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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Bariatrics
Satisfied Customers: 56181
Experience:  Medical Doctor Trained at a Top Academic Institution
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Im thinking of weight loss surgery an I know there are

Customer Question

Im thinking of weight loss surgery an I know there are several different types need thorough information to decide which I want to go with
Submitted: 1 year ago.
Category: Bariatrics
Expert:  Michael Salama replied 1 year ago.


You are right there are many different types. I will highlight the 3 most common procedures for you to consider:

In gastric bypass, the surgeon creates a small pouch at the top of the stomach. The pouch is the only part of the stomach that receives food. This greatly limits the amount that you can comfortably eat and drink at one time.

In a sleeve gastrectomy, part of the stomach is separated and removed from the body. The remaining section of the stomach is formed into a tube-like structure. This smaller stomach cannot hold as much food. It also produces less of the appetite-regulating hormone ghrelin, which may lessen your desire to eat. However, sleeve gastrectomy does not affect the absorption of calories and nutrients in the intestines.

In the adjustable laparoscopic gastric banding procedure, a band containing an inflatable balloon is placed around the upper part of the stomach and fixed in place. This creates a small stomach pouch above the band with a very narrow opening to the rest of the stomach. A port is then placed under the skin of the abdomen. A tube connects the port to the band. By injecting or removing fluid through the port, the balloon can be inflated or deflated to adjust the size of the band. Gastric banding restricts the amount of food that your stomach can hold, so you feel full sooner, but it doesn't reduce the absorption of calories and nutrients.

In general, gastric bypass patients will lose around 70 percent of their excess weight, sleeve gastrectomy patients will lose around 60 percent, and gastric banding patients will lose around 50 percent.

Let me know if you have any other questions. If not, please don't forget to leave a positive rating as that's the only way I get credit for answering your question. Thank you.

Customer: replied 1 year ago.
Can u give me the main reason for y someone would pick each. They all sound the same that they make u eat less so whats the main thing that makes each of them different. Do any affect carrying a baby
Expert:  Michael Salama replied 1 year ago.

Gastric bypass is the oldest procedure but has become less popular because the amount of food consumed cannot be modified. Sleeve gastrectomy is favorable because if someone maintains a healthy lifestyle they can resume a normal diet afterwards without gaining weight. Gastric banding is chosen when the amount of food needs to modified. If someone is gaining, the band can be tightened and vice versa.

Expert:  Michael Salama replied 1 year ago.

Is there anything else I can help you with?

Customer: replied 1 year ago.
can you still carry a baby in your belly? if u are full but keep eating could u blow up ur stomach ? and would liposuction make you lose any lbs or just shape u better?
Customer: replied 1 year ago.
hello? i have more questions?
Expert:  Michael Salama replied 1 year ago.

Yes, you can still carry a baby in your belly. It is recommended to wait 18 months before becoming pregnant. You will not blow up your stomach if you overeat but will likely vomit. Liposuction really will not make you lose much weight and is not a permanent solution for weight loss.

Customer: replied 1 year ago.
why would crown's disease affect someone getting a gastric bypass? do insurance's cover all 3 usually or is one more accepted by insurance than others? gastric band can me tightened or loosened but it is still under your skin and involves surgery to modify it each time right? sleeve gastrectomy vs gastric bypass, is the size of ur stomach left the same, or does one allow you to consume more food than others? are there stomach sizes to choose from since you can't modify it later? so sleeve gastrectomy allows you to eat all kinds of food but in moderation, but gastric bypass and gastric band you have to stay on a diet?
Expert:  Michael Salama replied 1 year ago.

To my knowledge there are no issues with Crohn's disease and gastric bypass although a bariatric surgeon and/or GI doctor might have more info on that. Insurance coverage is highly dependent on your particular policy and what your surgeon recommends to be the best option for you. No, the gastric band does not involve surgery to tighten/loosen each time, only adding/removing saline to the balloon wrapped around the stomach. Both gastric sleeve and gastric bypass will significantly decrease the amount you are able to consume although those who have done the gastric sleeve tend to be able to eat more. Unfortunately there are no stomach sizes to choose from, that will depend on the surgeon. Actually you should be on a strict diet after any of the procedures, one is not less restricting than the others.

Expert:  Michael Salama replied 1 year ago.

Is there anything else I can help you with today?

Customer: replied 1 year ago.
Iv heard that some people after a gastric bypass can still have trouble feeling full. Is it true that u can still have a big appetite?
Customer: replied 1 year ago.
can u please refer me to someone else, ur responses are very slow
Expert:  Dr. Phil, MD replied 1 year ago.

are you referring to the roux en Y?

Customer: replied 1 year ago.
i believe so, what other gastric bypasses r there? an r u a bariatric physician or a cardiologist cause i have u under both just wondering
Expert:  Dr. Phil, MD replied 1 year ago.

I'm an internist.

I would say that it is uncommon to not feel full after bypass.

However, if you don't follow the diet it can happen. The stomach stretches especially if you overeat or drink pop

Customer: replied 1 year ago.
what is an internist? an should i ask u my cardiologist questions and my bariatric questions on this thread, or keep them separate?
Expert:  Dr. Phil, MD replied 1 year ago.

You should keep them separate.

I'm a doctor of internal medicine. Anything basically.

We specialize in a lot of areas

and I'm very familiar with bariatric surgery

Customer: replied 1 year ago.
i heard that most insurances cover gastric bypass if you meet certain requirements, but my insurance said its not covered, is there some sort of loop hole I might be missing? i have a ppo, not an hmo i figure it would b covered
Customer: replied 1 year ago.
is there any other weight loss surgeries that have good results, other than gastric bypass, gastric sleeve, an gastric band? is there anything more accepted through insurances than gastric bypass? if u don't lose much weight from liposuction, does it look like u lost a lot of weight with liposuction? i there anything like liposuction that is instant weight loss but that takes off more weight? do u know anything about medical's coverage for weight loss surgery? any ideas for the most weight loss the fastest
Expert:  Dr. Phil, MD replied 1 year ago.

you have to ask your insurance why they won't cover it

what is the reason?

there are ways around it

Customer: replied 1 year ago.
i asked my insurance if they cover it an they flat out said no an when i said y she just said ur plan doesn't cover it at all. so what ways are there around it? an there were several other questions in my last message that were unanswered
Expert:  Dr. Phil, MD replied 1 year ago.

They gave you wrong information.

They have to cover it

Customer: replied 1 year ago.
y do they have to cover it, ur saying all insurances "have to cover it"? and u still aren't answering my previous questions, i sent a whole paragraph of questions, please respond to them
Expert:  Dr. Phil, MD replied 1 year ago.

I will opt out for another expert. I think you need someone more familiar with the ins and outs of insurance carriers. In my experience though, most cover at least part of it