This section answers the following FAQs:

What does the evaluation for obesity surgery involve?
How much weight will I lose after the operation?
Will I ‘overshoot’ and get too thin?
Is the operation reversible?
What is the follow-up after the operation?
What will happen on the long term?
Will I have trouble with gallstones?
I am a diabetic; should I continue to take my diabetes medicine?
Will I need plastic surgery?
Can I become pregnant?





What does the evaluation for obesity surgery involve?

Most patients will need to see our dietician. Accurate preoperative assessment of your knowledge about nutrition, personal habits, and commitment to change are essential for a successful long-term outcome.

You will be called to the outpatient preoperative assessment unit at the Alexandra Hospital a few days/weeks before the planned operation and will receive general medical evaluation. This will include an ECG, a chest X-ray, and some blood tests.

If you are severely obese, there is a 20% chance of having already developed gallstones. If that is the case, your may need to have the gallbladder removed at the same time as your obesity operation. To assess whether or not that is necessary, you will have a scan of your gallbladder.

If you have breathing problems, or if we are concerned that you may be suffering with some degree of obstruction to your breathing during sleep you will be admitted to the Alexandra Hospital a few days/weeks before the operation and will stay in hospital for one night. You will have continuous monitoring of the amount of oxygen in the blood during the night (without disturbing your sleep). This test will help us determine where you should spend the first night after your operation – on the Ward (if the test is negative) or on the High Dependency Unit (if the test is positive).

If we feel necessary, we may recommend that you see a psychiatrist to make sure that an operation would be advisable and that you are mentally and emotionally prepared for the restriction on the amount of food that you will be able to at after the operation. We may also recommend that you see an endocrine doctor if your blood tests are abnormal, or if we are concerned that you may have an endocrine illness causing the diabetes and requiring treatment with medications.


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How much weight will I lose after the operation?

After the gastric bypass operation, weight loss is initially very swift – most patients will lose a stone a month. This will slow down with time as you approach your target weight. Weight loss after the gastric banding operation is slower, but can be increased by adjusting the band.

Patients are individual people and no two are the same. Of course different patients need to lose different amounts of weight and the dimensions of the bypass are adjusted to take this into account. As a rule of thumb however, most patients will lose about two thirds of their excess body weight in the first year, and about half of the patients will halve their weight after 12-18 months. After about 18 months the weight will probably have leveled off and most people are happy with their weight at this stage. It is possible to lose more weight by a combination of regular exercise and additional dieting usually by reducing high calorie snack foods or fluids rather than reducing the meal size. Unlike ordinary dieting, where weight is regained very rapidly when the diet stops, weight loss after the surgery is more permanent and once lost, weight tends to stay off.


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Will I ‘overshoot’ and get too thin?

This has not been a problem with any of our patients. The operation has been designed to reduce the calorie intake to a level that is adequate to nourish the patient at their correct body weight. The weight will fall until this point is reached, and will then stabilise.


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Is the operation reversible?

It is technically possible to reverse the operation surgically, but no patient has ever asked us to do this. The gastric band could be easily removed by another keyhole surgery, and this may rarely be required if there are complications related to the band.


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What is the follow-up after the operation?

The surgeon and the dietician will see you one month, 3 months, 6 months and a year after the operation, and yearly thereafter. If you have had the gastric banding operation, then you may need to see the doctor on monthly basis for the first few months until the size of the band and the degree of restriction on food intake that the band imposes have reached the desired level to achieve the desired weight loss.

Surgery is but one piece of your lifetime commitment to weight control and altered habits. Nutritional and psychological counseling are available after surgery as needed.


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What will happen on the long term?

The gastric bypass operation has an excellent long-term track record with good follow-up on several thousands patients who have been observed for up to 20 years. Weight loss is shown to be durable but to achieving good results is a two-way thing and following these rules in the long-term is important. We have found that once patients settle into their new lifestyle, their new pattern of eating becomes their new way of life and breaking the rules long-term is extremely uncommon.

We do suggest that you ask your doctor to check your blood count once a year after the gastric bypass operation to make sure that you are not anaemic although this is usually only a problem in women who have very heavy losses with their periods. You should also continue to take the supplements and we prefer it if you can take one ranitidine at night.


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Will I have trouble with gallstones?

Weight loss by any means (including diet) promotes the production of gallstones. If the scan you had before your operation shows gallstones, the gallbladder is removed at the time of the gastric bypass. If normal, the gallbladder is left in place and you are prescribed a tablet called Ursodeoxycholic acid to reduce the risk of forming gallstones. This is started after a month and is continued for 6 months. In my experience, about 10% of patients may still develop gallstones later and may need surgery.


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I am a diabetic; should I continue to take my diabetes medicine?

It is not uncommon for diabetic patients, particularly those who were taking tablets to control their diabetes to be cured and no longer need treatment. This happens gradually as the extra weight comes off. It is important therefore for you to see your doctor regularly during the first 12-18 months after the operation to check your blood sugar. Your doctor will then decide whether the dose of your diabetes medicine should be reduced. This is important as your blood sugar may otherwise drop quite low, which can be dangerous.


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Will I need plastic surgery?

A variety of factors including your starting weight, weight loss that you have achieved after surgery, location of excess weight and your age influence the need for plastic surgery. In general, skin elasticity is greater in younger patients and the need for plastic surgery is less. You may need an operation to remove what might become a very saggy abdominal skin (apron) after your weight has leveled. This is usually after two years from the gastric bypass operation.


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Can I become pregnant?

Yes. Thousands of women have become pregnant after this operation without complications. Extra vitamins and iron supplements are usually necessary.


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