Metabolic Surgery

6 Questions to Consider Before Metabolic Surgery

July 6, 2021

Since metabolic surgery has evolved and improved, it has also become a little more complicated. Although the sleeve procedure has taken center stage in recent years, some centers and some surgeons might favor a different approach in individual cases.

As an example, some surgeons may advise gastric bypass for a person with severe gastroesophageal reflux, and another surgeon might recommend a duodenal switch for a person with a higher BMI (body mass index).

6 Questions to Consider Before Metabolic Surgery


Which procedure would be the best for me?

What’s most important from the patient’s perspective is to do your homework, so you are completely comfortable with the procedure you and your surgeon agree upon. It is important to make sure the recommended procedure feels right to you and that the recommendation is specific to you and your health.


Will the team I am considering for metabolic surgery be there for the long haul?

Obesity is a life-long condition to battle. Metabolic surgery, while hugely helpful, can have some long-term side effects, like vitamin deficiencies. Additionally, ensure you have a psychologist on the team as well. As everyone knows, life is full of its ups and downs. Those patients with established relationships with mental health often do better over the long- term.

So, it’s imperative the center, surgeon, and their colleagues will be around to provide long-term care and guidance, and they will help solve any long-term problems that could arise. The commitment to a long-term relationship is invaluable and should not be undervalued. Metabolic surgery should never be a transaction. Thus, it’s our guidance that patients do not choose to travel outside the country for this type of care.


What happens if the metabolic surgery procedure does not bring the desired success or I re-gain my weight?

This might sound like something no one wants to consider, but at least 10% of people with either gastric bypass or sleeve will not achieve a satisfactory result and would benefit from a revision procedure. Nowadays, in the correct hands, revision procedures are highly successful, safe, and minimal invasive in achieving successful weight loss. It is helpful to know your surgeon has experience with revisions in the surgery, and your genetics/biology do not result in the desired success.


Can metabolic surgery reduce my blood pressure and diabetes medications?

For millions of people taking medicine for high blood pressure and high blood sugar, metabolic surgery is not only a lifeline but a doorway to a better world without those medications.  The question we field often is, how do I know if I can stop taking the meds?

Some surgeon and their teams are comfortable managing the transition, while others rely on the primary care providers and other sub-specialists to make decisions about reducing or stopping medications. If you take medications like these, a tip is to be mindful of your blood pressure and blood sugar levels after surgery and often communicate with your primary doctor and surgeon as you safely wean off these meds.


If I have diagnosed sleep apnea and use a CPAP or Bi-PAP machine, will I still need this device after surgery?

The short answer is it depends. If you have been diagnosed with sleep apnea, the longer answer is making sure both your weight loss surgeon and pulmonologist (sleep doctor) are in the loop. As your body’s weight declines, it is possible that sleep apnea can wane or disappear completely. Staying in contact with your team is imperative to calculating if and when these devices can be discontinued.

Additionally, you should definitely plan to bring your sleep equipment with you if the plan is to stay a night or two at the hospital. Doing so will make for a much smoother transition and recovery.


When should I call my primary care provider vs. weight loss surgical team?

This is a good question to ask your surgeon and his staff. In our opinion, this is a great “test” question of the surgeon you are consulting. The correct answer should be something along the lines of, “call us any time you have a concern.”

In most cases, the kinds of worries and troubles people experience after weight loss surgery are easily handled over the phone or with a scheduled visit. Again, remember, you are establishing a long-term relationship and not just a transaction, and you want and need a team behind you for long-term support.

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Kent Sasse


Dr. Kent Sasse performed the first laparoscopic colon resection procedure and the first laparoscopic gastric bypass procedure in northern Nevada more than 14 years ago. Dr. Sasse is the author of numerous books and publications, and a featured speaker nationally in the field of weight reduction, bariatric medicine and surgery. Dr. Sasse founded Sasse Surgical Associates, located in Reno, NV.
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