Frequently Asked Questions
What is the process?
We encourage attendance to our free, informational weight loss seminars. These seminars are offered on a monthly basis. The next step is to set-up an appointment with Dr. Domkowski. During your initial consultation, the surgeon will evaluate your medical condition and determine if you are a good candidate.
Do I qualify for weight loss surgery?
Qualifications for weight loss surgery include:
Your BMI is 40 or higher.
- Your BMI is 35 or higher and you also suffer from one or more health problems such as type II diabetes or hypertension.
- Your BMI is between 30 and 35 and you also have significant weight induced comorbidities.
- You have been overweight for more than 5 years.
- Your serious attempts to lose weight have had only short-term success.
- You do not have any other disease that may have caused your obesity.
- You are prepared to make substantial changes in your eating habits and lifestyle.
- You do not drink alcohol in excess.
Weight loss and health benefits vary from patient-to-patient. Consult with your physician about the benefits and risks of weight loss surgery.
Which surgery is best for my weight loss and health goals?
This is a common question. The laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are both excellent and safe surgeries. Each of these surgeries has different weight loss profiles and the amount of data available on long term weight loss varies. Many factors go into deciding which surgery is most appropriate. Preferences and goals for weight and restoration of health are important factors in making this decision. During the initial consultation, our team will discuss all surgery options in more detail and recommend the best option for your health needs.
Is bariatric (weight Loss) surgery safe?
Surgical weight loss procedures have been proven to be safe. It can be as safe as many standard general surgery procedures. What is often overlooked is that the risk of morbidity and mortality from continuing to live with morbid obesity, especially with conditions such as high blood pressure, diabetes, sleep apnea, and high cholesterol are a greater threat than having a weight loss procedure.
There are risks with every surgery and patients should discuss all risks with their physician.
What are the most common risks?
Risks specific to weight loss surgery are minimal. Risk exists for all surgical procedures including bleeding, infection, blood clots, and dehydration. All risks should be discussed with your physician during your consultation and visits.
There are risks with every surgery and patients should discuss all risks with their physician.
People tell me surgery is the easy way out.
Surgery is NOT the easy way out. Changing biology, new metabolic set points as people age, genetics and years of dieting all affect weight, making it more and more challenging to lose the weight and keep it off. Many people find they lose the weight only to put it back on again and then some additional weight, creating the yo-yo effect.
Surgery combined with permanent lifestyle changes can help you to achieve and keep your weight loss goals and live a healthier lifestyle. After surgery, it will be critical to take your vitamins, maintain hydration, always place protein first when choosing foods, practice appropriate food portions, and increase physical activity.
Always consult your physician on the level of physical activity that is appropriate for you.
Will I regain the weight I initially lost?
Statistics demonstrate that as many as 50% of patients may regain 5% back after two to three years. However, they remain successful in their long-term weight loss efforts.
“Successful” weight loss is defined as greater than or equal to 50% of a person’s excess body weight. Take your BMI and compare it to a normal BMI. Half, or 50%, of that difference is the amount of weight that is expected from bariatric surgery. Regaining 50% of excess weight that was lost is rare.
There are many reasons for which patients regain weight. Most of these reasons are behavioral. This may include stress, loss of a loved one, loss of employment, or economic hardship. In these cases, individuals may turn back to bad eating habits as a coping mechanism.
Resorting to bad eating habits with high calorie, sugary, or fatty foods including sweets, even in small amounts throughout the day, can lead to weight regain in the long run.
Patient who have had the procedure done incorrectly may also experience weight regain.
Do I have to take supplements or vitamins after surgery?
The type of surgery will dictate the required vitamins and supplements.
Are their food restrictions after surgery?
Patients can eat their favorite foods after surgery, but their bodies will be completely satisfied with a small portion. After returning to a regular diet, a patient will consume between 1-3 ounces and feel very full – this is when the patient should stop eating. The daily approximate calorie intake will be between 800-1000 calories daily.
Patients should avoid carbonated beverages due to the increased gas, alcoholic beverages as well as any sugary drinks.
Foods high in protein are encouraged to be eaten first before carbohydrates such as breads, rice, and pasta which will fill patients up too quickly.
