Frequently Asked Questions

Surgery Questions

Life After Surgery

Nutrition, Food & Eating After Surgery

General Questions

  • What is Body Mass Index?

    It is an estimate of your total body fat. BMI is calculated by dividing your weight (in kilograms) by the square of your height (in meters). To calculate your BMI, click here

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  • How is obesity defined?

    According to the National Institutes of Health, anyone with a Body Mass Index of 25 (BMI) or above is considered overweight. A BMI of 30 or higher indicates obesity.

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  • What are the primary risks related to or associated with obesity?

    According to the CDC, obesity-related risks include three diseases that are the leading killers of Americans: heart disease, cancer, and cerebrovascular conditions, including stroke. Obesity also contributes to diabetes, the sixth-leading cause of death in America. In addition, occurrences of sleep apnea – known as the silent killer – significantly increase with excess weight.

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  • Who is The Davis Clinic?

    The Davis Clinic is Houston’s premier weight management clinic, where highly skilled and experienced bariatric surgeons, dietitians, bariatricians, psychologists, and exercise psychologists, along with a team of licensed, certified healthcare professionals, provide surgical and non-surgical treatment for the disease of obesity. At The Davis Clinic, we have literally treated thousands of individuals struggling with their weight, just like you. Our team is dedicated to providing you with the most effective medically-supervised treatments for obesity and weight management available today. We perform gastric bypass, sleeve gastrectomy, and revision surgery for prior bariatric procedures that have either failed mechanically or which may be causing health issues for individuals. Because weight loss is all we do, we’re experts in this area of health management. Regular diets don’t work and lead to failure over and over again. At The Davis Clinic, expect success.

    In addition to highly-qualified surgeons, The Davis Clinic employs specially-trained medical and nursing staff, certified bariatric nurses, allied health, and American Society for Metabolic and Bariatric Surgery (ASMBS) affiliate associate professionals, all with a heart to help those that suffer from the disease of obesity. Because we’re passionate about what we do, we hire people that are passionate, too. The Davis Clinic employs members of the ASMBS, National Association of Bariatric Nurses (NABN), Bariatric RN Credentialing Task Force, past members of the ASMBS Foundation’s National Advisory Board, members of WLS Lifestyles magazine Editorial Advisory Board and the ASMBS Foundation’s Walk from Obesity former National Chair and National Vice-Chair.

    We provide a compassionate, understanding environment for those suffering from obesity or dealing with excess weight, and we rejoice in every success story in which we have the privilege to participate.

    Every one of our employees is committed to helping make your journey a safe, easy and effective one.

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  • Why choose The Davis Clinic?

    The Davis Clinic is the premier, comprehensive weight management program in Houston, Texas. We cater not only to the needs of Houstonians, but our reputation for weight loss success brings patients from all over the United States, Mexico, Canada, and as far away as Dubai, and even Vietnam. We’re leaders in the field of weight loss for good reason:

    • Our highly-skilled bariatric surgeons who are among some of the most experienced bariatric surgeons in the nation;
    • Every hospital facility where we perform surgery is designated as a bariatric Center of Excellence, which means that they are specially designed and equipped to meet the specific needs of weight loss surgery patients;
    • Our bariatrician is recognized as a leader nationally in non-surgical weight management;
    • Our licensed, certified healthcare professionals and staff are specially trained in caring for the physical and emotional needs of overweight individuals;
    • We provide compassionate care and understanding in caring for individuals struggling with excess weight;
    • The myDavisClinicSM aftercare and support programs will prepare you for long-term success by providing you with the tools, resources, and education you need to maintain a healthy weight for life
    • Our comprehensive program includes on-site dietitian, psychologist, exercise physiology, behavior modification classes, vitamin & mineral education and therapy;
    • Commitment to long-term follow-up care of every patient.

     

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  • How do I know if I qualify for weight loss surgery?

    To be eligible, you must have a BMI of 40 or greater without co-morbidities, or a BMI between 35 and 40 with at least one co-existing co-morbidity related to obesity (these must be sleep apnea, type 2 diabetes, hypertension or coronary artery disease). In addition, you must show that you have seriously tried to lose weight in the past; have no physical, mental or other problems that would make surgery unnecessarily risky; and be able to participate in your treatment and lifetime follow-up care.

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  • How old do I have to be to have weight loss surgery?

    We recommend patients should be at least 18. This is primarily because younger patients may not have matured physically to the point that their body can handle the procedure or emotionally to the point that they can make a decision this important. We see adolescent patients on a case-by-case basis.

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  • Is there an age limit?

    For our program, we will evaluate patients for weight loss surgery up to the age of 70. This is on a case-by-case basis, and evaluation does not imply that the surgeon will recommend surgery.

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  • Can weight loss surgery help me live longer?

