Frequently Asked Weight Loss Questions

Find answers to many of the questions you may have about bariatrics, obesity and weight loss. Click on the questions below to read the answers.

Bariatrics encompasses the study, diagnosis and treatment of obesity and its causes.

In a broad sense, obesity is the label for when excess weight affects health and lifestyle. Doctors define obesity more specifically by looking at a patient’s Body Mass Index (BMI). The BMI is a calculation that looks at weight and height to figure out whether an individual is underweight, within a normal weight range, overweight, or obese.

You can calculate your BMI here.

Read more about the physical difference between obesity and being overweight.

Body Mass Index (BMI) is a number showing body weight adjusted for height that can be calculated mathematically using inches and pounds or meters and kilograms. For adults aged 20 years or older, BMI falls into the categories of underweight, normal, overweight or obese. Please see the chart below for the classifications of BMI number ranges by the National Institutes of Health, or calculate your BMI yourself.

Obesity can be caused by a combination of genetics, health issues, and behavior. Some people’s genetics make their bodies store more fat. Some hormone problems can lead to carrying extra weight. And lifestyle – including what you eat, how much you eat, and how much you exercise – can also lead to obesity. Read more information on all causes of obesity.

The Emory Bariatric Center is comprised of physicians, dietitians, mental health professionals and exercise specialists who collaborate to offer a wide range of treatment options, the program offers lifestyle education and nutritional counseling; group support; liquid meal replacement programs; pharmacotherapy; and surgical procedures all under one roof.

Our team is engaged in cross-discipline bariatric research with experts in topics from cardiology to sociology. At Emory, we don’t just do weight loss surgery; we’re collaborating with scientists and patients to figure out why obesity happens, how to minimize surgery side-effects, and how to help patients keep the most weight off in the long-term.

The Emory Bariatric Center works with patients to create individualized plans for weight loss and weight maintenance. Our specialists evaluate eating patterns and work on establishing healthy diets, while educating patients about lifestyle choices.

Medical treatment options and surgical treatment options combine the expertise of our bariatric physicians, surgeons, psychologists, and dietitians. Our most successful patients are committed to lifelong behavioral change and regular medical follow-up.

Candidates for bariatric surgery usually have a Body Mass Index (BMI) above 40. That means surgery may be a good option for men overweight by 100 pounds or more, or for women overweight by 80 pounds or more.

Surgery may also help people with a BMI between 35 and 40 who suffer from chronic or life-threatening complications from their obesity (such as severe sleep apnea or obesity-related heart disease or diabetes).

Surgical procedures lead to weight loss in two main ways:

By limiting how much you eat. Gastric banding, gastric bypass and sleeve gastrectomy limit the amount of food the stomach can hold by closing off or removing parts of the stomach.

By causing the body to only partially digest and absorb food. In gastric bypass procedures, surgeons directly connect the stomach to a lower segment of the small intestine, bypassing intestinal areas responsible for digestion. That means some calories aren’t absorbed by the body, and instead pass through the digestive track.

In gastric banding, a silicone band is placed around the upper end of the stomach, creating a small pouch and a narrow passage into the remainder of the stomach. The small pouch makes patients feel full more quickly. Gastric banding is reversible and doesn’t interfere with digestion.

With a sleeve gastrectomy, surgeons permanently remove about 75 percent of the stomach, leaving the remainder shaped like a long tube or sleeve. Food intake is restricted, but digestion is normal.

A gastric bypass, surgically reduces stomach size with stapling, and then reroutes of the small intestine. The result is reduced calorie and nutrient absorption.

In other words, gastric banding can be reversible, while sleeve gastrectomy and gastric bypass are permanent. Gastric bypass affects stomach size as well as digestion, while gastric banding and sleeve gastrectomy only affect stomach size.

To learn more about these procedures, view our online surgical weight loss seminar.

Immediately following surgery, most patients lose weight rapidly. That weight loss continues for up to 2 years. After this period, many regain some weight, but few patients regain it all.

Surgery improves most obesity-related medical conditions, including heart disease, risk of stroke, and diabetes. For example, one recent study showed that the blood sugar levels of most diabetic patients returned to normal after weight-loss surgery.

Because the stomach is reduced, after surgery it is common for the stomach to become stretched because of overeating, or because a patient hasn’t thoroughly chewed their food. Stomach stretching can lead to discomfort, nausea, vomiting, and weight re-gain.

Ten to twenty percent of patients who have weight-loss operations require follow-up procedures to correct complications, including stomach stretching. Abdominal hernias are the most common complication. A less-frequent issue is the breakdown of the staple line, which could, if left untreated, lead to food leaking into the abdomen.

Nearly 30 percent of patients who have weight-loss surgery develop nutritional deficiencies such as anemia, osteoporosis and metabolic bone disease. Malabsorption of vitamin B12 and iron may result in anemia, while decreased absorption of calcium can contribute to osteoporosis and metabolic bone disease. In the majority of cases, medical monitoring and nutritional supplements prevent these deficiencies. This is why it is critical to follow-up with our physicians and dietitians at specified, regular intervals.

During rapid or substantial weight loss, the risk of developing gallstones increases. About a third of people who get gallstones after bariatric surgery require an operation to remove them.

Since rapid weight loss and nutritional deficiencies can harm a developing fetus, women of childbearing age who have bariatric surgery should avoid pregnancy until their weight stabilizes.

Gastric bypass operations may also cause "dumping syndrome," a situation where food or liquids travel too rapidly through the small intestine. Sweets are often the culprit. Dumping symptoms, which occur after eating, can include nausea, weakness, sweating, faintness, and sometimes diarrhea.

All three bariatric procedures lead to weight loss in almost all patients, but weight regain can occur. The stomach can expand again, in time, if patients consistently overeat. In all weight-loss procedures, successful results depend on the patient's motivation and behaviors.

Surgery may be appropriate for obese patients who have been unable to lose weight through lifestyle changes, or for those who have an obesity-related illness.

For other patients, changing eating habits, modifying behavior and increasing physical activity may be more suitable.

Answering the following questions may help you see if surgery’s a good option for you.

Are you:
  • Unlikely to lose weight and sustain weight loss with non-surgical measures?
  • Well-informed about the surgical procedure, including its benefits, risks and side effects?
  • Determined to lose weight and improve your health?
  • Aware of how your life may change after the operation?
  • Willing to make long-term adjustments, like chewing thoroughly and eating smaller meals?
  • Committed to follow-up medical care for the rest of your life?
Do you:
  • Have a Body Mass Index (BMI) of 40 or more? Click here for BMI calculator.
  • Have an obesity-related physical problem that interferes with employment, mobility or family function?
  • Have a high-risk obesity-related health problem, such as severe sleep apnea, obesity-related heart disease, or diabetes?
  • Have good emotional and psychological support from family and/or friends?
If you’ve answered yes to these questions, you may be a good candidate for bariatric surgery. If you’ve answered no to most of the questions, Emory Bariatric Center can still help through nonsurgical treatment options.