FAQ—Long Term Outcomes
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How much weight should I expect to lose?
Weight loss is very individualized. You hold the keys to your own success. The more effort you put in, the better you work with your new "tool", the better you adhere to exercise and diet guidelines, then the better your results will be. Based on our own data, individual results vary from 50–100% of extra body weight loss depending both on the type of surgery and the discipline and determination of the individual; on the average, our patients lose 65% of their excess weight with the biggest weight loss occuring within the first year to the first year and a half after surgery.
How can I achieve the best weight loss?
The best results are seen in patients who take the weight loss surgery as an opportunity to make sweeping changes in their life habits. The most successful patients exercise regularly. They also comply with the recommended diet which means eating three meals per day, eating healthy solid foods, taking 20–30 minutes per meal, not mixing fluids with foods, and minimizing/eliminating carbohydrates.
How can I know that I won't just keep losing weight until I waste away to nothing?
Patients may begin to wonder about this early after the surgery when they lose 20–40 pounds in the first month, or maybe when they've lost more than 100 pounds and they're still losing. Two things happen to allow weight to stabilize. First, a patient's ongoing metabolic needs (i.e. calories burned) decrease as the body sheds the load imposed by the many excess pounds. Second, there is a natural progressive increase in calorie and nutrient intake over the months following gastric bypass; basically the stomach pouch and the attached small intestine learn to work together better, along with slight expansion in pouch size over a period of months. The bottom line is that, in the absence of a surgical complication, patients are very unlikely to lose down to a point of malnutrition.
How big will my stomach pouch really be in the long run?
The stomach pouch is created at one ounce or less in size, and in the first few months it is rather stiff due to natural surgical inflammation. From about 6–12 months after surgery, the stomach pouch expands a bit and becomes more pliable as the inflammation subsides—most patients end up with a meal capacity of 3–7 ounces.
What can I do to prevent lots of excess hanging skin? Will exercise help?
Unfortunately, most people who have gotten heavy enough to need gastric bypass surgery have stretched their skin beyond a point from which it can "snap back." Exercise is good in so many other ways that we definitely recommend a regular exercise program, but the unfortunate reality is that most patients are left with large flaps of loose skin. In our program we can refer you to plastic surgeons who are available for consultation to allow you to learn about available approaches for dealing with the excess skin resulting from weight loss surgery.
Will I be miserably hungry after gastric bypass since I'm not eating much? What if I am really hungry?
Most patients say no. In fact, for the first 4–6 weeks patients have almost no appetite. Over the next several months the appetite returns but it tends not to be a ravenous type of hunger due to the types of food you are consuming particularly starches (e.g. rice, pasta, potatoes, etc.). You can avoid feeling hungry too soon by making absolutely sure not to drink liquids with foods as liquids tend to wash food out of the pouch.
Will I have to change my medications?
Many medications such as those used to control blood pressure, diabetes, etc., can be stopped at some point after surgery. For medications that need to be continued the vast majority can still be swallowed and absorbed as they were prior to the surgery and they will also work the same as before. Usually no change in dose is required.