Frequently Asked Questions
While most people think obesity means to be excessively overweight, the definition of obesity is excess adipose or fat tissue.
A more accurate number utilized by clinicians, is body mass index or BMI. Your BMI is calculated by dividing your weight in kilograms by your height in meters squared. A BMI of 22-25 is considered normal, 25-30 overweight, 30-35 obese, 35-40 class II obesity and more than 40 morbidly obese or class III obesity.
|18.5 – 24.9||Normal Weight||Minimal|
|25 – 29.9||Overweight||Increased|
|30 – 34.9||Obese||High|
|35 – 39.9||Severely Obese||Very High|
|40 and above||Morbidly Obese||Extremely High|
Our bariatric surgery specialists consider individuals with a BMI of 40 as candidates for surgery, as well as those with BMI of 35 with life threatening complications from their obesity.
Bariatric surgery should be considered for morbidly obese people who have failed non-operative weight loss options. They should qualify as obese for several years prior and not have any active drug or alcohol addictions or major psychiatric disorders. In addition, the risk and emotional cost of their obesity should exceed the risk of having an invasive operation.
Bariatric surgery is the only remedy that has documented long term weight loss in the majority of morbidly obese individuals. This does not mean that no one is successful without surgery, because some certainly are, however, most lose weight only to relapse and regain their weight. Surgery does not replace the need to exercise and wise food choices, but it makes these goals realistic and provides a long-term control mechanism to assist in managing this chronic problem.
The physicians at our practice in Manhattan stress that gastric bypass or LAP-BAND® Adjustable Gastric Band surgery for obesity should not be a first option for treating your weight problem. In fact, if you can lose weight without an operation, it is preferable.
Here are some of the things a patient should consider when deciding which surgery is right for them. In general, gastric bypass patients will lose around 70 percent of their excess weight, sleeve gastrectomy patients will lose around 60 percent, and gastric banding patients will lose around 50 percent.
If you qualify for gastric bypass or other weight-loss surgeries, your health care team gives you instructions on how to prepare for your specific type of surgery. You may need to have various lab tests and exams before surgery. You may have restrictions on eating and drinking and which medications you can take. You may be required to start a physical activity program and to stop any tobacco use.
You may also need to prepare by planning ahead for your recovery after surgery. For instance, arrange for help at home if you think you’ll need it.
This varies by procedure. The laparoscopic adjustable gastric band is done on an outpatient basis with a possible overnight stay, two to three days for a laparoscopic gastric bypass and sleeve gastrectomy, and five to seven days for an open gastric bypass.
There is no specific time limit when a post-operative bariatric patient can return to work—generally, it takes two to three weeks, and occasionally more. The potential reason for delay is not pain, but lack of strength and difficulty making the adjustment to a different way of eating. Any medical complication can also cause delay. We suggest that you plan to be away from your job for three to four weeks. For patients with strenuous physical jobs, 4-6 weeks is necessary to allow for adequate healing. If arrangements can be made, you can return to light duty earlier.
Many patients are hesitant about exercising after surgery, but exercise is an essential component of success after surgery. Exercise actually begins on the afternoon of surgery – the patient must be out of bed and walking. The goal is to walk further on the next day, and progressively further every day after that, including the first few weeks at home. Patients are often released from medical restrictions and encouraged to begin exercising about two weeks after surgery, limited only by the level of wound discomfort. The type of exercise is dictated by the patient’s overall condition. Some patients who have severe knee problems can’t walk well, but may be able to swim or bicycle. Many patients begin with low stress forms of exercise and are encouraged to progress to more vigorous activity when they are able.
A bariatric surgery costs anywhere between Rs2.5 to Rs5lakh, and the equipment and technology alone costs around Rs1.75lakh. Surgeons with the Obesity and Metabolic Surgery Society of India (OMSSI) say they have written to the union government to ensure the laparoscopic procedure is insured.
While you are healing, you will be seen on a regular basis, usually once after two weeks and again six weeks after surgery. You return for a follow-up visit after six months to make sure you are adjusting well, and then once a year after that. It is important for us to follow your vitamin and mineral levels (particularly after gastric bypass) as well as your protein intake.