Bariatric Surgery (Weight-loss Surgery)

We know that being overweight isn't about a lack of willpower, and we offer proven, medically-based solutions. Most importantly, we genuinely care about your success. You'll find sensitive, supportive and respectful help from experts in multiple medical specialties. You'll also be given information on insurance, medical consultations, hospital and follow-up care, exercise and nutrition, counseling and support groups along the journey. Your weight and other health information will be held in strict confidence. We support your every step, focusing on your emotional, physical, nutritional and educational needs.

Our bariatric surgery program has received an advanced, high-acuity accreditation as a comprehensive center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). MBSAQIP is a comprehensive, nationwide surgical quality program aimed at ensuring the safe and effective performance of metabolic and bariatric surgery. Surgical outcomes focus on weight loss and the treatment of obesity-related diseases, like diabetes, sleep apnea, and others. Research shows accredited centers experience lower complications, and better outcomes than that of non-accredited facilities.

This recognition illustrates the comprehensive care bariatric surgical patients receive here. It's a multidisciplinary program — not just a surgical procedure — which improves patient outcomes and ensures long-term success.

Find out more about our bariatric surgery services:

• Conditions and consultations
• Diagnosis and treatments
• Bariatric surgery specialists
• Referrals
• FAQ
• Bariatric surgery locations near you
• Bariatric surgery specialists near you

Conditions and consultations

Bariatric surgery may be an option for adults with a body mass index (BMI) of 30 or higher, depending on medical conditions. Insurance coverage for surgery varies, and some insurance programs require a higher BMI.

Conditions that can be improved with bariatric surgery include:

• Difficulty breathing
• Heartburn or gastroesophageal reflux disease (GERD)
• High blood pressure and cholesterol
• Low back pain and degenerative disk or joint disease
• Risk of cancer
• Risk of heart disease
• Sleep apnea
• Type 2 diabetes

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Diagnosis and treatments

We specialize in two types of minimally invasive bariatric surgery and will help you select the one that is right for you.

The two types of surgery we provide are:

Roux-en-Y gastric bypass

The surgeon creates a small pouch at the top of the stomach and reroutes the small bowel into this pouch, restricting the amount of food you can eat. The body also experiences hormonal and chemical changes that help with losing weight and becoming more sensitive to insulin.

Watch a video on how a Roux-en-Y gastric bypass is done:

Sleeve gastrectomy

The surgeon removes about 75% of the stomach, resulting in a smaller, banana-shaped stomach, decreasing the amount of food you can eat. It also results in some metabolic changes, but they typically are less than with gastric bypass surgery.

Watch a video on how a sleeve gastrectomy is done:

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Bariatric surgery specialists

Our team of experts is sensitive, supportive and respectful. We're with you every step of the way — before, during and after surgery — while focusing on your emotional, physical, nutritional and educational needs.

Our specialists include:

• Surgeon — Meets during surgery consideration and performs the surgery
• Medical bariatrician — Treats chronic and undiagnosed medical conditions, and follows up after surgery to monitor weight loss, vitamin levels and manage medication for long-term health maintenance
• Bariatric surgery coordinator — Facilitates pre- and postoperative care phases
• Psychologist or psychiatrist — Assesses emotional readiness for bariatric surgery in addition to lifestyle changes preparation necessary for long-term success
• Exercise counselor — Develops a personalized fitness plan
• Nutrition counselor — Coaches proper nutrition, portion size, lifestyle changes and dietary changes needed before and after surgery
• Polysomnography technologist or sleep physician — Assesses for and treats sleep apnea

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Referrals

You can make an appointment without a referral from your provider — simply call the appointment number of your preferred Bariatric Surgery location.

If you're a non-Mayo Clinic Health System provider, you can refer patients to Bariatric Surgery online, by phone or by fax. We value the opportunity to collaborate with you on a treatment plan.

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FAQ

What causes obesity?

