Bariatric Surgery

Bariatric surgery is performed when diet and exercise haven't worked or when you have serious weight-related health problems.

While bariatric surgery can offer many benefits, all forms of weight-loss surgery are major procedures that can pose serious risks and side effects. Also, you must make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of bariatric surgery.

Getting Started

The criteria for most insurance companies to cover bariatric surgery includes:

  • a BMI of more than 40 kg/m2, or
  • a BMI of over 35 with conditions such as type II diabetes mellitus, COPD, sleep apnea, other lung conditions, and/or certain heart conditions.

Calculate Your BMI 

If you are interested in discussing surgical options with our bariatric surgeon, please call 319-362-5118 to get the process started.

Following your initial consultation, you will be set up for some testing and specialty appointments. These tests and appointments include a sleep apnea evaluation, mental health assessment, assessment by a registered dietitian, and lab work. Included in the lab work is a nicotine test, as you will need to be nicotine-free in order to qualify for weight-loss surgery.

Watch the Bariatric Surgery Seminar

To get started, you will need to watch the full seminar video, then confirm below the video that you have watched it and are ready for the next steps.

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Bariatric Procedures 

  • Sleeve Gastrectomy - A surgical weight loss procedure in which the stomach is reduced to about 15 percent of its original size, by surgical removal of  a large portion of the stomach along the greater curvature. The result is a sleeve or tube-like structure.
  • Gastric Bypass - A surgical process in which the stomach is divided into a small upper pouch and a much larger lower "remnant" pouch. The small intestine is is rearranged to connect to both.
  • SADI - Single Anastomosis Duodenal Ileal Bypass with sleeve gastrectomy is a surgical process that combines aspects of sleeve gastrectomy and gastric bypass. About 80 percent of the stomach is removed, creating the tube-like sleeve. Then, the top part of the small intestine, just below the stomach, is separated and reattached to a lower part of the small intestine, shortening the intestine by about half and therefore decreasing calorie absorption.
  • Revision - Sometimes, a previous bariatric procedure can be surgically changed to a different bariatric process. Surgeries are revised due to mechanical issues, weight regain or because the original procedure was inadequate or ineffective.
  • Lap Band Maintenance - Lap bands should be checked annually to ensure it is not only functioning properly but also ensure there are no complications such as band erosion, band migration/slippage, band infection, gastric prolapse, esophageal and/or pouch dilation.

Frequently Asked Questions

There are lots of “rules” to bariatric surgery – let us help you breakdown the WHY behind the rules!

Why no smoking and no nicotine? 

  • Patients undergoing bariatric surgery need to abstain from smoking and nicotine from any source for two months prior to the operation and for life after
  • Nicotine affects blood vessels and can impair healing, leading to leaks or other issues 
  • Nicotine can lead to ulcers that can cause massive bleeding or even rupture of the sleeve/pouch which can even lead to death! 

Why the preoperative diet? 

  • One week of clear liquids plus 1-2 cups of vegetables or fruits per day prior to surgery
  • Other programs do it differently – some places do 2 weeks! 
  • This helps decrease the size of the liver, allowing for better visualization  -  we can’t operate if we can’t see! 
  • If it helps … PLAN for your LAST SUPPER -- One week and one day before your surgery, plan for your favorite meal! Indulge yourself before you start the preoperative clear liquid diet! 

Why the postoperative diet?

We have our patients follow this diet postoperatively:

  • 2 weeks of bariatric clear liquids  —  Including protein shakes
  • 2 weeks of pureed foods
  • 2 weeks of soft foods

Then introduce normal foods 

  • The body takes, on average, 6-12 weeks to heal staple lines and connection points (anastomosis)
  • Remember to chew thoroughly and eat slowly 
  • Your pouch or sleeved stomach is smaller than you think! 
  • Your body needs time to tell you that you are full! 

Why no caffeine?

  • We suggest no caffeine for first six months
  • Caffeine is acidic and can contribute to reflux 
  • Caffeine is a diuretic – meaning it can make you urinate a lot! We need you to stay very hydrated and don’t want you peeing out more fluid than you’re taking in 

Why no carbonation?

  • We recommend no carbonation for a while after bariatric surgery 
  • It can contribute to gas formation leading to bloating and discomfort! 
  • Carbonated drinks have very little or no nutritional value. It’s taking up space in your pouch or sleeve instead of something nutritious! 

Why no Alcohol?

  • We recommend waiting at least 6 months after bariatric surgery before ingesting alcohol 
  • It’s a simple carbohydrate  - Just like drinking soda pop!
  • Can cause reflux 
  • The way alcohol is absorbed is different after bariatric surgery, and can cause a greater effect than prior to surgery – there are case reports of patients having one drink after a gastric bypass and getting a DUI!

Why the abdominal binder?

  • For patients who have had a sleeve, bypass, or SADI, we suggest an abdominal binder and we will provide that for you at the hospital 
  • To help with discomfort/pain
  • Okay to take it off if you feel like you can’t breathe well! 
  • Theoretically reduces the risk of hernia  

Why the bariatric multivitamins?

  • You need more than what over-the-counter multivitamins can give you after bariatric surgery, in some cases, 145 times what is in a regular multivitamin! 
  • There is a lifelong risk of vitamin/mineral deficiencies! 
  • Your body is always at increased risk of malabsorption because of the surgery, that never goes away! 
  • If you took an OTC multivitamin, you’d have to add in so many to equal out a bariatric multivitamin – so it costs more in the end! 
  • Bariatric multivitamins for life!

Why do you need to walk so much?

  • Every surgery has the risk of blood clots (DVTs or PEs)  —  so we want you walking the day of surgery! 
  • And keep walking when you are at home! 
  • It also helps with gas reabsorption right after surgery 
  • It’s good for your heart and lungs! 
  • Some people think it helps with bowel movements 

Why do we tell you to sip fluids??

  • We want you to stay hydrated! 
  • With the small size of your pouch and sleeve, you can’t just guzzle water anymore! Sipping every 10 to 15 minutes helps you stay on top of your fluid requirements 
  • 64 ounces while you’re awake! 

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