Long-Term Outlook

	What kind of weight loss should I expect following the procedure?
	Most patients lose weight steadily during the first year. Many will lose more than 100 lbs during that time. Some patients lose weight for as long as two years following the procedure and may lose more than 200 lbs during that time.

Gradual Weight Loss

Weight loss after gastric restrictive operations is gradual and occurs at the greatest rate during the first several months after the operation. Over the long term, consistency rather than rapidity of weight loss is stressed. After a few months, the rate of weight loss will gradually decrease. This is because the weight which is lost is fat (adipose tissue) rather than lean body mass (muscle). Hence, the more fatty tissue that is lost, the less remaining fat there is to be lost. Few patients will reach ideal body weight. Patients whose weight stabilizes within 50 percent of their ideal body weight are considered successful. The heaviest patients must lose more weight to be successful.

The main reasons for poor weight loss after gastric restrictive surgery are bad food choices and frequent snacking. Patients may "lose track" of their eating pattern and redevelop some of their former eating habits which caused their obesity in the first place. In almost every case, these bad habits can be corrected by minor changes or substitutions in their diet. This is why regular follow-up visits are absolutely crucial after this type of surgery.

Obesity related medical problems may improve with a modest degree of weight loss after gastric restrictive surgery. Blood pressure is routinely monitored at each follow-up visit, as is blood sugar (glucose) in diabetics and blood fats (cholesterol and triglycerides) in patients with hyperlipidemia. Patients are encouraged to see their own medical doctor at regular intervals after the operation, particularly for adjustments in their medications. With steady weight loss, patients often require lower doses of medications for diabetes and high blood pressure. Patients may not require any medications for these problems after achieving a substantial amount of weight loss.

Uncommon Problems

In the long term, changes in the original configuration of the operation can occur. Staple line breakdown is rare, but it may occur beyond six weeks from the time of surgery. Stretching of the upper part of the stomach may also occur to some degree, but this is rarely a reason for inadequate weight loss.

Pregnancy After Surgery

Vitamin and mineral deficiencies should be corrected with strict follow-up during pregnancy. If not corrected, they can affect the baby's health. Pregnancy should be postponed for the first 18 to 24 months after gastric restrictive surgery.

Reversibility

All gastric restrictive operations are potentially reversible. Reversal requires an operation of the same magnitude and risk as the original operation. Reversal of the Lap Band is more common than reversal of gastric bypass.