It is important to note that successful patients do, on occasion, treat themselves and still enjoy a healthy active lifestyle with a new and improved relationship with food.
How long does recovery take?
Recovery time is different for everyone. Most patients spend one night in the hospital and leave the next morning. It is recommended to take a week to two weeks off from work. This will be addressed on an individual basis in consult with your physician. Time from work will allow you to get used to your dietary program.
Will my medical issues be resolved after surgery?
Weight loss surgery has shown to have considerable improvements or resolution of many health conditions. Patients have seen resolution of or improvement in medical conditions such as:
- High blood pressure
- High cholesterol
- Gastro Esophageal Reflux Disease (GERD)
- Sleep apnea
- Joint pain
Every patient is different and will have a different outcome in regard to the resolution or improvement of health conditions. It is important to discuss all your current health conditions with your physician prior to surgery.
Can I exercise after surgery?
Exercise is encouraged but every individual is different, so it is important to discuss your exercise goals with your physician and the bariatric team. As with any surgery, there are physical restrictions during a specified time before returning to an exercise routine. Your bariatric team can help guide you on this journey.
Is hair loss associated with weight loss surgery?
Bariatric surgery decreases calorie intake. As this happens, the body craves protein and protein turnover is reduced. Hair has one of the most rapid protein turnovers within the human body. Telogen Effluvium is hair loss following bariatric surgery. This occurs because hair follicles remain in the resting phase. Hair follicles typically do not stay in the resting phase for more than six months and hair will grow back sometimes healthier and thicker than before. The best way to prevent hair loss is to strictly follow the post-surgical dietary guidelines.
Will I have excess skin after weight loss surgery?
This is a concern after weight loss surgery. It is important to follow the post bariatric intake program and stay hydrated. Once cleared to go back to exercising, it can be discussed if a strength training program may be of benefit and assist to tighten the skin.
Plastic surgery options can be discussed with your physician.
Will my health insurance cover the Laparoscopic Sleeve and Gastric Bypass Surgery?
Many private insurance companies provide coverage for the laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. Some insurance companies require a three to six-month physician supervised weight loss program prior to approving your surgery. If your own doctor is familiar with medical weight loss management, he or she may be able to provide that service to you. If your doctor is unfamiliar with medical weight loss management, our program can provide the three to six-month physician supervised visits that may be required by some insurance companies. If your surgery is initially denied, we will appeal it for you.
How much does each operation cost if my insurance does not cover it?
The laparoscopic adjustable gastric band surgery can usually be done as an outpatient procedure. The total cost for the laparoscopic sleeve can be as low as $13,000. The lap gastric bypass can be as low as $16,000. This includes the surgeon’s fee, anesthesia, psychology consult, nutrition consult, and the hospital fee. If there are unexpected complications or additional services or hospital stays required, the patients will be billed accordingly and in addition to above costs.
If my health insurance doesn't cover it will my payment for surgery be tax-deductible?
Yes. If your health insurance does not cover your payment for surgery, it is tax deductible since these operations are deemed medically necessary. In the year you finance or pay cash for your weight loss surgery, you may be eligible to receive thousands of dollars back in potential tax savings. IRS Publication 502 states you can deduct your medical expenses when they total more than 7.5% of your Adjusted Gross Income. Please consult your tax advisor to learn more about this before making any financial decisions.
What should I bring to my appointment?
- Your patient information forms.
- Medical Information: Please bring copies of any letters or medical records from other health care providers. Medical records for the past 5 years are necessary to file for insurance and to give the doctors a complete medical history.
- Physician Recommendation: If filing for insurance, please provide a written recommendation for weight-loss surgery from your primary care physician.
- Diet / Weight-Loss Info: Any documentation proving you participated in any diet / weight loss attempts. (This includes office notes, receipts or prescriptions.)
- Insurance card
- Driver's License
- Physician Referral: If your insurance plan requires a referral for this consultation, please contact your primary care physician and have one faxed to our office fax at 772.581.8005 before your appointment.
For more information, register for a seminar or support group, call (888) 671-7762.