Bariatrics and Weight Loss Surgery FAQs

UofL Physicians Advanced Bariatric Surgery offers a full range of the most advanced and effective weight loss surgery options at UofL Hospital, including the following: (link each to a separate page with details about the procedure – details are below)

• Sleeve Gastrectomy
• Roux-en-Y Gastric Bypass
• Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy
• Biliopancreatic Diversion with Duodenal Switch
• Revisional Bariatric Surgery
  • Laparoscopic adjustable gastric band removal +/- conversion to another bariatric procedure
  • Sleeve gastrectomy conversion to gastric bypass
  • Revisional surgery for weight regain
  • Revisional surgery to correct a complication from prior surgery
  • Reversal of prior bariatric surgery
• Endoscopic sleeve gastroplasty

The procedures are performed with minimally invasive techniques through four or five small incisions.

We accept all major insurances, including Medicare and all Kentucky and Indiana Medicaid plans. We will verify your insurance benefits prior to your first appointment.

We are not currently accepting self-pay patients.

Many factors go into how long it takes after your initial appointment to have your surgery. Insurance may require a certain amount of time to complete your nutrition education and to undergo medically-supervised weight loss. You will be provided with a checklist of pre-operative requirements based on your health history at your initial appointment. After your final appointment, authorization will be sent to your insurance company which can take up to two weeks to complete.

Surgery is performed at UofL Health – UofL Hospital, located at 530 S Jackson St., Louisville, KY 40202.

We specialize in minimally invasive techniques and utilize enhanced recovery protocols to make your recovery as fast as possible. Most people spend one night in the hospital and go home the next day.  Some people go right back to work, if their job is more sedentary. Some prefer to take up to four weeks off. Most feel like themselves within a week after surgery and feel good enough to return to work in two weeks.

Right away! To start, you will take easy, short walks while you are in the hospital. The key is to start slow. Listen to your body. If you lift weights or do sports, stay “low impact” for the first month.

You will be on a special pre-operative diet starting two weeks before surgery. The reason for the pre-operative diet is to shrink the liver and reduce fat in the abdomen. This helps during the procedure and makes it safer.

Some insurance companies will also require a physician-monitored weight-loss program three to six months prior to surgery as part of their coverage requirement. These diets are very different from the short-term diets and usually are more about food education and showing a willingness to complete appointments and to learn.

Remember, bariatric surgery is not about “dieting.” “Dieting” has repeatedly been shown to be an ineffective tool for long term weight loss. It is hard to stick to a “diet” for your entire life! Rather, bariatric surgery is a tool to help you jumpstart a new life of healthy habits, including nutritious and well-balanced eating, regular exercise, good sleep, and a healthy mindset. In general, you will be encouraged to start incorporating these healthy habits right away. This will help you prepare for surgery and increase the likelihood that you will get as much benefit out of surgery as possible.

You will have specific foods that you can and cannot eat in the weeks immediately following surgery. This is to allow your body to heal from surgery and to adjust to your new anatomy. You will be allowed to eat regular foods starting four weeks after surgery. This does not mean you can whatever and whenever you want! Healthier food choices are important for best results, but most patients still enjoy tasty food and even occasional “treats.”

We advise waiting 18 months after surgery before getting pregnant. This will allow you to get the most benefit out of your surgery as possible.

Most women are much more fertile after surgery, even with moderate weight loss. Birth control pills are not very reliable during the time your weight is changing. For this reason, having an IUD or using condoms and spermicide with ALL intercourse is needed. Menstrual periods can be very irregular, and you can get pregnant when you least expect it!

Yes. After surgery, there is much less risk of experiencing problems during pregnancy and during childbirth. There are also fewer miscarriages and stillbirths than in women with obesity who have not had surgery and weight loss.

Children born after mom’s surgery are LESS at risk of being affected by obesity later, due to activation of certain genes during fetal growth. There is also less risk of needing a C-section.

Some hair loss or thinning is common between three to six months following surgery, but it is almost always temporary. The reasons for hair loss are not totally understood. Even if you take all recommended supplements and meet protein requirements, hair loss may be noticed until the follicles come back. Adequate intake of protein, vitamins, and minerals will help to ensure hair re-growth, and avoid longer term thinning. If hair thinning does occur, additional supplementation with specific vitamins and minerals may help combat it and expedite re-growth.

Some patients may choose to have plastic surgery to remove excess skin, but this depends on many factors. You can be assessed for this approximately 18 months after surgery.

No. A small number of patients can regain their weight but the vast majority lose significant weight and keep this weight off.

