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Mercy Hospital - Miami
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Bariatric Surgery FAQs

What is Obesity?

Weight Category BMI
Normal Weight 18.5 – 24.9
Overweight 25 – 29.9
Obesity 30 – 34.9
Severe Obesity 35 – 39.9
Morbid Obesity Greater than 40

Obesity is complex, medical disease, which affects more than 4 million people in the United States and the number is increasing. It is not a moral problem due to a lack of will power. Studies have shown that conventional weight loss measures i.e. diets, medications, behavioral modification and exercises programs have a 95% failure rate. Obesity occurs due to many contributing factors such as heredity, cultural, environmental, socioeconomic and physiological. Morbid obesity is defined as:

  1. 100 # above ideal body weight.
  2. Body mass index (BMI), (Wt in Kg/ Ht. in m2) of 40 or more.
  3. Those with a BMI of 35 – 40 and several co-morbidities.
Weight Height (ft)’
(lbs.) 4’9” 4’11” 5’1” 5’3” 5’5” 5’7” 5’9” 5’11” 6’1” 6’3”
154 33 31 29 27 26 24 23 22 20 19
165 36 33 31 29 28 26 24 23 22 21
176 38 36 33 31 29 28 26 25 23 22
187 40 38 35 33 31 29 28 26 25 24
198 43 40 37 35 33 31 29 28 26 25
209 45 42 40 37 35 33 31 29 28 26
220 48 44 42 39 37 35 33 31 29 28
231 50 47 44 41 39 36 34 32 31 29
243 52 49 46 43 40 38 36 34 32 30
254 55 51 48 45 42 40 38 35 34 32
265 57 53 50 47 44 42 39 37 35 33
276 59 56 52 49 46 43 41 39 37 35
287 62 58 54 51 48 45 42 40 38 36
298 64 60 56 53 50 47 44 42 39 37
309 67 62 58 55 51 48 46 43 41 39
320 69 64 60 57 53 50 47 45 42 40

What are the Co-morbidities?

  1. Diabetes (Sugar)
  2. Hypertension (High blood pressure)
  3. Sleep apnea
  4. Degenerative joint disease (DJD)
  5. Venous stasis disease
  6. Infertility, loss of menstrual periods with masculinization
  7. Shortness of breath with exercise
  8. High cholesterol, lipid and triglyceride levels
  9. Gastro esophageal reflux disease (GERD)
  10. Incontinence of urine or stool
  11. Increased risk of cancer
  12. Joint or back problems
  13. Enlarged Liver (abnormal liver test)
  14. Arthritis
  15. Blood clots
  16. Cardiovascular disease
  17. Depression and other psychological issues

What are the Surgical Procedures for Obesity Offered at Mercy?

All the procedures are done by the minimally invasive approach known as laparoscopic. We offer different procedures because each patient is individual and the level of assistance and/or medical problems are unique to the individual. We encourage you to learn about all procedures, reflect on your personal needs, and speak with your surgeon in order to determine which procedure would be most beneficial for you. Please remember that no procedure is a cure, but a tool.

All procedures require your commitment to a lifelong change in eating habits, exercise, support group attendance and at least a five year follow up plan.

Adjustable Lap-Band

This procedure is purely restrictive in which a band is placed around the upper most part of the stomach. This band divides the stomach into two portions, one small and one larger portion. The food is regulated by the small opening so that the patient feels full faster thus eating less calories. The anatomy is not changed and digestion and absorption occurs naturally. If necessary this band can be adjusted in order to make the opening between the two stomach portions smaller or larger.

Advantages Disadvantages
Shorter operative time Problems with the device
Adjustable Nausea and vomiting
Reversible Slower weight loss
All food is absorbed May need several adjustments
Restricts food intake Slippage
Does not change your anatomy
Out patient or 23 hour stay
Shorter recovery period  

Roux-en-Y Gastric By-pass

Currently known as the gold standard in the medical field. This procedure works by restricting the stomach size by creating a small pouch, by malabsorption via by-passing a portion if the small intestine, and by producing the dumping syndrome when sugar, high fat or greasy foods are consumed.

Advantages Disadvantages
Restrictive, malabsorptive procedure Longer operative time
Will lose an average of 60% of excess body weight 2 day hospital stay
Rapid weight loss Changes anatomy
Gold standard with longer study results Possible leak and/or obstruction
Possible nutritional deficiencies
Reversal is more difficult

Gastric Sleeve

This procedure was the first step in the biliopancreatic diversion, duodenal switch and the by-pass. Research is beginning to show that the second portions of those surgeries were not needed because the patients lost their weight and became healthy. The stomach size is surgically decreased by 2/3. Can be either a two step (BMI > 60 or severe medical complications) or as a single procedure.

Advantages Disadvantages
Out patient or 23 hour stay Purely a restrictive procedure
Absorption and digestion is not altered Anatomy permanently altered
Shorter operative time Not reversible
Rapid weight loss All food is absorbed – including high sugar
All food and nutrients are absorbed

Are there complications to obesity surgery?

Yes, as with any surgery there are potential risks and complications. The more obese the patient the higher risk of complication. The immediate risks are leaks, infection, pneumonia, blood clots of the legs or lungs, and rarely death. Long term risk for all procedures may be weight regain if diet changes and increased exercise are not maintained.

How can you help make your surgery a success?

Please remember these surgeries help you help yourself and the ultimate success is up to you. Start following these rules even before your surgery.

  1. NO sweets
  2. NO high calorie liquids i.e. milkshakes, soda, beer
  3. NO fatty junk food i.e. chips, crackers, popcorn
  4. NO fried foods
  5. Exercise by walking a minimum of 1 hour per day
  6. Stop smoking
  7. Attend information session, classes, and support groups.

Bariatric Surgery Requirements

Please note that each case is individual and the surgeons may add or delete some tests or consultations. However, all results of tests and reports must be received prior to submission to your insurance company for approval.

  1. Medical necessity letter from your medical doctor.
  2. Psychological evaluation
  3. Medically supervised diet history
  4. Blood work
  5. Chest x-ray – radiology test that looks at your heart and lungs
  6. EKG – demonstrates the electrical activity of your heart
  7. Certificate of attendance for information session.
  8. Sleep test – this determines if you stop breathing during sleep.

Some patients may also need:

  1. Cardiology consult
  2. Pulmonary consult
  3. Endocrinology consult
  4. Cardiac echo – sing sound waves to look at your heart and measures its function. We can also see your pulmonary artery pressure.
  5. Stress Echo – using exercise or medication to increase your heart rate and see how your heart performs.
  6. Pulmonary function tests – measures your breathing to evaluate your lung function.

Plus any other test deemed necessary by your surgeon.