There are many things that can lead to an unhealthy weight. These include:

• Family history — Genes do play a part in how your body balances calories and energy. Children whose parents are overweight are also more likely to be overweight. You can’t change your genetic makeup by willpower any more than you can make yourself taller or shorter by wishing. But, you can still lose weight and keep it off, even if you have a family history of unhealthy weight.
• Culture — We tend to eat and cook the same way our parents did and the foods we choose are often those we grew up with. Family gatherings and social events such as weddings and holiday parties often center around food.
• Physical inactivity — Not getting enough physical activity can lead to an unhealthy weight. These days, many people spend a lot of time watching TV, playing video games or doing other activities that do not require a lot of energy.
• Emotional or psychological factors — For many people, food is a source of comfort or celebration. Some people eat when they are feeling sad or stressed. In order to lose weight and keep it off, it is important to find more healthful ways of dealing with emotions.
• Gender — Women are more likely to have an unhealthy weight than men simply because men have more muscle than women. Muscle uses more energy than fat does, and men burn 10 to 20 percent more calories than women do at rest.
• Age — As you get older, the amount of muscle in your body tends to decrease and fat accounts for a greater percentage of your weight. This lower muscle mass leads to a decrease in metabolism, meaning a body needs fewer calories.
• High-fat/high-calorie diets — Typical restaurant meals are high in fat and calories. Even seemingly healthful foods such as salads can be high in fat if you add a lot of salad dressing. Ounce for ounce, fat provides more than twice as many calories as protein or carbohydrates.

Is my weight unhealthy?

A calculation called the Body Mass Index (BMI) is used to determine if you are overweight or obese. If your BMI is over 25, you are considered overweight. A BMI over 30 is considered obese. Click here to calculate your BMI.

Another indicator of risk for obesity is if waist circumference is greater than 40 inches for men or more than 3 inches for women.

How overweight do I have to be to qualify for weight-loss surgery?

The National Institute of Health defines morbid obesity as a body mass index, or BMI, of 35 or greater with obesity-related medical conditions, such as diabetes, high blood pressure or sleep apnea, or a BMI of 40 or greater in the absence of obesity-related medical conditions. Insurance companies ultimately determine whether they will pay for your operation based on your BMI, weight-loss attempt history and demonstration of commitment to a post-surgical weight-loss program. The criteria that each insurance company uses are subject to change at any moment.

Am I a candidate for bariatric surgery?

To be considered as a surgical candidate, you must:

• Be at least 18 years old
• Have a body mass index, or BMI, of 40 or above, or have a BMI of 35–40 with significant associated health problems, such as diabetes, heart problems, high blood pressure, high cholesterol or sleep apnea
• Have made documented attempts in the past to lose weight
• Have not had alcohol or chemical abuse issues
• Have no untreated psychiatric conditions as determined by a licensed psychologist or psychiatrist

How does bariatric surgery help me lose weight?

In the digestive process, juices in the stomach break down food. Nutrients are absorbed as food moves through the small intestine. Your body gets calories from absorbed nutrients. Bariatric surgery changes the structure of the digestive system by either limiting the size of the stomach (restrictive) or by reducing the nutrients absorbed by the stomach (malabsorptive). The most common type of bariatric surgery is both restrictive and malabsorptive and called Roux-en-Y gastric bypass.

How much weight will I lose after surgery?

Surgery is a tool to help you lose weight. You'll need to make changes to your eating and exercise patterns to achieve weight-loss results. If you make these changes and stick to them, most people lose two-thirds of their excess weight in the first year. This depends on the operation performed, as well as your food choices and following a consistent exercise program. Excess weight loss with the laparoscopic sleeve gastrectomy is lower than that with the Roux-En-Y gastric bypass.

How long will I be out of work after the surgery?

You can expect to stay in the hospital two to three days. Longer hospitalization may be necessary if you develop complications. Many people return to work within two weeks after surgery. Some may have an additional length of time off due to other health concerns or if their job requires heavy lifting.