More than 95% of patients will successfully lose half of their extra body weight or more after surgery for weight loss. Roux-en-Y gastric bypass patients, for example, on average lose approximately 70% of their extra body weight initially, and two years or more after surgery will only regain approximately 5% of their extra body weight. Compared to these results, patients who attempt weight loss without surgery, on average, lose little weight and may gain weight in the long-term.

Because bariatric surgery results in remission of many obesity-related conditions, many patients are able to stop taking some or all of the medications they were taking before surgery. We will work closely with you to determine if and when you can stop taking these medications.

You will need to take a bariatric multivitamin for life. You may need higher doses of certain vitamins or minerals, especially iron, calcium a vitamin D. You will also need to have at least yearly lab checks. Insurance almost never pays for vitamin and mineral supplements but usually does pay for labs. You can pay for supplements out of a flexible spending or health savings account.

As long as patients take their appropriate vitamins, it is rare to have health problems from vitamin deficiency.

Weight loss surgery can lead to reduced amounts of vitamins and minerals because people eat less and may absorb less in the intestines. Weight loss surgeries have different effects on vitamins and minerals based on how much change in absorption they cause. Deficiencies in vitamins, minerals, and protein can negatively affect health causing:

• fatigue (feeling tired)
• anemia (low levels of red blood cells that carry oxygen through your body)
• bone and muscle loss
• impaired night vision
• low immunity (your body’s ability to stay healthy)
• loss of nerve function (can affect your senses such as touch, taste, and smell)
• mental function deficits (changes how clearly you think)

Fortunately, nutrient deficiencies following surgery can be easily avoided with a good diet and the use of supplements including vitamins, minerals, and sometimes protein supplements. Before and after surgery, patients are advised of the appropriate diet and vitamin supplement needed. Most weight loss surgery programs also require patients to have their vitamins and minerals checked on a regular basis after surgery. Nutrient deficiencies and any associated health problems are preventable with monitoring and patients following diet and supplement (vitamin and mineral) recommendations. Health problems due to deficiencies usually occur in patients who do not regularly follow-up to monitor healthy vitamin and mineral levels. Be sure you stay in touch with our weight loss surgery team for best results!

Yes. Weight loss surgery is very safe and decreases the chance of dying from obesity. In fact, weight loss surgery is safer than removing the gallbladder or having a knee replacement.

The risk of death from weight loss surgery has been found to be considerably less than most other surgeries, including gallbladder and hip replacement surgery. Large studies find that the risk of death from any cause is considerably less for patients after weight loss surgery than for those who have severe obesity and have never had the surgery. As with any serious surgical operation, the decision to have weight loss surgery should be discussed with your surgeon, family members and loved ones.

We require abstinence from alcohol for one year following bariatric surgery. Alcohol sensitivity is increased after weight loss surgery so that the effects of alcohol are felt with fewer drinks than before surgery. Studies also find that with certain weight loss procedures (such as the gastric bypass or sleeve gastrectomy), drinking an alcoholic beverage increases blood alcohol to levels that are considerably higher than before surgery or in comparison to the alcohol levels of individuals who have not had a weight loss procedure. In addition, studies have found that alcohol takes much longer to clear out of a person’s system if they have had weight loss surgery, which can pose safety and legal hazards for driving. Furthermore, it has been found that some patients may feel as though they are sober (‘not drunk’) even when they are over the legal blood alcohol limit for driving. For all of these reasons, weight loss surgery patients are advised to take precautions regarding alcohol.

There is a small group of patients after weight loss surgery who have a problem with alcohol abuse. Contact your primary care doctor and/or your surgeon for help.

Recommended precautions after weight loss surgery:

• Avoid alcoholic beverages during the rapid weight loss period (first 12 months), and then drink only rarely
• Be aware that even small amounts of alcohol can cause intoxication (‘being drunk’)
• Avoid driving or operating heavy equipment after drinking any alcohol
• Remember that you may feel less intoxicated than you are, and will not be a reliable judge of whether it is safe for you to drive after drinking.
• Seek help if drinking becomes a problem.

After surgery, most patients have improved mental health but there may be a small increase in the risk of suicide. This is why patients are required to have a mental health screening before surgery.

People affected by severe obesity who are seeking weight loss surgery are more likely to suffer from depression or anxiety and to have lower self-esteem and overall quality of life than someone who is normal weight. Weight loss surgery results in significant improvement in mental health for the majority of patients. However, studies have found a small increase in suicide following weight loss surgery. In some cases, these may have been patients with undiagnosed mental disorders. In others, patients may have experienced major life stressors that can increase the risk for suicide. In rare cases, the suicides are unexplained. For this reason, comprehensive bariatric programs require psychological evaluations prior to weight loss surgery. In addition, if a patient sees a psychologist or psychiatrist before surgery, they should continue seeing them after surgery.