Weight Loss Surgery FAQs

We accept most insurances and have a cash pay option available for those who may not have coverage through their insurance company. We have a financial counselor who will work with you and your insurance company throughout every step of the surgery process. We’ll review your insurance policy to identify what we need to do to get your weight loss surgery financed in the most efficient way possible.

Like any major procedure, there are risks involved with having bariatric surgery. If you want to be considered for this type of surgery, you will have to undergo a thorough evaluation to determine if surgery is a suitable option for you.

While insurance requirements may vary, a person who meets the following criteria is most likely eligible for weight loss surgery:

• You’re between the ages of 18 and 65.
• You’ve tried medically supervised weight loss programs and have not been successful long term.
• You have a Body Mass Index (BMI) of:
  • 40 or greater OR
  • A BMI between 35-40 and have other obesity-related medical problems like type 2 diabetes, high blood pressure, or severe sleep apnea OR
  • A BMI between 30-35 and have diabetes

(BMI and obesity-related medical problems can vary based on insurance criteria)

• You are mentally ready for the surgery and the effects of the weight loss.
• You’re motivated to do the hard work ahead.
  • There will be significant life changes that need to be made along with the surgery. You’re going to have to learn a new way of eating and exercising.

Nearly 5% of the U.S. population meet the criteria for weight loss surgery, including those with a BMI (body mass index) of 40 or greater and those with a BMI of 35 or greater with severe health complications.

Millions of Americans have found that diet, exercise and medications alone are not sufficient to lose their excess weight. Years of failed dieting and weight gain and loss often change a person’s metabolism, making it more difficult to lose weight and keep it off.

Based on your insurance and our program requirements, we will let you know from the start whether you are a candidate for surgery.

Choosing your weight loss surgery surgeon is one of the most important decisions you can make in your journey to decide if surgery is right for you.  The process can seem daunting.  Don’t be afraid to ask questions about your provider's practice and experience, your life post-surgery, and anything else you’re concerned about. At Iowa Weight Loss Specialists, we’re here to address your concerns to ensure you are comfortable and confident with your decision.

Our dedicated bariatric surgeon, Dr. Todd Eibes, received his medical degree from the University of Iowa Carver College of Medicine, training with Dr. Ed Mason who is considered one of the founding fathers of Bariatric surgery. An accomplished doctor for over 20 years, Dr. Eibes began performing bariatric surgery in 2001.

Dr. Eibes has performed over 500 gastric bypasses, 650 lap-bands, and over 2,800 sleeve gastrectomies. Dr. Eibes’ patients typically lose 60-70% of excess weight after surgery with hard work and ongoing support from our weight management team. Dr. Eibes’ risk for major complications fall within the national average of 1-2% occurrence rate.

There are three major weight loss surgeries available today: the Gastric Sleeve, the Lap-Band, and the Gastric Bypass.

Iowa Weight Loss Specialists performs the Gastric Sleeve on our patients, because we believe the advantages of the surgery are greater than any of the other options and the downsides are far less. The risk of major post-operative complications with the Gastric Sleeve are less than any other weight loss surgery.

Please click on each link below to review the list of pros and cons of each procedure.

Laparoscopic Sleeve Gastrectomy (Gastric Sleeve)

Laparoscopic Adjustable Gastric Band (Lap-Band)

Roux-en-Y Gastric Bypass

Morbid obesity is a term that is defined as being at least 100 lbs. overweight or 100% over your ideal body weight. We use your height and weight to calculate your body mass index (BMI). Any BMI reading over 40 is defined as morbidly obese. 

BMI Calculator

If you are one of the millions of patients in the world diagnosed with type 2 diabetes, weight loss surgery can make a remarkable improvement in your blood sugar levels.