    Yes. On average, studies show that weight loss surgery increases life expectancy up to 6.5 years. By comparison, heart bypass surgery increases life expectancy by about 3.5 years.

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  • How might weight loss affect or improve my current medical problems?

    With even minimal weight loss, many medical problems may be improved. Serious medical problems such as hypertension, type 2 diabetes (adult onset) and sleep apnea may be improved or, in many cases, completely resolved. It is not necessary to lose all of your excess weight in order to achieve improvement with many of these medical conditions. The physicians at The Davis Clinic will consider your individual medical issues and will discuss how weight loss may positively impact your existing weight-related medical problems.

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  • How much weight should I expect to lose with weight loss surgery? What if I choose to go the non-surgical route for weight loss?

    Weight-loss varies from person to person and the amount of weight you lose depends on several factors. You will need to be committed to your new, healthier lifestyle and eating habits. Obesity surgery is not a miracle cure. It is not uncommon for individuals that undergo weight loss surgery to lose 100 pounds or more within the first six to seven months after their procedure. The type of procedure, your starting weight, co-morbid conditions, age, and commitment to eating right and exercising will all play a part in how much weight you will lose after surgery. For individuals that choose a non-surgical treatment, a weight loss of one to five pounds a week should be expected. Again, your personal commitment to success will be a huge determining factor in how much weight you lose. It is very important to work with your physician to set achievable weight-loss goals from the beginning.

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  • Why do I need a psychological evaluation before surgery?

    There are three reasons you will undergo a psychological evaluation. Firstly, you will undergo a psychological because an evaluation is required by our program and may be required by your insurance company in order to receive approval for surgery. Secondly, we need to assess how well you understand the surgery and its risks, and whether you have the ability to make the life-long commitment required to maintain good health. Thirdly, undergoing a psychological evaluation will help identify whether or not there are any underlying issues that would affect your success after surgery, such as purging, binging, or other addictive behaviors. Working with our team will allow you the greatest opportunity for success.

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  • Does weight loss surgery require frequent visits with my surgeon after surgery?

    Follow-up care with your surgeon is very important after any weight loss surgery. At The Davis Clinic, we see our patients within two weeks after surgery, and then again within two months after surgery. We see patients every four to 12 weeks thereafter for the first year after surgery, depending on the procedure. Check with your surgeon as to the specifics of your follow-up schedule. It is imperative that we draw labs and monitor your protein, vitamin and mineral intake on a regular basis. All patients are followed annually for a minimum of five years, but we encourage all of our patients to follow up with us annually for life. Working closely with your surgeon and our team at The Davis Clinic will help ensure your weight-loss success and will greatly reduce risks and complications.

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  • Do you have live support group meetings? Are patients of other surgeons allowed to attend?

    We offer monthly live support group meetings and encourage our patients to attend, as studies show that patients that actively attend support group meetings and stay plugged in, achieve long-term success. Our support groups are a “safe place” for you and we recommend you begin attending right away – even before you’ve had your surgery – so that you can get a true picture of what lies ahead. Through myDavisClinicSM, you’ll be able to remain plugged in online with an amazing community of people just like you, who can offer support, encouragement, and practical advice. Changing behavior is not easy and we’re sensitive to this fact. At The Davis Clinic, you will receive the tools you will need to help you modify your behavior. At many support group meetings, you will be sent home with “homework” designed to assist you in facing the issues that may contribute to your obesity. In addition, our support group schedule includes guest speakers such as plastic surgeons, our psychologist, our dietitian, our surgeons, and more! Our support group calendar is updated frequently, as we continue to add new classes. Click here to access the current PDF file of our support group meetings. Many of our patients like to hang the support group schedule on their refrigerator as a reminder.

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  • Does weight loss surgery limit any physical activity?

    You must follow the instructions of your surgeon regarding return to normal activity. Generally speaking, after you have been released from your recovery period by your surgeon, your weight loss procedure will not hamper or restrict any physical activity, including swimming, aerobics, stretching, strenuous exercise or activities normally associated with work, such as lifting and climbing. Before returning to normal activities, you will need to be cleared by your surgeon. A normal recovery period will last anywhere from two to six weeks.

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  • How much does the surgery cost if my insurance will not pay for it, or if I do not have health insurance coverage?

    At The Davis Clinic, the first step is to verify whether or not you have benefits for weight-loss surgery through your health insurance policy. Our insurance specialists are experts with bariatric insurance verification, pre-certification, and approval. If you have an exclusion on your health insurance policy, meaning there are no benefits available for bariatric surgery, we will be happy to speak with you in our office during your consultation about the options available to you if you decide to self pay. Costs vary based on procedure and hospital location.

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  • Are there any tax deduction benefits for medical treatment of obesity?