What about activity after surgery?

Most patients can do most of their normal daily activities shortly after surgery. You'll be asked not to lift, push or pull more than 20 pounds for the first month. This is more to protect the work done on the intestine than for the small incisions made.

What are the potential risks and complications of bariatric surgery?

A variety of complications can occur with weight-loss surgery. The risks of surgery depend upon which surgery you have and any medical problems you had before surgery, as well as your age at the time of surgery. Some of the more common surgical complications include bleeding, infection, leakage from the intestine and blood clots in the legs or lungs.

How will my eating change after surgery?

Bariatric surgery is designed to give you a tool to be able to permanently change your eating habits. Weight-loss surgery is not "magic." You'll need to consume fewer calories than your body needs to lose weight. Surgery does not make these changes for you. Instead, it gives you a way to help you make better food choices by inducing negative consequences.

Each type of weight-loss surgery has its own way of reminding you about what are good and bad food choices. In restrictive operations, such as the Roux-en-Y gastric bypass, as you eat, your little stomach pouch gets stretched. This sends a signal to your brain, telling you to stop eating. If you do not heed this signal, the next bite may bring a sense of pain or severe pressure. If you still do not listen to this signal, the next bite may exceed the capacity of the small pouch and cause vomiting of the food. It's important to eat slowly, taking at least 30 to 45 seconds for each small bite of food. This gives the pouch time to send the signal to the brain and for you to pay attention to the cues your body is giving you. The sleeve gastrectomy is less restricted but still may limit the amount of food that is eaten at one time. In addition, if you eat high-carbohydrate or high-fat foods, these can lead to loose stools and foul-smelling gas.

After any weight-loss surgery, you'll need to stay on blended foods for several weeks. You'll work closely with the dietitian to tailor your diet to soft foods. We want you to emphasize protein as the most important nutrient, getting at least 60 grams of protein each day. Some people may need to take protein supplements in the early post-operative period to meet these requirements. By three months after surgery, you'll be back to eating many of the healthy foods that you enjoyed before surgery.

Why would my surgeon ask me to stop smoking before surgery?

Your surgeon will require you to stop all tobacco use before surgery and will expect you to remain tobacco-free. The purpose of weight-loss surgery is to improve your health and extend your life. People who use tobacco have an increased risk of health problems and a decreased life expectancy, so weight-loss surgery may not be worth the risk since tobacco users will not have optimal benefit from the surgery. Also, people who use tobacco products, especially smoking, have a higher risk of anesthesia complications and developing stomach ulcers after surgery.

Is surgery reversible?

You should consider this an irreversible procedure.

Will I need cosmetic surgery?

After losing a large amount of weight, many patients will have some excess skin. You're encouraged to exercise, which increases muscle tone and may minimize the need for cosmetic surgery. However, should you choose this type of surgery, we can refer you to a skilled plastic surgeon. Most insurance companies do not pay for cosmetic surgery unless it is medically necessary.

What are some nutritional tips and recipes for healthy weight-loss success?

As you continue to lose weight, it's important to develop and maintain healthy eating habits. The stomach pouch created by your surgery is a tool you'll need to become accustomed to so you can meet your weight-loss goals. Our dietitians in Eau Claire, Wisconsin, focus on your weight-loss success by guiding you to nutritious food choices and teaching you how to avoid snacking between meals.

