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Surgical Weight Loss FAQs

Q: Why should I choose the Summa Health Weight Management Institute?

A: The Summa Health Weight Management Institute understands that obesity is a disease, not just lack of will power. It therefore takes a traditional physician-driven approach to treating each patient, with a focus on individual needs. Additionally, we know from experience that weight gain is complicated and is usually a result of many factors. Therefore, our comprehensive program, comprised of physicians, psychologists, dietitians, clinical exercise specialists and an array of highly trained support staff work hard to insure you have the best possible outcome.

Making the Surgery Decision

Q: Why should I choose the Summa Health Weight Management Institute for my surgery?

A: The Summa Health Weight Management Institute focuses on the individual needs of each patient. Our comprehensive surgical program, comprised of fellowship-trained surgeons, psychologists, nurses, dietitians, and an array of highly trained support staff work hard to insure you have the best possible outcome. Our program provides a high level of coordination of care throughout the process to make sure nothing falls through the cracks.

Q: Why is it important to be designated an MBSAQIP?

A: As an MBSAQIP Accredited – Comprehensive Center, Summa Health System – Akron Campus meets rigorous program guidelines set by the American Society for Metabolic & Bariatric Surgery. Being MBSAQIP Accredited is a significant distinction among surgical weight loss programs that directly benefits each patient.

Q: Why is it important to have a fellowship-trained surgeon?

A: After completing a traditional five-year general surgery residency, some surgeons complete an additional year of surgical training that focuses solely on advanced laparoscopic and weight loss surgery. All of our surgeons have trained with renowned leaders in the field of minimally invasive surgery with a special emphasis on weight loss surgery.

Pre-Operative Testing and Preparation

Q: Once I start the process, how long do I have to wait until surgery?

A: The average time from program enrollment to surgery is approximately six to eight months. This can vary depending on your readiness for surgery, the requirements of your insurance company, and the results of the testing ordered by your surgeon.

You must complete all required testing and have approval from your insurance before your surgery can be scheduled.

Q: What kind of testing is required before surgery?

A: Some of the testing is required by your insurance company and some is required by your surgeon. All insurance companies require a normal Thyroid Stimulating Hormone (TSH) level, psychological clearance and nutrition clearance. Most also require you to complete a certain number of months of physician supervised diet and exercise visits during which you lose at least a little bit of weight each month. The remainder of pre-op testing required by your surgeon varies based upon patient history, but could include cardiology clearance, pulmonary clearance, a sleep apnea evaluation, other lab work and/or other clearances or tests.

Q: Will I have to go on a special diet before surgery?

A: Most weight loss surgeons recommend a very low calorie specialized pre-operative diet for 2-4 weeks right before surgery. This diet promotes rapid weight loss which decreases the amount of fat in the liver and makes it shrink in size. This makes the surgery safer for you. At Summa, patients may be prescribed the use of Optifast for this specialized diet.

Financial Questions

Q: How much does surgery cost?

A: Understanding the details of medical insurance coverage as it relates to paying for weight loss surgery can be overwhelming. That’s why our team has a full-time financial specialist who helps you understand your insurance benefits and out-of-pocket financial responsibilities.

Patients who do not have the weight loss surgery benefit on their plan may choose to take advantage of our private pay program. Participation in the private pay program requires the patient to be enrolled in a major health insurance throughout the process and for 6 months after surgery.

The Surgery

Q: How long will I be in the hospital?

A: The average hospital stay for patients undergoing laparoscopic gastric bypass surgery at Summa is two days. The average hospital stay for patients undergoing laparoscopic sleeve gastrectomy surgery is one day.

Q: What kind of support will I need at home after surgery?

A: During your first week after surgery, you will need someone to assist you. All patients are required to have someone staying with them for their first week.

Q: How long will I be off of work?

A: Most patients are off work for four weeks following a laparoscopic weight loss procedure. The actual length of time may vary depending on the type of surgery that you undergo, other medical conditions that you may have and your individual recovery. Regardless of which surgery is performed, heavy lifting is prohibited for a minimum of one month following surgery. If your job involves lifting objects that weigh more than 15 pounds, your time off work may be longer.

Q: How will the size of my stomach change after surgery?

A: This will vary, depending upon your surgeon. A gastric bypass pouch will typically be about the size of an egg, and will hold about an ounce of fluid (30 - 50cc’s). A sleeve gastrectomy results in a sleeve-shaped tube that will hold about 2-3 ounces (60-100cc’s).

Q: What happens to the old stomach?

A: For Gastric Bypass patients, the remaining stomach is left in the body, where it continues to function by making important digestive juices that are used to process food farther down in the small intestine. For Sleeve Gastrectomy patients, part of the stomach is completely removed at the time of surgery.

Pain Management

Q: Should I be feeling pain after my surgery?

A: It is normal to feel pain after surgery. The day of surgery you may be given a special non-narcotic pain block to help you with pain control. We will give you a prescription for oral pain medication prior to sending you home. You should take that medication as directed because it is important that your pain be controlled so that you can walk, take deep breaths and drink liquids.

Q: My left incision hurts a lot more than the others – is this normal?

