Ask The Expert/FAQs

Other Frequently Asked Questions:

	Q.	What causes obesity?
	Q.	What is severe obesity?
	Q.	How can obesity be treated?
	Q.	What are the surgical options for severely obese individuals?
	Q.	How much does the laparoscopic gastric bypass or laparoscopic adjustable gastric banding procedure cost?
	Q.	How long will I be in the hospital?
	Q.	How experienced are the bariatric surgeons at UC Irvine Healthcare?
	Q.	What is laparoscopic bariatric surgery?
	Q.	Who is eligible for laparoscopic bariatric surgery?
	Q.	What will happen if I am eligible and wish to proceed with surgery?
	Q.	How long does the surgery take?
	Q.	How long will it take for me to recover?
	Q.	How much weight can I expect to lose after bariatric sugery?

Q. What causes obesity?

A. The development of obesity is complex and involves a combination of genetics, metabolism, endocrine regulation, and psychosocial and cultural factors, but the basic mechanism occurs when energy intake exceeds energy output.

Q. What is severe obesity?

A. Severe obesity, sometimes known as "morbid obesity," is defined as being 100 lbs. or twice your ideal body weight according to the Metropolitan Life Insurance Company height and weight table.

Three to five percent of the United States adult population has severe obesity. Severe obesity is a well-established risk factor for development of coronary artery disease, type II diabetes, dyslipidemia, gallbladder disease, hypertension and certain cancers. The risk of developing these additional medical problems is proportional to the degree of obesity.

Q. How can obesity be treated?

A. Treatment of morbid obesity consists of both medical and surgical options. Numerous medical therapeutic approaches to this problem have been advocated, including low calorie diets, drugs, behavioral modification and exercise therapy. Unfortunately, most fail to maintain the reduced body weight in the majority of patients. Surgical intervention is a treatment proven to be effective in the long-term management of morbid obesity.

Q. What are the surgical options for severely obese individuals?

A. UC Irvine Healthcare’s bariatric surgery services offer both the LAP-BAND® and the Roux-en-Y gastric bypass as surgical options. Choosing between the LAP-BAND® and the Roux-en-Y procedures involves many factors, including the patient's preference and consideration of the patient's eating habits.

Q. How much does the laparoscopic gastric bypass or laparoscopic adjustable gastric banding procedure cost?

A. Most insurance carriers will cover the laparoscopic gastric bypass procedure if you are eligible for the procedure. Insurance coverage for laparoscopic adjustable gastric banding is variable and will depend on your insurance. If your insurance does not cover these procedures, you may discuss other options with our office.

Q. How long will I be in the hospital?

A. Length of hospital stay for either an open or laparoscopic gastric bypass surgery is about a three to four days, and less than 24 hours for a LAP-BAND® patient. The time spent in the hospital depends upon the individual and whether or not there are complications.

Q. How experienced are the bariatric surgeons at UC Irvine Healthcare?

A. Our surgeons are specialists in minimally invasive laparoscopic techniques. Board-certified gastrointestinal surgeons, Dr. Ninh T. Nguyen and Dr. Kevin Reavis are experienced in the most advanced weight loss surgical procedures, including the Roux-en-Y gastric bypass and the reversible LAP-BAND® technique. They have preformed more than 1,000 bariatric laparoscopic gastric bypass and laparoscopic adjustable gastric banding procedures.

Q. What is laparoscopic bariatric surgery?

A. Laparoscopic surgery involves making five 1/2- inch incisions and performing the operation by observation through a small camera. The laparoscope, which is connected to a video camera, is inserted through one of the small abdominal incisions, giving the surgeon a magnified view of the patient’s internal abdominal space on a television monitor. The entire operation is performed "inside" the abdomen after gas has been inserted to expand the abdomen.

Advantages of the laparoscopic approach include reduced post-operative pain, shorter hospitalization, faster return to work and improved appearance. The recovery time for the laparoscopic procedure also is expected to be shorter, though similar possible complications exist.

Q. Who is eligible for laparoscopic bariatric surgery?

A. The eligibility for the laparoscopic approach is based on the patient’s body mass index (BMI) at the time of the initial consultation, body build (pear versus apple body type), prior surgical history, and the ability of the patient to tolerate inflation of the abdomen.

The following guidelines for selecting patients for obesity surgery were established in 1991 by the National Institutes of Health Consensus Development Panel for treatment of severe obesity.

Ideal candidates are individuals who:

• Have experienced failed attempts with nonsurgical means of weight loss for at least five years and are more than 100 lbs. overweight or twice their ideal weight.
• Fully understand the importance of the proposed surgical procedure, including all known and unknown risks.
• Are willing to be observed for a prolonged period of time.
• Have attempted weight reduction using conservative treatments without success. Documentation of such attempts will need to be provided at the time of consultation. If unavailable, a medically supervised weight reduction program may be recommended before bariatric surgery is considered.

Q. What will happen if I am eligible and wish to proceed with surgery?

A. Once you have been determined to be eligible for surgery, and your surgery has been authorized by your insurance company, you will be given a date for a preoperative history and physical exam. Preoperative laboratory studies will be ordered and the date for your operation will be set. You will be given instructions for a clear liquid diet and bowel preparation for the day before surgery and instructions regarding your current medications.

Q. How long does the surgery take?

A. Both laparoscopic and open gastric bypass take about three hours, though it may take longer if you have had previous abdominal surgery or if your anatomy makes the surgery difficult. Laparoscopic adjustable gastric banding normally takes about 60-90 minutes.

Q. How long will it take for me to recover?

A. If you have the laparoscopic gastric bypass procedure, you can expect to be in the hospital for two to three days postoperatively and may be able to return to most of your usual activities in seven to 10 days.

Patients undergoing the open gastric bypass procedure may be in the hospital for four to five days after surgery and return to most activities three to four weeks later.

With the LAP-BAND® procedure, the hospital stay may be one to two days with a return to most activities in seven to 10 days.

You will be advised to avoid strenuous activity for six weeks following surgery by any of the above methods. These estimates are for patients who have optimal operations.

Most patients will feel tired, less energetic and sore for several weeks following either operation, as these are major operative procedures. However, you may still lose weight while your wounds are healing.

Q. How much weight can I expect to lose after bariatric surgery?

A. Most gastric bypass patients experience fairly rapid weight loss in the first three to six months after surgery. Weight loss slows, but generally continues up to 12 to 18 months after surgery, averaging 65 to 75 percent of excess body weight. After 18 months, it is critical to adhere to the low-fat, low-sugar diet and exercise recommendations you will receive in order to maintain your weight loss. With the LAP-BAND® weight loss is generally slower and more gradual compared to the gastric bypass. Weight loss may continue for up to two years.

Questions? Contact Bariatric Surgery Services at 888.717.GIMD (4463).

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