Frequently Asked Questions

• BMI is too low
• Failure to keep a scheduled pre-operative appointment without advance notification. The lack of commitment might identify the patient who won’t follow through with post-operative visits and instructions.
• Failure to comply with sample menus and diet assignments
• Failure to have a support person
• Failure to stop smoking 6 weeks before surgery (a blood test for nicotine can be checked prior to surgery)
• Risk is too high due to existing health problems adding increased risk of complications during and after surgery
• Perceived lack of understanding of commitment to the life-long dietary restrictions created by this major operation

The hospital stay is dependent on a variety of factors, but ultimately, patients remain at Wise Health System in Texas until the surgeon feels they are well enough to leave. Typically, patients who undergo the LAP-BAND® System procedure can return home the same day, patients who undergo Roux-en-Y Gastric Bypass surgery stay for 2-3 days, and patients who undergo laparoscopic Sleeve Gastrectomy surgery patients go home same day or the following day. Patients that undergo the NEW Orbera™ Intragastric Balloon procedure go home the same day.

Individuals who undergo bariatric surgery are prescribed various medications that can cause drowsiness and severely limit motor skills and reaction times. Patients are typically prohibited from driving automobiles or operating heavy machinery for up to 7 days after surgery.

Bariatric surgery is just one phase of a comprehensive plan to help patients achieve their weight loss goals. It is imperative that patients who undergo weight loss surgery eat a healthy, well-balanced diet and exercise on a regular basis to ensure that they maximize the procedure’s results.

Most patients report that after the completion of their surgery, they have little to no appetite for the first 4 to 6 weeks. Over time, patients’ appetites return, but cravings and “ravenous” appetites are typically not a problem after bariatric surgery.

Any person who suffers health complications as a result of their weight and is also willing to commit to the lifestyle changes necessary to make bariatric surgery a success is a good candidate.

The answer is an enthusiastic “Yes!” If you or a loved one suffers from weight-related health complications, bariatric surgery may be right for you. Combined with proactive changes to your diet and your exercise routine, bariatric surgery can give you a new attitude on life and greatly improve your health!

Weight loss questions vary from patient to patient. There are several factors that play into weight loss which include: age, weight before surgery, overall patient’s health, surgery performed, physical activity, and commitment to dietary guidelines and follow-up care. Patients can lose 30 to 50% of their excess weight loss in the first 6 months and up to 75% in the first year.

For all surgical procedures, patients are usually walking on the very first day after their procedure. The day after surgery you are able to be on a liquid diet. For most patients, pain is well controlled with oral medications after the first day. Lapband and gastric sleeve patients are typically discharged on the first day. Gastric bypass patients stay in the hospital around 2 days. Balloon patients leave the same day and have a period of nausea that is expected but are able to resume activities as quickly as they feel capable. Band, Sleeve, and Bypass patients are able to return to their normal activities within 7 to 14 days.

Research has shown that patients who regularly follow-up with a physician after weight loss surgery have a higher excess weight loss than those who do not. We require that patients see the Surgeon/Nurse Practitioner 1 week following surgery. This visit is to ensure a patient does not have any problems going on following their procedure. We then recommend for our gastric sleeve and gastric bypass patients see our Nurse Practitioners at months 3, 6, 12, 18, and every year thereafter. For our lapband patients, an adjustment is scheduled one month following their procedure. Patients are then seen as needed for adjustments. We recommend seeing the Nurse Practitioner at months 6 and 12 and then every year thereafter. Patients can schedule additional appointments with the Dietitian, Psychologists, and/or Exercise Specialist as needed.

This depends on factors such as insurance, and/or financing, scheduling, completing pretesting requirements such as psychological evaluations, education modules, etc. Typically patients that use their insurance take about 3 to 12 months depending on the insurance criteria listed on their policy. Patients paying cash or financing their procedure take a min of 2 weeks to get scheduled.

Patients may be sexually active following weight loss surgery. We advise patients to listen to their bodies on what is comfortable or not.

Women should avoid becoming pregnant for at least 18 months after surgery. Please discuss any pregnancy plans with the Bariatric physician. Pregnancy after weight loss surgery can be safe for both the mother and the baby.

Hair loss is a stress response with weight loss. At least 50% of those that undergo weight loss surgery have some hair loss. To help prevent hair loss as much as possible, we encourage patients to consume protein and vitamins regularly. If patients feel that their hair loss is more than normal, they may call our office to speak with one of our Dietitians.

All major surgery comes with risk and the risks are different with each patient. Our surgical outcomes are better than most hospitals around. Our lifetime mortality rate is .0008%. Your surgeon: Dr. Arsalla Islam or Dr. Heath Smith will explain to patients their individual risks during their first consultation.

We have 3 convenient locations in the DFW Area. We have offices in Argyle, Keller/Ft.Worth, Decatur and Waco. We also have a mobile unit that travels to locations such as Waco, Abilene, and Decatur.

We highly encourage patients to start walking as much as they can tolerate after weight loss surgery. We recommend to patients to hold off on starting any weight bearing exercises for at least 1 month following surgery. If you are ready to start an exercise program, call our office today and ask to speak with the Exercise Specialist.

As you start losing weight, your body changes all over. The amount of excess skin depends on several factors such as age, amount of weight loss, how long one has been over weight, smoking habits, and to some extent exercise. Sometimes patients choose to have plastic surgery. We do not recommend seeking plastic surgery until at least 18 months after weight loss surgery. If you need some referrals for plastic surgery, our patient advocates and patient coordinators are here to assist you.