Lifestyle changes such as exercise and diet modification should be attempted first for conservative diabetes treatment. If conservative treatment fails, weight loss surgery could be the permanent solution you are looking for.

https://youtu.be/GNJ3hCZCPiU (Video of Dr. Eibes)

(Read more about this topic) https://www.iowaweightloss.com/news-and-events/blog/2014/07/04/can-weight-loss-surgery-reduce-or-eliminate-the-impact-of-diabetes

There is a strong association between obesity and infertility, and weight loss can increase fertility in obese women.

It is believed that the rise in obesity is partly to blame for the rise in infertility. But new studies are proving that surgical weight loss procedures have helped many couples in their effort to become pregnant.

As an added benefit, significant weight loss in obese women prior to pregnancy also greatly reduced serious maternal and fetal complications during pregnancy including gestational diabetes and hypertensive disorders, such as preeclampsia.

An excess of fat cells negatively impacts hormone production. The considerable weight-loss (often 100 pounds or more) achieved by women who undergo weight loss surgery reduces the strain on the body’s ability to operate at an optimal level.

Significant weight loss can also improve the regularity of menstrual cycles and increase ovulation rate in anovulatory (non-ovulating) obese women. Polycystic ovary syndrome (PCOS), another common cause of infertility in overweight women, improves as well.

All of these physical improvements increase the potential of getting pregnant.

https://youtu.be/ZM0AKJokYiU (video of Dr. Eibes)

Many women elect to have a Gastric Sleeve, because their obesity is preventing them from getting pregnant. You may become more fertile as you lose weight. Often, your obesity causes abnormal estrogen levels that can return to normal as you lose weight.  

It’s important that you wait until it’s safe for you to be pregnant after your surgery. Your birth control pills may not work around the time of your surgery due to the medication you receive with surgery. Remember to use other methods of birth control (barrier contraceptive) and talk with your family physician about this.

You should avoid pregnancy for the first 12 months after surgery due to your rapid weight loss. A pregnancy that occurs soon after weight loss surgery can have severe consequences for both the mother and the baby. Once you are over a year, your risks during pregnancy fall to significantly less than when you were morbidly obese. Your risk of gestational diabetes and preeclampsia are much lower than when you were morbidly obese. If you require a C-section during the delivery, the surgical risk is significantly less once you lose your excess weight.

An advantage of the Gastric Sleeve is that you continue to absorb nutrients normally, so your risk of vitamin deficiency is much less than with a gastric bypass. When all factors are considered, once you have your Sleeve and you have time to get your weight under control, your fertility increases and pregnancy becomes much safer for both mother and baby.

However, please do take the following precautions:

• Correct vitamin deficiencies before conception
• Add prenatal supplements (calcium citrate, iron, vitamin D)
• Pay attention to overall nutrition during first trimester
• Talk to high-risk OB/GYN for monitoring during pregnancy
• Check homocystein levels (Neural tube defects can occur from folic acid deficiency)
• Limit daily intake of Vitamin A to no more than 10,000 IU/day (Fetal malformations have been linked to daily exposure of 20,000 IU of Vitamin A from supplements)

If you struggle with sleep apnea and are overweight, you are not alone. Morbid obesity can cause sleep apnea and other respiratory problems that may result in chronic fatigue.

Obesity is one of the most important factors for the development of sleep apnea, which is when breathing suddenly stops because soft tissue in the back of the throat collapses and closes during sleep.

Studies have shown that weight loss surgery is an effective tool for treating obesity, and for preventing, treating and even resolving sleep apnea.

By losing just 10% of your body weight, you can decrease your risk of developing sleep apnea by over 25%.

Successful bariatric surgery is associated with the improvement or complete resolution of obstructive sleep apnea. Individuals that have had weight loss surgery report significant reductions in snoring and daytime sleepiness. Many individuals who had to use a CPAP before surgery do not require it months after their weight loss procedure.

Depression and anxiety are common among morbidly obese patients who have weight loss surgery. In a 2011 study, Jonathan Finks, an assistant professor of surgery of University Michigan and his co-authors observed that 46% of the patients receiving weight loss surgery had a psychiatric disorder.

