1. How do I know if I am overweight or not?

By calculating your body mass index (BMI), an internationally acknowledged index, people with BMI 25-29.9 are considered as overweight and those about 30 are obese.
The formula is
Weight (kg) ÷〔height（m）ｘheight（m）〕

2. What kind of people need bariatric surgery? (According to Asia’s standard)?

• BMI ≥ 32 + either two of any obesity related diseases (eg. Hypertension, high blood glucose level, hyperlipidemia)
• BMI ≥ 37
• Failed to lose weight with the help of medication, diet modification and exercising.
• Experienced many weight loss methods, such as meal planning by qualified dietitians, but still fail to maintain weight loss result.

3. How long does laparoscopic gastric banding surgery last? Do I need to be hospitalized for a long time? Do I need to have medications for a long period of time?

The surgery lasts for about 1 hour. Patients can walk around on the day after surgery. Generally patients will stay in hospital for a day or two after the surgery. No medications are required but strict diet control is advised.

4. How often do I need to follow up after laparoscopic gastric banding?

The first two years require more frequent follow up as it is crucial to successful weight loss. Doctors would adjust the banding according to patient’s conditions.

5. Can I take the gastric band out after the surgery?

Yes. However, it is suggested to keep the gastric band as patients weight may rebound after removal.

6. Will there be any discomfort after laparoscopic gastric banding?

After the surgery, patients may experience nausea, vomiting and difficulty breathing. Doctors can help relieve the discomfort by adjusting the gastric band.

7. Any points to note on diet before laparoscopic gastrectomy?

Patients can only have fluid diet two weeks before the surgery. No food is allowed the day before the surgery.

8. Is laparoscopic gastrectomy useful to diabetic patients?

Patients will experience early satiety as 70-80% of the stomach is removed in the surgery. Surgery results in significant changes in several gut hormones that helps to improve diabetic control.

9. Any points to note on diet after laparoscopic gastrectomy?

Patients can only have fluid diet on the first two weeks after the surgery in order to facilitate wound healing. Then patients can have puree diet. Normal diet can be resumed after one month.

10. Will there be any discomfort during eating after gastrectomy?

There may be reflux of gastric juice but it can be avoided by controlling the amount of food intake.

11. How long does laparoscopic gastric plication take? Do I need to be hospitalized for a long time? Any points to note after surgery?

Laparoscopic gastric plication usually takes about one and half to two hours. Patients can walk around on the day of the surgery. Generally patients will stay in hospital for 3-4 days after the surgery. Patients can only have fluid diet on the first two weeks after the surgery. Then patients can have puree diet. Normal diet can be resumed after one month.

12. Is laparoscopic gastric plication effective?

Laparoscopic gastric plication ALONE is relatively less effective than other surgeries as the part controlling hormonal secretion is unaffected. Thus there is no effect on appetite control. Therefore, patients need to restrict their diet and maintain a healthy lifestyle in order to avoid further weight gain. This procedure is usually combined with gastric banding to achieve longer term weight loss. Studies have shown that laparoscopic gastric plication alone results in weight regain after 2 years.

13. Which bariatric surgery is the best and the most effective?

Gastric bypass is the gold standard treatment for obesity. Its success rate in diabetic treatment is over 80%, which is also effective on hypertension, high blood cholesterol and sleep apnea. Patients have a short recovery period which only need to stay in hospital for 4-5 days. This surgery reduces stomach volume and reconnect the stomach to the small intestine, bypassing the duodenum to minimize intestinal absorption and induces changes in gut hormones that is essential in diabetic control.

14. What is the range of BMI indicated for gastric bypass? Does it require general anesthesia?

Laparoscopic gastric bypass is indicated for patients with BMI over 40 and it requires general anesthesia.

15. Besides weight loss, is there any other benefits of laparoscopic gastric bypass?

Laparoscopic gastric bypass has by far the best result amongst the most commonly performed laparoscopic bariatric surgeries. This surgery affects hormones which is effective in diabetes management. About 80-90% of diabetic patients is expected to be in remission after this surgery, as well as hypertension, hyperlipidemia and sleep apnea.

16. Does laparoscopic gastric bypass requires a long period hospitalization? Do patients need to rely on medications in the long term?

Patients can be mobilized after the surgery, with 4-5 days of hospital stay. Long term medication and vitamin supplement are required as the surgery affects absorption. So the patients are prone to vitamin deficiency and anemia, which require regular follow-up in order to avoid anemia and malnutrition.

17. Any diet modification after laparoscopic gastric bypass?

Patients can only have fluid diet on the first two weeks after the surgery in order to facilitate wound healing. Then patients can have puree diet. Normal diet can be resumed after one month.

18. If I want to lose weight but I don’t want any invasive / irreversible surgery, is there any alternative treatments for me?

These patients may opt for gastric balloon. A gastric balloon filled with saline will be placed inside the stomach to reduce stomach volume, and thereby reduces intake and induces early satiety.

19. How long does the placement of gastric balloon take?

Gastric balloon is only a temporary treatment as the balloon cannot be placed for more than 6 months. The longer it is place, the greater the chance it may cause serious complications.

20. What is the difference between bariatric surgery and liposuction?

Although liposuction can give an immediate weight loss effect, this cannot solve the underlying problem of obesity as it only takes away the subcutaneous fat but not altering patients’ eating habit and body functions. It is difficult to maintain the effect of treatment due to patients’ eating habit. On the other hand, bariatric surgery results in a much more complex effects to your gut system. The effect is more long lasting with the help of diet control and regular exercises.