When looking for any physician and surgeon, one always needs to do research. We highly encourage this. We recommend only going to a board certified plastic surgeon that specializes in treating Bariatric patients. We have several surgeons that we recommend. Call our office for more information.

Gastric bypass surgery causes food to be moved from the small stomach pouch straight into the small intestine. Sweets and foods high in fat can irritate the small intestine and produces an unpleasant feeling. If you eat while drinking fluids, the same effect is produced. You should wait half an hour between drinking and eating.

Yes, because smoking causes narrowing of your blood vessels that in turn decreases circulation. This decrease in circulation interferes with your ability to heal properly. This inability to heal properly can increase your risk of developing an incisional hernia among other things. Smoking can also cause you to have problems with your ability to breathe on your own after you have been under anesthesia and may require you to remain intubated (mechanically assisted breathing) for a longer period of time post surgically. You must stop smoking at least 4 to 6 weeks prior to having your procedure. You must also refrain from smoking after your weight loss surgery procedure.

This visit is normally to discuss your surgical options, review and discuss insurance benefits or surgery payment options, review and discuss pre/post op diet requirements. This visit may last an hour or more.

• Visit with the physician to discuss surgery options
• Have your picture taken for your record-release form and sign if you would/would not like to use for marketing
• Meet the Financial Specialist to go over insurance requirements as needed and/or discuss payment and options
• Meet the Dietitian
• You may also be able to get your cardiac and psychological testing scheduled during this visit.

Normally this visit is to discuss your surgery, discuss discharge instructions, receive post op lab orders, receive support group meeting information, and to sign surgical consents. This visit may last an hour or more.

• Visit with the Physician so that he may answer any operative questions
• Have your picture taken for your record-release form and sign if you would/would not like to use for marketing (as indicated)
• Meet/Visit with the Financial Specialist if indicated
• Meet/Visit with the Dietitian if indicated
• Meet the Exercise Specialist for measurements and discuss exercise plans

Normally these visits are MANDATED by your insurance company as a pre-requisite before they can approve your bariatric surgery. During this visit you will meet with the doctor and/or the dietitian to discuss your pre-operative weight loss diet and exercise progress. Remember that some insurance companies will deny your bariatric surgery if you do not demonstrate some weight loss (4-10lbs) during this period. This visit may last up to an hour or more.

• Visit with the physician to discuss medications that may need to be started or discontinued and in regards to any preoperative testing
• Visit with the Physician and/or Dietitian to discuss diet progress or limitations
• Visit with the Dietitian and discuss any nutrition supplements to help with your overall pre-operative and post-operative diet
• Visit with Exercise Specialist as needed to monitor percent body fat, discuss exercise plan as needed, obtain measurements if indicated

Normally this visit is just to check your incisions to make sure you do not have any signs of an infection or bleeding and to address any surgery related concerns you may have.

• Visit with the Physician or Nurse Practitioner to check incisions
• Ask any questions you may have

This visit is for your first adjustment.

• Meet adjustment team personnel – (patient care tech and mobile unit driver), (nurse – performs adjustments), (Radiology Technician)
• Receive first adjustment to the lapband – After your adjustment, you will receive a handout that lists post-fill requirements
• Have your picture taken (as indicated)
• Ask any questions you may have

Normally this visit is to discuss your lab results, monitor weight loss, assess for subtle signs of nutritional deficits, educate you on how to properly meet your weight loss goal, and address any clinical conditions that may affect your ability to lose weight.

• Visit with the Nurse Practitioner
• Have your picture taken
• Visit with Dietitian if needed/requested
• Visit with Exercise Specialist to monitor percent body fat lost, make adjustment to exercise plan as needed
• Ask any questions you may have

This visit should address your weight loss questions. Normally this visit is to discuss your lab results, monitor weight loss, assess for subtle signs of nutritional deficits, educate you on how to properly meet your weight loss goal, and address any clinical conditions that may affect your ability to lose weight

• Visit with the Nurse Practitioner
• Have your picture taken
• Visit with Dietitian if needed/requested
• Visit with Exercise Specialist to monitor percent body fat lost, make adjustment to exercise plan as needed, obtain measurements if indicated
• Continue Lap-Band Adjustments as indicated (if applicable)
• Ask any questions you may have

Normally this visit is to discuss your lab results, monitor weight loss, and assess for subtle signs of nutritional deficits, discuss plans to maintain your weight loss or sustain your “goal” weight/overcome weight loss plateaus

• Have your picture taken
• Visit with Dietitian if needed/requested
• Visit with Exercise Specialist to monitor percent body fat lost, make adjustment to exercise plan as needed, obtain measurements if indicated
• Ask any questions you may have

Normally this visit is to discuss your lab results, monitor weight loss, and assess for subtle signs of nutritional deficits, discuss plans to maintain your weight loss or sustain your “goal” weight/overcome weight loss plateaus

• Visit with the Nurse Practitioner
• Have your picture taken
• Visit with Dietitian if needed/requested
• Visit with Exercise Specialist to monitor percent body fat lost, make adjustment to exercise plan as needed, obtain measurements if indicated
• Continue Lap-Band Adjustments as indicated/Swallow only band check if no adjustment needed
• Ask any questions you may have