A: This is normal. Most patients find that the left incision is the most painful because the instruments used to perform your surgery cause increased pressure on the left side of the abdomen. We recommend wearing your binder at all times and using ice packs to minimize the amount of discomfort.

Nausea and Vomiting After Surgery

Q: Is it normal to feel nauseated after surgery

A: Some patients do feel nauseated after weight loss surgery. We provide you with a prescription for anti-nausea medication, which we encourage you to take so that you can drink all of your fluids.

If you find that you are unable to drink the quantity of liquids that you were instructed to drink at the time of discharge, it is possible for you to become dehydrated. Symptoms of dehydration can include a headache, decreased or dark urine output, or nausea or vomiting. If you experience these symptoms, and you know you are not drinking all of your fluids, please call us.

Wound Concerns

Q: What should my incisions look like after surgery?

A: You will have 5-6 small ½” incisions located on your upper abdomen. These incisions will be covered with steri-strips, which are temporary. You will have internal, dissolvable stitches. Keep your incisions clean and dry. You will be given home going instructions as to how to care for your incisions.

Q: What are the signs of a wound infection?

A: When a wound becomes infected, it can become red and warm to the touch. It may drain green or yellow or think white fluid. You may or may not have a temperature. It may also feel swollen and tender to the touch. If you notice any of these symptoms, please call us. Wound infections are not common, but they do need to be treated if they occur. If you think you have a post-operative wound infection, call our triage line at 330.375.4199 or 330.375.6590.

Post-op Diet Questions

Q: What will I be able to drink right after surgery?

A: All patients are started on a clear liquid diet the morning after surgery. Specific instructions are given to you by the RN Case Manager when you are in the hospital. You will be asked to measure, time and write down all of the fluids you drink while you are in the hospital.

Q: When will I be able to advance my diet?

A: You will be sent home with instructions to begin a full liquid diet on post-op day 3 after surgery.

You will stay on a full liquid diet until your first post-op office visit with your surgeon (usually 7-10 days after surgery).

You will advance to a pureed diet after you see your surgeon, and will follow that diet for 2 weeks.

You will advance to a pureed/blenderized diet after completing the full liquid diet and will follow that diet for 2 weeks.

You will advance to a regular/maintenance diet once you have completed the Pureed/Blenderized diet and will continue this diet for life.

Q: What will happen if I do not follow the prescribed diet?

A: it is very important to follow the diet progression carefully. Not following instructions can result in nausea, vomiting, diarrhea, difficulty swallowing, pain with swallowing, sweating, abdominal cramping and flatulence.

Q: Will I need to take vitamins after weight loss surgery?

A: All patients take vitamin supplements for the rest of their life after weight loss surgery, including a multivitamin with iron, calcium, vitamin D and vitamin B12. It is very important to take all of the vitamins as prescribed to avoid malnutrition.

Post-op Follow Up

Q: How often will I see my surgeon after surgery?

A: Post-operative visits are scheduled for all patients at one week after surgery. After your initial post-op visit, you will be scheduled for appointments with your surgeon or our Nurse Practitioner at the following intervals:

  • Year One: One month, three months, six months, 12 months
  • If you need to be seen more often, additional visits will be scheduled

Q: Who will provide my follow-up care after the first year?

A: After the first year of follow-up, your needs will change. At that point all surgical needs are generally resolved, and your need will change to a focus on continuing to lose weight until you reach your goal weight, and then on maintaining that weight loss for the rest of your life. We have found that this is best accomplished through follow-up with our team of Obesity Medicine Specialists. You will be scheduled for ongoing follow-up at the following intervals:

  • Year Two: 18 months, 24 months
  • Annually thereafter

Q: Why is post-operative follow-up so important?

A: Success after weight loss surgery is directly related to how closely you follow your post-operative program. This includes diet, exercise and vitamin supplementation. Because we know that there are numerous changes to make and requirements to follow, we see you frequently in our office for follow-up. History shows that patients who come in for all scheduled visits and who regularly attend monthly support group meetings have the best outcomes.

Q: Will I continue seeing my primary care physician after surgery?

A: Yes. Your medical condition will change after surgery and your medications will need to be monitored and adjusted. Additionally, our team treats your weight condition, but your primary care physician treats all of you. It is therefore very important that you continue to see your primary care physician soon after surgery, and thereafter.

Managing Stress and Emotions

Q: What should I do if I start to worry after surgery?

A: It is very normal to worry after surgery. Many patients start to worry about whether they will lose weight, whether they will lose enough weight, whether they will be hungry, whether they will be able to follow the meal plan, and for many other reasons.

This is VERY normal.

We have four behavioral health specialists that are available for our patients. They see all of our patients before surgery, and they strongly encourage patients to come back after surgery if they start to have these worries. Your body goes through many changes after surgery, so we expect that there will be some psychological changes that will also occur. Please do not hesitate to reach out for help.

Our behavioral health specialists also co-lead our monthly surgical support groups. We strongly encourage all patients to take advantage of our free support groups so that they can get the additional nutrition and behavioral health support that is provided by a dietitian and a specialist at each meeting.

