Dear Doctor, I’ve had bariatric surgery. Will I ever get to normal weight?
Answer provided by Lloyd Stegemann, MD, FASMBS

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This is a great question and one that, ideally, should be answered before someone has bariatric surgery. I say “before” because I believe it is critically important that patients have a very realistic expectation of how much weight they are likely to lose after bariatric surgery. This can prevent them from being disappointed or feeling like they “failed” if they don’t get back to a “normal” weight. Most patients, in fact, will not get back to a normal weight (body mass index 20-25) after bariatric surgery. We’ll talk more about this in a bit.

What is excess weight?
We need to start this discussion by defining excess weight, which is how much “extra” weight someone is carrying. Excess weight can be calculated by taking your actual weight and subtracting your ideal weight (www.calculator.net/ideal-weight-calculator). If you weigh 250 pounds and your ideal weight is 150 pounds, then your excess weight would be 100 pounds.

The below breakdown shows you the expected weight-loss with each of the different surgical procedures.

Adjustable Gastric Band – 50% of excess weight

Sleeve Gastrectomy – 60% of excess weight

Roux-en-y Gastric Bypass – 70% of excess weight

Duodenal Switch – 80% of excess weight

If you are thinking about having a gastric band (or you have one) and your excess weight is 100 pounds, then it is realistic to expect that you will lose around 50 pounds after the operation. Make sense? It’s important to keep in mind that the numbers listed in the chart are averages, meaning that some patients will do much better in terms of expected weight-loss and some won’t reach the amount of expected weight-loss. Not reaching the expected weight-loss does not make you a failure! Many factors can impact someone’s overall weight-loss including age, medical conditions, physical condition and willingness to work on the dietary, exercise and behavioral changes that are necessary after surgery.

Health Improvements
The best news is that you don’t have to get back to a “normal weight” to achieve incredible health benefits after bariatric surgery. The average bariatric surgery patient sees a dramatic reduction in the number of medications they need to take to control their obesity-related medical problems and a significant improvement in their quality of life even if their final body mass index is still in the “overweight” or “obese” range. In fact, I find in my own practice that if a patient tries to force their weight down to what would be considered “normal,” many times they don’t feel very good and often times don’t look very healthy (that Skeletor look!). I always encourage patients to focus on getting back to a “better” weight for them, not necessarily what society considers a “normal” weight.

In summary, some bariatric surgery patients will achieve a “normal” weight but most will not. If you don’t reach a “normal” weight, well, that just makes you normal!

Answer provided by:
Lloyd Stegemann, MD, FASMBS, is a private practice bariatric surgeon in Corpus Christi, TX. He is the driving force behind the Texas Weight-loss Surgery Summit and the formation of the Texas Association of Bariatric Surgeons. Dr. Stegemann is a member of the American Society for Metabolic and Bariatric Surgery, OAC National Board of Directors, Co-chair of the Convention Program Agenda Subcommittee and is Chair of the OAC Sponsored Membership Program.



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