Frequently Asked Questions

Morbid obesity is a Body Mass Index (BMI) of 40 or more, which is roughly equal to 100 pounds or more over ideal body weight. The disease of morbid obesity interferes with basic physical functions such as breathing or walking. Long-term effects of the disease include shorter life expectancy, serious health consequences in the form of weight-related health problems (co-morbid conditions) such as type 2 diabetes and heart disease, and a lower quality of life with fewer economic and social opportunities.

There are two definitions for a co-morbid condition: the presence of one or more disorder or disease in addition to a primary disorder or disease; or, the presence of a disorder or disease that is caused by or otherwise related to another condition in the same patient. The primary disease of morbid obesity can lead to several co-morbid conditions. Learn more about the health risks associated with obesity.

Bariatric surgery is a treatment option for people who are struggling with their weight and have not had success with other weight loss therapies such as diet, exercise, or medications.

BMI is a measure used to index a person’s height and weight. BMI allows healthcare professionals and patients to better understand health issues associated with a specific weight classification (classifications such as obesity and morbid obesity). Check your BMI.

Patients should have:

• 100 pounds or more of excess weight; or a BMI of 40 or greater
• A BMI of 35 or greater with one or more co-morbid condition

Other common guidelines include:

• Understanding the risks of bariatric surgery
• Committing to dietary and other lifestyle changes as recommended by the surgeon
• Having a history of weight loss treatments having failed the patient
• Undergoing a complete examination including medical tests

Determine if you qualify for bariatric surgery.

Talk with your surgeon about the different surgical treatments, as well as the benefits and risks.

Remember:

• Bariatric surgery is not cosmetic surgery.
• Bariatric surgery does not involve the removal of adipose tissue (fat) by suction or surgical removal. 
• The patient must commit to long-term lifestyle changes, including diet and exercise, which are key to the success of bariatric surgery. 
• Problems after surgery are rare, but corrective procedures may be required.

Determine if bariatric surgery is right for you.

As with any surgery, there are immediate and long-term complications and risks. Possible risks can include, but are not limited to:

• Bleeding 
• Complications due to anesthesia and medications 
• Deep vein thrombosis
• Dehiscence (separation of areas that are stitched or stapled together) 
• Infections 
• Leaks from staple lines 
• Marginal ulcers 
• Pulmonary problems 
• Spleen injury 
• Stenosis (narrowing of a passage, such as a valve) 
• Death

Side effects include:

• Vomiting
• Dumping syndrome 
• Nutritional deficiencies 
• Gallstones 
• Need to avoid pregnancy temporarily
• Nausea, vomiting, bloating, diarrhea, excessive sweating, increased gas, and dizziness

Roux-en-Y (pronounced ROO-en-why) gastric bypass surgery is the most popular bariatric surgery in the United States. In this procedure, the surgeon creates a small stomach pouch and then constructs a “bypass” of some of the small intestine. The smaller stomach pouch restricts the amount of food the patient can comfortably eat, and the bypass decreases the number of nutrients and calories absorbed. Learn more about gastric bypass surgery.

The sleeve gastrectomy procedure permanently alters the size of your stomach by removing about 75% of the stomach, creating a thin, small stomach pouch about the size and shape of a small banana. Learn more about sleeve gastrectomy.

Adjustable gastric banding is a purely restrictive surgical procedure in which a silicone band is placed around the uppermost part of the stomach. During surgery a port site stitch is placed and is used to periodically tighten or loosen depending on the patient’s needs. Learn more about gastric banding.

Studies show that bariatric surgery can effectively improve and resolve many co-morbid conditions. A review of more than 22,000 bariatric surgery patients showed:

• Improvement in or complete resolution of conditions including type 2 diabetes, hypertension, and sleep apnea
• 61.2% reduction of excess weight

Because every insurance policy is unique, it's important that you thoroughly understand your Certificate of Coverage to know exactly what is and isn't covered through your plan. We do accept Medicaid. Learn more.

The first step is to contact your insurance plan to find out if the procedure is covered. Many insurance companies now offer coverage but it varies by state and insurance provider. We have someone in the office who will speak with you about your insurance concerns and questions.

Although many insurance companies offer weight loss surgery as a benefit, some also require patients to participate in a physician supervised diet plan lasting between 3 and 12 months depending on your plan. This is required by Medicaid, Aetna, and several BCBS plans, among others. At your first visit with the Bariatric Surgeon, one of our Bariatric Program Specialists will get you started and guide you through the process. You can start now by completing our online info session!

Our office offers a self pay option, which will include surgery, anesthesia, the hospital facility and the surgeon’s fees. After surgery, additional costs are likely which may include nutritional supplements and diet/fitness plans. Please call the office at 843-958-2590 for more information on self pay and financing options.

The qualification process includes a series of tests with your bariatric surgeon. You also will meet with a nutritionist, psychologist, and other support staff members in sessions leading up to surgery. Each healthcare professional will help you prepare for the changes and challenges that lie ahead. Learn more.

Certain basic tests typically are performed:

• Complete Blood Count (CBC) 
• Urinalysis 
• Chemistry screen 
• Electrocardiogram
• Psychological evaluation

Other tests that may be requested include:

• Blood glucose test
• Pulmonary function testing 
• Sleep study 
• GI evaluation 
• Cardiology evaluation

Learn more about the pathway to surgery.

