AdventHealth Surgeons Answer Frequently Asked Questions About Bariatric Surgery

Dr. Gustavo Bello: Bariatric surgeries reduce your stomach size, and your food is rerouted and absorbed differently as it digests. Most candidates have a BMI higher than 35 kg/m².

Roux-en-Y gastric bypass is the most performed bariatric surgery. It works by combining both restrictive and malabsorptive elements. The restrictive element can be achieved by stapling the stomach into two sections. The top section becomes a small pouch that serves as a “new” stomach. The stomach’s size is so reduced that it restricts the amount of food you consume. You feel full longer with smaller portions of food.

The malabsorptive element is achieved by surgically dividing the small intestine in a certain area. Once divided, the lower part of the intestine (jejunum) is pulled up to directly connect to the small pouch or new stomach. The other end of this divided intestine is surgically sewn back at a specific point further down the small intestine. The shape of the intestine now somewhat resembles the letter Y. As a result, when food is eaten, it enters the new stomach, then travels into the jejunum, first bypassing the upper part of the intestine. The effect of bypassing the upper portion of the intestine decreases the nutrients that are absorbed into the body. Patients should supplement their health with vitamins and minerals.

Dr. Dennis Smith: The amount of weight that patients lose after bariatric surgery varies from patient to patient, and to some degree, can be estimated in advance. Most importantly, each patient has the most influence over their success. Bariatric surgery is a tool. And like any other tool, using it wisely will improve the results, especially in the long term.

Our team trains patients how to use their bariatric operation to the fullest. If they eat the recommended types and portions of food, supplement with the right vitamins and minerals, exercise and stay mindful of their health, they’ll improve their chances of long-term success.

Each operation has a different expectation for weight loss, and it will also differ from patient to patient. We’ll discuss this with you in detail at your initial consultation.

Dr. Christian Birkedal: Bariatric surgery shouldn’t be seen as a quick fix to lose weight. Rather, it’s a tool for people whose diet and exercise do not work well enough to lose weight. People who want bariatric success must prepare for it physically and psychologically. You’ll need to commit upfront to the lifestyle that’s required after surgery.

It’s important to start eating differently before surgery by eating the same diet you will eat after surgery. This means smaller portions and meals with fewer carbohydrates and more protein. Patients should practice this diet so it’s not new to them and their bodies as they recover from surgery.

Make proper nutrition a priority. I often see patients who eat a disproportionate amount of carbohydrates, which gives the body an easy source of energy in the form of sugar. Our AdventHealth Weight Loss and Bariatric Surgery physicians help educate patients about the differences between macronutrients — carbohydrates, fats and proteins — so they know how to improve their diets. It’s also important to exercise regularly and stay hydrated.

Dr. Shiva Seetahal: Our team recommends that weight loss surgery patients take a complete multivitamin, calcium, iron and vitamin C, vitamin D and vitamin B12. Others may be recommended based on your unique health needs.

It’s important to ensure weight loss surgery patients are receiving the right level of dietary supplements, because after some bariatric procedures like the Roux-en-Y gastric bypass, food skips the part of the intestine that most effectively absorbs minerals such as calcium and iron. There are bariatric multivitamins specifically for people who have had weight loss surgery. Our team helps patients find the right bariatric multivitamin as well as iron and calcium supplements to ensure optimal nutrition and health.