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Making the Decision for Bariatric Surgery at UPMC in Central Pa.

If you are struggling to lose weight despite going on diet and exercise programs, you may want to consider weight loss (or bariatric) surgery as an option.

This is particularly important if you suffer from other health problems like diabetes, high blood pressure, and sleep apnea. Your life could depend on losing weight.

But it’s not an easy decision. There are pros and cons to consider. Fortunately, at UPMC in Central Pa., we provide all of the information you need to empower your journey. We'll provide in-depth information on your surgical weight loss options so you can decide if a procedure can help you take charge of your health.

Eligibility for Bariatric Surgery

To ensure that patients are healthy enough for surgery and can maintain a healthy routine after the procedure, before being considered for bariatric surgery a candidate must:

  • Be at least 18 years of age
  • Demonstrate that he or she has made several serious attempts to lose weight through a medically recommended plan.
  • Check with insurance for bariatric coverage.
  • Have a body mass index (BMI) greater than 40 OR have a BMI of 35 or higher plus medical conditions such as high blood pressure, diabetes, sleep apnea, etc.

BMI, Waist Size, and Your Health

If you decide to move ahead with surgery, you will also need to complete a comprehensive evaluation, including a wide range of health and psychological screenings. A comprehensive screening process is in place to ensure you are physically and emotionally prepared for the procedure and the lifestyle changes that accompany it.

If you proceed with insurance, it is important to note that many insurance companies require a three- to six-month physician-monitored diet prior to approving bariatric surgery. Patients approved for bariatric surgery may choose to take advantage of our non-surgical Medical Management Weight Loss Programs to lose weight during this time. Weight loss prior to surgery may lessen complications and recovery time.

The Pros and Cons

If you meet these requirements, our staff will help you understand the pros and cons of bariatric surgery.

On the pro side, you will lose weight quickly after surgery. Bariatric surgery has proven to significantly improve diseases caused or worsened by obesity, including heart disease, hypertension, stroke, sleep apnea, arthritis, asthma, acid reflux and more. It has also shown to drastically reduce — or even eliminate — type 2 diabetes.

Several large studies of severely obese people have also found that those who have had weight loss surgery have a significantly lower risk of death than those who have not. The exceptionally low mortality rate is remarkable, considering that most patients affected by severe obesity are in poor health and have one or more life-threatening diseases at the time of their surgery.

And as you can imagine, significant weight loss from bariatric surgery brings more than just physical benefits. Studies have shown that self-esteem, work, social interactions, and sexual function all improve. Disability, depression and anxiety are also significantly reduced, allowing you to live the life you want.

Like any surgery, though, bariatric surgery has risks that you need to consider. We talk to patients about the potential complications. Pneumonia, blood clots, infection, bleeding, leaking at staple lines, as well as ulcers, hernia and gallstones may occur, but are infrequent. Generally, the risks associated with weight loss surgery are significantly less than the risk of remaining morbidly obese.

You should also be aware that the surgery can lead to long-term problems too, like feeling sick to your stomach, vomiting, having low blood sugar, or not getting enough nutrients for good health. And when you lose weight quickly, you may have a lot of extra skin and it won't go away unless you have another surgery to remove it.

Making the Right Decision for You

This is not an easy decision, nor one you should make lightly. Any surgery is serious, and the results of bariatric surgery will lead to a dramatic change in your life and your lifestyle. Your thoughts and feelings are important, and our team will listen. We are there to answer your questions, and to support your decision whatever it is.

Bariatric Surgery Options

If you decide to proceed with surgery and complete the screenings, you have the choice of several minimally invasive options that offer faster healing and better results. At UPMC in Central Pa., our surgical options include:

Gastric Sleeve Surgery

Gastric sleeve surgery removes approximately 85 percent of your stomach and re-shapes the remaining portion into a tube or sleeve. The result is a much smaller stomach which leaves you feeling less hunger and limits the amount of food you can take in.

Gastric sleeve surgery reduces the size of meal portions your body can tolerate without changing the digestive process. However, you may need to eat a specialized diet and regimen of chewable and/or dissolvable vitamin supplements following the procedure.

Gastric bypass surgery closes off a small section of the stomach, creating a stomach pouch. That pouch is then connected directly to the small intestine, allowing food to bypass the rest of the stomach, as well as the start of the intestinal tract. As a result, the new stomach will hold less food and keep it for a shorter period of time. Following the procedure, you will need to commit to a lifelong maintenance plan which focuses on foods your body can easily process, as well as a regular exercise program.

Gastric Bypass Surgery for Obesity

Gastric bypass is surgery to make the stomach smaller and change the connection between the stomach and the intestines. The small intestine is attached to a new opening made in the stomach (above the double row of staples). The two parts of the small intestine are connected so that the unused part of the stomach can drain.

Recovery and Follow-up Care

For most people, the average hospital stay is one or two days. While most patients go back to work within two weeks, the actual length of time will be determined by your surgeon. There are also some restrictions that apply.

The surgery, though, is just the start of a lifelong commitment to maintaining a healthy weight. Sustained weight loss is challenging. That’s why UPMC offers patients a wide range of tools, information, and support to achieve and maintain a healthy weight for the rest of their lives, including:

  • Education about nutrition and health so you can create the lifelong habits you need to sustain weight loss.
  • Medical food for healthy meal replacement.
  • Exercise instruction and support to guide you safely toward a more active life.
  • Interactive tools that can help you calculate your BMI, understand how to order a healthy restaurant meal, and provide other up-to-date and useful information.
  • Support groups so you don't have to face the complex challenges of weight loss alone.

Choosing the Right Team

Successful surgery starts with choosing the right team. Since 1998, UPMC surgeons in Central Pa. have completed more than 5,000 bariatric procedures. Our program is characterized by its very low infection and complication rates and excellent results.

UPMC in Central Pa. offers a variety of weight loss programs. We will work with you to find the right program to meet your weight loss needs. Whatever your goals, we will help you decide which treatment plan is appropriate for you, taking into account your weight loss history and medical condition.