Type 2 diabetes is a long-term metabolic disorder where the body produces insulin, but resists it. Insulin is necessary for the body to utilize sugar. 

• Most individuals show improvement with Type 2 diabetes after bariatric surgery.
• Patients who had bariatric surgery had lower insulin resistance, and their risk for metabolic syndrome, high blood pressure, and high amount of fats in the blood also decreased.

Excess body weight is associated with an increased risk of heart disease, elevated cholesterol, and high blood pressure. These conditions can lead to heart attacks, strokes, and heart and kidney damage. Bariatric surgery reduces excess body weight over time, which decreases strain on the heart.

• Changes in diet and exercise after surgery can lead to significant improvement of cardiovascular problems.
   

High cholesterol is a disorder of lipids—the fat-like substances in the blood. A common form of dyslipidemia is hyperlipidemia (or high cholesterol), the condition that exists when someone has too much of certain lipids in the blood. As these lipids build up inside the artery walls, harmful scar tissue and other debris begin thickening and hardening the walls. Long-term, this can lead to heart disease and high blood pressure.

• Bariatric surgery often improves lipid levels in patients.

Obstructive sleep apnea is when breathing suddenly stops because soft tissue in the back of the throat collapses and closes during sleep. Morbid obesity can cause sleep apnea and other respiratory problems that may result in chronic fatigue.

• 86.6% of patients who had gastric bypass surgery experienced complete resolution of sleep apnea.
• 94.6% of patients who had gastric banding surgery experienced complete resolution of sleep apnea.

Reproductive health can be a concern for women struggling with morbid obesity. Issues such as infertility (the inability or reduced ability to produce children) and menstrual irregularities may occur due to morbid obesity. Fertility issues include possible miscarriage, reduced success with fertility treatments, and polycystic ovarian syndrome (PCOS). Additionally, women living with morbid obesity are more likely to have children with certain birth defects.30 A recent study of women following gastric bypass surgery showed improvement of multiple clinical problems related to infertility and PCOS.19,20

• 100% of patients who had gastric bypass surgery experienced complete resolution of menstrual dysfunction due to PCOS.19,20
• 79% of patients who had gastric bypass surgery experienced complete resolution of excess hair due to PCOS.19,20
• Patients who had gastric bypass surgery experienced restored ovulation and fertility.

For people who have spent years living with morbid obesity, bariatric surgery can transform their lives. However, it’s important to be prepared for all aspects of the treatment. Surgery changes your body by creating a smaller stomach pouch.

For many people, bariatric surgery is affordable because it is covered by their health insurance plan. People who do not have insurance coverage for bariatric surgery must pay for it on their own. This is called self-pay or cash-pay. Even without insurance, many people feel that the surgery is worth the investment in their health and seek out alternative financing options.

• Generally, the out-of-pocket costs for gastric bypass are between $20,000 and $30,000.
• Generally, the out-of-pocket costs for adjustable gastric banding are between $14,000 and $18,000.
• Generally, the out-of-pocket costs for sleeve gastrectomy are between $14,000 and $17,000.

Few people are able to pay cash up front for bariatric surgery. If you do not have health insurance coverage for bariatric surgery, there are alternative financing options available, such as medical loans.

It varies from person to person. Generally, the hospital stay (including the day of surgery) can be one to two days for an adjustable gastric banding, laparoscopic gastric bypass, and laparoscopic sleeve gastrectomy.

A typical comprehensive bariatric program will consist of a combination of the following healthcare professionals: a program coordinator, psychologist, dietician, exercise physiologist, and other healthcare professionals. Each expert is dedicated to providing support for bariatric patients both before and after surgery. Check with your program to find out about support groups that can be helpful in adjusting to new daily habits. Learn more about the lifetime of support following surgery.

For people suffering from morbid obesity, bariatric surgery can be a powerful tool. For the surgery to be effective long term, it must be used properly. Through lifestyle changes, such as regular exercise, vitamins & nutritional supplements regimen and a healthy food plan, many patients are able to make a long-term change for better health. 

Band patients need to work with their surgeons to have their band adjusted several times during the first 12 to 18 months after surgery. Bypass patients typically see their surgeons for three to five follow-up appointments the first year, then once per year thereafter. Over time, gastric bypass patients will need regular checks for anemia (low red blood cell count) and vitamin B12, folate, and iron levels. Learn more about the lifetime of support following surgery.

Support groups give patients an excellent opportunity to talk about personal issues. Most patients learn, for example, that bariatric surgery will not resolve personal relationship issues. Most bariatric surgeons who frequently perform bariatric surgery will tell you that ongoing support after surgery helps to achieve the greatest level of success for their patients. Patients help keep each other motivated, celebrate small victories together, and provide perspective on the everyday successes and challenges that patients generally experience. Learn about support groups available through Roper St. Francis.

Studies show that bariatric surgery can effectively improve and resolve many weight-related health conditions. A review of more than 22,000 bariatric surgery patients showed:

• Improvement in or complete resolution of conditions including type 2 diabetes, hypertension, and sleep apnea
• 61.2% reduction of excess weight