as gut hormones as well as through the weight-loss these procedures produce to cause the improvement or remission of type 2 diabetes.  Studies find a greater than 95 percent of patients have improvement of type 2 diabetes with weight loss procedures and up to 85 percent have remission of their diabetes with these surgeries.  Some studies have even reported improvement of type 1 diabetes mellitus following weight loss procedures.

A:Bariatric surgeons generally recommend that patients wait approximately 12 months after surgery to become pregnant because most of the patient’s weight loss is within the first year after surgery.  Obesity is a major cause of infertility and with weight-loss you fertility levels may increase.  It is important to practice effective contraception other than birth control pills during this period in avoid getting pregnant.  With appropriate nutrition and vitamin/mineral supplementation, weight loss surgery does not cause growth or development problems for offspring.  In fact, studies find that women who had weight loss surgery have improved pregnancy and offspring outcomes than those who are affected by severe obesity and have not had weight loss surgery.  These improvements include a reduced rate of preeclampsia (an increase in blood pressure leading to chronic high blood pressure) and gestational diabetes, a lower incidence of stillbirths, and fewer miscarriages.  The offspring of weight loss surgery patients are also less likely to be underweight or overweight at the time of birth.

A:Yes, surgery leads to significant improvement in conditions associated with or contributing to heart disease, including lipid abnormalities, an enlarged heart, vascular and coronary disease and hypertension.  However, if you have heart disease, you will need medical clearance for weight loss surgery from your cardiologist.

A:Whether or not your skin will sag after surgery depends upon several things including how much weight you lose, your age, your genetics and whether or not you exercise.  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.  Generally loose skin is well hidden by clothing.  Some patients will choose to have plastic surgery, which is the only solution for removing the excess skin.  Most surgeons recommend waiting at least 12-18 months before having plastic surgery, but you should consult with your surgeon before doing so.  Plastic surgery for removal of excess skin is rarely covered by insurance because it is generally considered cosmetic.

A:Some hair loss is common following surgery and typically occurs between the third and sixth months following surgery.  This is a result of several factors including the physiologic stress, the emotional stress of the adjustments and the nutritional stress following surgery.  This is temporary, and an adequate intake of protein, vitamins and minerals will help to ensure hair re-growth.  The dieticians can advise which supplements are good for hair loss if required.

A:An everyday vitamin and mineral supplement is necessary after you have had weight loss surgery.  At your follow-up visits we may ask you to undertake a blood test to check your B12, Folate and Iron levels.  We will advise you if you need additional supplements.

A:Yes. We ask our patients to undertake a Kicstart shake diet for 2 weeks prior to surgery in order to shrink the liver and reduce fat in the abdomen.  This helps with surgery and makes it safer for the patient.

A:Yes. Surgery is just a tool that will enable you to lose weight.  Although surgery does produce changes in your body that help with the initial weight-loss and maintenance of the weight-loss, it is ultimately up to you to make lifelong changes to be successful.

This includes making right food choices, controlling portions, taking vitamin and mineral supplements as directed, getting plenty of fluid, rest and regular exercise.  In addition, sufficient sleep and stress control may help to improve long-term weight-loss success and maintenance.  Without these lifelong changes weight regain is likely to occur.  The dieticians offer meal plans to patients who want advice on food choices that are high in protein and need some cooking inspiration and tips.

A:Most surgeons will not perform bariatric surgery on a person that smokes heavily and often require a smoke-free period prior to surgery.  It is not only very important to stop smoking prior to surgery, but it is also critical to remain smoke free after surgery because smoking significantly increases the risks of complications even after surgery such as development of breathing difficulties, clots and ulcers.

A:With weight-loss you may be able to go off or reduce the dosage of many of the medications you take for obesity-associated co-morbidities, such as blood pressure, heart disease, arthritis, lipid abnormalities, and type 2 diabetes. If you have had sleeve gastrectomy, gastric bypass or a mini gastric bypass, you may even be able to discontinue using or to reduce the dosage of your diabetes medications in the early period following surgery.  You should however see your GP, physician or surgeon before lowering and/or ceasing these medications.

A: You may. It’s possible you may not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron.

A: Order only a small amount of food, such as an entree.  Eat slowly over the time and finish at the same time as your table companions finish their meal.  You might want to let your host or hostess know in advance that you cannot eat very much.

A: Alcohol has a high number of calories. It also breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.  Please note that due to the weight loss surgery you have undergone your alcohol tolerance will be lowered and your blood alcohol level will be affected more rapidly and stay in your system longer.  Please refrain from drinking if you are driving.

A: There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fibre.  The dieticians will be able to advise you which fibre supplements you may use to increase the fibre in your diet if you suffer from constipation.  If difficulties do arise, let us know as soon as possible.