    The IRS has recognized obesity as a disease; therefore, some medical expenses may qualify as a tax deduction. You should consult with a licensed accounting professional to see if any of your expenses qualify for a medical tax deduction. We have included specific information about IRS guidelines in our “Paying for Your Surgery” section.

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  • With what insurance providers is The Davis Clinic contracted?

    We are contracted with the following insurance providers.  This list is up-to-date as of 12/01/10.

    • Aetna HMO, PPO, POS, EPO
    • Beech Street PPO
    • Blue Cross Blue Shield of Texas PPO, POS
    • CIGNA
    • ChampVA -Tricare Standard
    • Galaxy Health Network
    • GEHA
    • Guardian
    • HealthSmart PPO
    • HHPO
    • Humana Choicecare PPO
    • Medicare - Traditional (contracted for Medicare Texas patients only)
    • Memorial Hermann Healthnet Providers
    • Multiplan 
    • Pacificare PPO
    • PHCS
    • Texas Municipal League
    • Texas True Choice
    • Trisurant
    • UMR
    • Unicare HMO, PPO
    • United Healthcare

     

     

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Surgery Questions

  • What are some potential complications of weight loss surgery?

    Possible complications include, but are not limited to, gallstones, liver problems, hernia, pouch leak, intestinal blockage, deep vein thrombosis (DVT), pulmonary embolus (PE), and other risks typically associated with any surgery.

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  • Will I have to undergo any medical testing prior to surgery or joining the non-surgical weight loss program?

    Whether or not you have to undergo any medical testing will depend on your health history, your current co-morbid conditions, and other indications of risk. Your surgeon or bariatrician will discuss any necessary tests required during your consultation.

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  • Will I be required to lose weight before having weight loss surgery?

    For individuals with a body mass index (BMI) greater than 55, weight loss prior to surgery may be required in order to perform surgery more safely. If this is the case with you, our bariatric dietitian will work with you one-on-one to establish a program for weight loss success.

    In addition, all patients go on a two-week pre-operative high protein, low carbohydrate diet, as obese individuals tend to have enlarged, fatty livers. All weight loss surgery procedures require surgical access to specific areas of the abdomen, and access to these areas may be compromised if a patient has an enlarged, fatty liver. Putting patients on our two-week protein shake meal replacement regimen allows the liver to shrink, making surgery easier to be performed, and ultimately safer for you.

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  • Are staples used in surgery, and if so, what kind are used in the surgery?

    With gastric bypass and sleeve gastrectomy, staples are used. They are made of stainless steel or titanium, and are very small.

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  • Will the staples set off metal detectors?

    No.

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  • How big will my stomach pouch be after surgery?

    For bypass patients, the pouch will hold about one ounce of food after surgery.

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  • How long will my weight loss procedure take?

    Gastric bypass is generally performed in 45 to 90 minutes, and sleeve gastrectomy is generally performed in an hour. Revision surgeries require more time and generally run two to three hours, depending on existing scar tissue and other findings within the abdomen.

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  • Will I be able to drive myself home after surgery?

    No. We do not allow patients to go home in taxis, buses, or any other form of public transportation. You will be required to have a responsible adult (at least 18 years of age) accompany you on the day of surgery and upon your discharge.

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  • Does weight loss surgery hurt?

    All weight loss surgery is performed under general anesthesia and your anesthesiology team and nursing staff will make sure you are kept comfortable during surgery and throughout your recovery while in the hospital. Everyone’s goal is that you experience as little pain as possible, but surgery does involve some inherent pain. We will send you home with a prescription for pain, but most patients report very little to no pain after laparoscopic surgery. You may experience discomfort from the gas (CO2) used to insufflate your belly for the procedure, and walking will help eliminate this gas from your abdominal cavity.

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  • Do men and women respond differently to the surgery?

    Both respond well, though men tend to lose weight faster than women. We encourage our patients not to compare their weight loss with the weight loss of others, because each person’s journey is unique and factors such as age, medical history, co-morbid and pre-existing conditions, and other factors all play a part in the rate at which individuals lose weight. The key to successful weight loss is to stay the course, follow your specific program instructions, make healthy food choices, take your vitamins and minerals, eat sufficient protein daily, drink plenty of fluids, and exercise.

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  • How long do I have to stay in the hospital?

    Most patients are discharged home one to three days after surgery.

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Life After Surgery

  • Why is it important to walk after surgery?

    The most serious life-threatening complication that can occur after surgery in a morbidly obese individual is in developing deep vein thrombosis (DVT) or blood clot, which can lead to a pulmonary embolism (PE, a sudden blockage in a lung artery). A clot can form in the leg and travel to the lung, resulting in death. During surgery, you will be prepped with special compression devices on your feet and lower legs that will help with circulation so that blood is not as likely to pool in your extremities. These compression devices will remain on your feet and legs after surgery and you will be required to keep them on during your hospital stay any time you are not up and walking.