This nutrition overview provides a few quick tips to keep you on the right track:

• Protein
  Because your body can't store protein, it needs a constant supply to repair and replace tissues that become worn out or damaged. Therefore, you need to eat protein every day to refresh your body's basic protein needs. Aim for a minimum of 60–80 grams of protein each day. Bariatric surgery procedures reduce stomach capacity to a small volume. Protein-rich foods must be eaten with each meal to ensure the body gets enough to preserve lean muscle mass. We don't advise using high-calorie protein supplements or beverages. Instead, we recommend eating high-protein containing foods at the beginning of each meal. Lean proteins, such as fish, poultry, eggs and low-fat cottage cheese, are just a few good choices.
• Vitamins and minerals
  After bariatric surgery, you won't be able to eat the amount or variety of foods needed to meet recommended vitamin and mineral requirements through your diet alone. A high-potency multivitamin or mineral supplement with iron must be taken every day. Daily calcium and vitamin B12 supplements also are recommended to maintain adequate vitamin and mineral stores and prevent anemia and osteoporosis. Some people require additional supplements after surgery. Your physician will determine your individual needs based on the results of lab work.
• Sugar and fats
  

  After bariatric surgery, a condition called "dumping syndrome" will occur if you eat foods that have greater than 10 grams of sugar and fat per serving. Symptoms of dumping syndrome include profound sleepiness, light-headedness, profuse sweating, rapid heart rate, cramping abdominal pain, nausea and diarrhea. Avoiding foods or liquids with high sugar and fat content will help prevent dumping syndrome. Sweets, candies, fruit juice, soda, high-fat meats and fried foods are choices that may cause problems.

• Nutritious recipes
  

  After bariatric surgery, your meal portions are much smaller. Your new diet helps you progress with weight loss in a nutritionally sound manner to reach your health goals. Eating a variety of foods will help you obtain adequate protein, vitamins and minerals.

  To help increase the variety in your diet, we offer a selection of recipes for you to enjoy. Many of our recipes were shared by other patients who have undergone gastric bypass, sleeve gastrectomy or another weight-loss surgery. All of the recipes provided have been reviewed for optimal nutritional content.

  Get the recipes (PDF).

  Note: Recipes may need to be modified based on your own weight-loss surgery diet stage. If you have any questions about using the recipes offered here, please consult your health care provider.

  What should I bring for my first appointment?

  For your first appointment, bring your current prescription information or medical records from non-Mayo Clinic Health System facilities. Complete a medical records release form (PDF) to authorize the transfer of health records from another healthcare facility to us. Visit our Medical Record Forms page for this form and other forms in multiple languages.

  How long will it take to complete the program?

  It varies for each patient. Some complete it in three to six months, while others may take much longer. In some cases, the length of completion is determined by insurance.

  Will my insurance pay for bariatric surgery?

  You'll need to know if bariatric surgery is a covered benefit of your policy. Contact your insurance company to ask these questions:

  • Are there limits or exclusions for bariatric coverage in my policy?
  • What specific bariatric surgical procedures are covered?
  • Will my pre-surgical evaluation, including any required tests, be covered?
  • Will my post-surgical follow-up appointments be covered?
  • Are related services, like nutrition counseling, covered?
  • Are surgical procedures to remove excess skin after weight loss covered?
  • Will I have any co-insurance, deductibles or co-pays?
  • What is the pre-authorization process and what are the requirements for bariatric surgery?

  Because the evaluation and preparation process for bariatric surgery may take four to six months, you should check your policy again before surgery to ensure it hasn't changed. If your insurance policy coverage for bariatric surgery is limited, we can provide estimates of your out-of-pocket expenses.

  What are my payment options, and do you offer financial assistance?

  Visit the billing page of your preferred location for information on insurance, billing and payments.

  We serve patients in difficult financial circumstances and offer financial assistance to those with an established need to receive medically necessary services. Learn more about financial assistance options.

  Can you provide a second opinion?

  Yes — call the appointment number at your preferred Bariatric Surgery location.

  Do you have an after-hours number in case of emergency?

  Always call 911 in case of an emergency. For after-hours help with other issues, get virtual care 24/7 through the Primary Care On Demand app or review our convenient care options.

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  Explore locations or providers near you for details on high-quality bariatric surgery:

Not all treatments, tests and services are available at all Mayo Clinic Health System locations. Check with your preferred location in advance.