Weight Loss

Q: When will I start to see results following surgery?

A: Patients will begin to lose weight immediately following surgery. Those who closely follow the recommendations of the team can expect to see significant weight loss as soon as six months after surgery.

Q: How much weight can I expect to lose?

A: People who have weight loss surgery can expect the following:

After gastric bypass surgery, patients will begin to lose weight quickly and will continue to do so during the first 12 months following surgery. Studies show that post-operative patients who choose to be compliant with post-op recommendations can expect to lose 60 to 70 percent of their excess body weight in the first 12 to 18 months following surgery. Studies also show that patients who continue to follow the program can maintain 50 to 60 percent of their weight loss. After Sleeve Gastrectomy, patients will begin to lose weight right away, although not as quickly as with Gastric Bypass surgery. Patients who follow all post-op dietary guidelines will lose about 50-60% of their excess body weight, and to maintain about 40% of their excess body weight lost.

Q: How will my weight loss affect my health?

A: In addition to lower BMI and other health benefits from weight loss, 96 percent of patients experience an improvement in or elimination of obesity-related health conditions such as Type 2 diabetes, high blood pressure, sleep apnea, reflux disease (GERD), etc. Patients also decrease their risk of some cancers/recurrence by lowering their BMI.

When to Call the Doctor

Q: How do I know when to call the doctor?

A: Some situations can be handled over the phone by one of our surgeons, but others need to be handled in the office by a live person. You can use the following general rules when trying to decide whether to call the doctor: The following situations should result in a call to the doctor. Because we have a full team available to help you Monday through Friday between 8:00 a.m. and 4:30 p.m., please try to call early in the day so that we can see you if needed, and so we can order testing if needed.

  • Severe pain that is uncontrolled with your pain medication
  • You are unable to drink liquids – feels like something is stuck when you swallow
  • You are unable to keep any liquids down
  • You see bright red blood when you use the bathroom or vomit
  • You have a fever greater than 101 F within the first two weeks after surgery
  • Your incision changes in appearance – redness, warm to touch, any drainage other than clear, swelling
  • To reach our office call 330.375.4199 or 330.375.6590

Questions about your diet or vitamin supplements are best answered by one of our dietitians. Our dietitians are available during business hours, so please call 330.375.6590, option 3, Monday through Friday 8:00 – 4:30 p.m. with all questions about your diet and vitamins.

The following situations are important enough to merit a call to our on-call surgeon:

  • Severe pain that is uncontrolled with your pain medication
  • You are unable to drink liquids – feels like something is stuck when you swallow
  • You are unable to keep any liquids down
  • You see bright red blood when you use the bathroom or vomit
  • You have a fever greater than 100 F within the first two weeks after surgery
  • To reach our on-call surgeon after hours, call the main number 330.375.6590 to reach the answering service.

Other Questions About Weight Loss Surgery

Q: Will I be able to stop taking some of my medications after surgery?

A: As you lose weight, you may be able to reduce or eliminate some or all of your medications for diabetes, high blood pressure, heart disease, arthritis, high cholesterol and sleep apnea. It is important that you not stop any medications without the guidance of the physician who prescribed them for you.

Q: Will I lose my hair?

A: Most patients will experience some hair thinning around 3-7 months following surgery. This occurs as part of the body’s response to a sudden decrease in nutrient intake. The hair follicles become dormant, but then begin to regenerate hair over time.

Q: How can I prevent hair loss?

A: We recommend that you consumer adequate amounts of protein and also take Biotin and/or Zinc on a daily basis after surgery. Your dietitian will guide you regarding when to start these supplements.

Q: What about all of the excess skin after I lose weight? Will I need plastic surgery?

A: Unfortunately, the skin that holds the fat tissue before surgery tends NOT to shrink down as the fat goes away. This means most patients are left with excess skin in areas such as the abdomen, upper arms, upper thighs, and breasts. Some patients choose to undergo plastic surgery to remove excess skin. We recommend that you wait until after you have achieved you weight loss goals and maintained them for at least 6 months before considering plastic surgery. Most plastic surgeons will not consider an evaluation until at least 18 months after surgery.

Q: When can I start exercising after surgery?

A: We want you to walk gently and frequently right away to prevent complications such a blood clots and pneumonia. The key is to start slowly – listen to your body and stop when you get tired. Exercise beyond walking is not recommended for the first month after surgery. Swimming is not allowed until after all incisions are completely healed.

Q: When can I get pregnant after surgery?

A: Women tend to be more fertile after surgery. Birth control pills are not reliable when your weight is changing. Menstrual periods can be very irregular and you can get pregnant quite easily. Most surgical programs recommend waiting 12-18 months after surgery before getting pregnant, as it is difficult for you and a baby to get adequate nutrition when you are rapidly losing weight.

Q: Will I develop gallstones after surgery?

A: Weight loss can promote the production of gallstones. A small percentage (15%) of patients develops gallstones after weight loss surgery, which may require surgery to remove. If it is determined that you have gallstones before surgery, your gallbladder may be removed prior to or during your weight loss surgery. You can discuss this with your surgeon prior to surgery.


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