    Because keeping your circulation moving is so important after surgery, you will be required to get up and walk shortly after surgery. In addition, you’ll be required to walk every hour during waking hours while in the hospital and at home, so that your risk of developing a blood clot is reduced. While it will be uncomfortable to push yourself to walk at first, it is vitally important to minimizing your risk of this severe complication.

    Signs and symptoms of a PE include unexplained shortness of breath, chest pain, anxiety, and coughing. Signs and symptoms of a DVT include swelling in the leg, pain or tenderness in the leg, increased warmth in the area of the leg, and red or discolored skin on the affected leg. If you experience any of these signs and symptoms while in the hospital, notify your nurse immediately. If you experience any of these signs and symptoms while at home, you should call 911 and seek immediate medical attention.

    We take this risk extremely seriously and expect you to walk regularly for many months after surgery to reduce your risk of this complication.

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  • When can I return to work?

    Most people return to work within 7 to 14 days after weight loss surgery.

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  • When can I return to my normal activities?

    Your surgeon will determine when it is okay for you to return to your normal activities, but most people return to their normal activities within 14 days to six weeks after surgery. You will not be permitted to lift anything over 10 pounds for the first four to six weeks after surgery.

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  • What kind of exercise regimen should I follow after surgery?

    Exercise is an important part of your recovery. Patients begin walking the day of their procedure – they walk a little more the next day, a little more the day after that, and so on. As you get stronger, you should aim to reach 30 to 60 minutes of aerobic exercise every day.

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  • Can I take medications after weight loss surgery?

    At first, your doctor may recommend taking pills in liquid or crushed form. After the first four weeks, most pills and capsules should easily pass through the stomach pouch. With a gastric bypass, you should not take extended release medications after your procedure. It is important that you work with your primary care physician to adjust your medications after weight loss surgery, including medications for diabetes, as many patients are able to leave the hospital on very little to no diabetes medications. In addition, hypertension medication will need to be adjusted frequently with rapid weight loss.

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  • Are there any limitations on the medicines I can take?

    In general, diuretics and some over-the-counter medications should be avoided. Some over-the-counter medications can cause ulcers in the small stomach and should be avoided (ibuprofen, Advil, Aleve, Motrin). We recommend Extra Strength Tylenol® for general aches and pains. Always consult with your bariatric surgeon about the medications you are taking or wish to begin taking.

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  • When can I resume sexual activity?

    You may resume sexual activity when you feel that you are able to do so.

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  • Can I continue to smoke after obesity surgery?

    No. Smoking increases the potential for lung problems before surgery, stalls the healing process, promotes infection and interferes with the blood flow to tissues that are healing. In addition, smoking significantly increases your chances for developing ulcers.

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  • Should I worry about losing too much weight?

    No; however, if you are concerned about your weight loss, talk with your bariatric surgeon or our dietitian.

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  • Will I lose my hair after surgery?

    Some patients experience thinning of the hair, typically in the first four to eight months after surgery. In most cases, it comes back naturally. You can help prevent hair loss by getting enough protein with meals and by drinking sufficient fluids during the day. You should consume 80 grams of protein daily, and 64 oz. of non-carbonated, sugar-free, decaffeinated liquids daily.

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  • When can I start driving again?

    You should wait to start driving until your doctor clears you. Usually you’ll be able to drive again one week after surgery. You may not drive as long as you are on prescription pain medication.

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  • Can I try to get pregnant after weight loss surgery?

    Many of our patients have weight loss surgery because of infertility issues. Because estrogen is released in fat cells, losing excess weight allows many women to become fertile and achieve pregnancy. To ensure you maximize your weight loss and that you have a healthy pregnancy, we want you to wait at least 18 months after weight loss surgery before trying to conceive. During this time period, we strongly recommend that you use two forms of birth control to avoid becoming pregnant. Weight-loss during pregnancy can be dangerous to the health of your developing baby. Once your bariatric surgeon has agreed that you are healthy enough to carry a pregnancy to term and that your weight loss has stabilized, you may begin trying to conceive.

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  • Will I need plastic surgery for the removal of excess skin after I have lost a significant amount of weight?

    Every person’s body is different. Skin elasticity is based on many factors including genetics, age, whether or not you have carried a pregnancy (or multiple pregnancies), whether or not you have ever smoked, and your overall general level of health. As a general rule, plastic surgery should not be considered for at least 18 months after your weight loss surgery so that you give your body time to settle in to its new shape and you maximize your weight loss. To maximize the benefits of plastic surgery, we recommend that you be within ten pounds of your ideal body weight and your weight has stabilized for at least six months.

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Nutrition, Food & Eating After Surgery