They examined data from the Michigan Bariatric Surgery Collaborative that contains data of more than 26,000 patients who have undergone weight loss surgery since 2006. The surgeries included gastric bypass, gastric sleeve, gastric banding, and the duodenal switch (similar to gastric bypass, but keeps some stomach and passes most of the intestine).

Before the surgery, 72% of patients with depression used antidepressants. A year after bariatric surgery, the percentage of people taking antidepressants dropped to 60%. Finks added that the percentage of people responding to the surveys a year later dropped to just 31%.

While weight loss alone can’t cure clinical depression, most post-surgical patients do report a significant improvement in their mood and outlook on life.

According to the Arthritis Association, studies have shown that even a modest amount of weight loss can have a significant effect on osteoarthritis pain for individuals who are overweight. Osteoarthritis pain is characterized by pain at the knee on beginning motion, such as arising from a chair, and increased pain with prolonged use.

In the early stages of osteoarthritis, the pain is relieved by rest. As the disease progresses, the pain can persist after activity and even interfere with sleep.

Weight loss surgery reduces knee pain in obese people, and the results are similar to those seen in patients who have had a knee replacement, according to a 2014 study.

The study included 20 obese patients who had weight-loss surgery and 40 patients who had total knee replacement due to arthritis. One year after their procedure, the patients who had weight loss surgery reported significant improvements in knee pain. Their results were comparable to the patients who had a knee replacement.

Your timeline for surgery will all depend on your insurance requirements, as well as your compliance with program requirements. The number of required supervised diet visits varies based on individual insurance policy. Your participation in supervised diet visits and progress toward goals set by our providers is critical to moving forward in the surgery process.

On average, most patients return to work in 2-3 weeks. You may need more time off if you have a strenuous, physical job like a firefighter or construction worker.

How long you will be off work after surgery is mostly determined by how weak and tired you feel. Your calories will be limited, plus you will be healing from a big surgery. The patients who don’t push their recovery find they have the fewest issues and challenges and actually get back to work the quickest.

Patients absolutely cannot return to work if still requiring medications that impact alertness and decision making.

As with any surgery, there can be immediate and long-term complications and risks. Over the last 20 years, we have found that weight loss surgery has become increasingly safe. When you look at the diseases that most patients live with such as diabetes, heart disease, renal problems, and sleep apnea, it’s by far safer now to have surgery than to live with these medical problems.

Possible risks can include, but are not limited to:

• Bleeding 
• Complications due to anesthesia and medications 
• Deep vein thrombosis
• Dehiscence (separation of areas that are stitched or stapled together) 
• Infections 
• Leaks from staple lines 
• Marginal ulcers 
• Pulmonary problems 
• Spleen injury 
• Stenosis (narrowing of a passage, such as a valve) 
• Death

Due to experiencing significant weight loss over a relatively short period of time, bariatric surgery patients are often left with excessive amounts of hanging skin. This excess skin can create a multitude of problems such as daily hygiene concerns and finding clothes that fit properly.

Reconstructive surgery is not required after a weight loss procedure; however, many patients begin to consider it as their health improves. We recommend waiting at least 12-18 months after gastric sleeve surgery to consider reconstructive surgery.

Read More About This Topic  

Patients typically can expect to lose 50-70% of their excess weight. However, this can depend on patient factors such as starting weight, age, and post-surgical lifestyle adjustments. 

While some patients do regain some of the weight lost after bariatric surgery, we strive to prevent this by offering comprehensive weight loss services. From medical weight management (such as behavioral health support) to patient support groups and community resources, we’re here ensure you achieve and maintain your weight loss goals.

During the Gastric Sleeve procedure, a bariatric surgeon removes approximately 75% of the stomach laparoscopically, so that the stomach takes the shape of a sleeve. This helps with weight loss by restricting food intake and reducing hunger.

Ideally, with proper diet, exercise, and support, bariatric surgery patients will not need medications for weight loss. However, in some cases due to lifestyle choices in the years after weight loss surgery, patients may be prescribed medications for weight loss.