Metabolic & Bariatric Surgery
Metabolic and bariatric surgery is also known as weight loss surgery treats obesity, diabetes, high blood pressure, sleep apnea and high cholesterol, and other diseases by making changes to the digestive system.
What to expect
Bariatric surgery is a great tool to help you reach your goal. However, you still need to make significant lifestyle changes to be successful in your efforts to lose weight and keep it off. Our team will help you work toward those sustainable changes before the surgery and will follow you up to 2 years after surgery to address any nutritional deficiencies and to support you through your journey.
Download the Richmond Metabolic & Bariatric surgery manual
The rate of weight loss depends on several factors, including your baseline weight, the weight that has been lost thus far, the type of surgery, activity, hydration and diet. Each person's weight loss pattern is different. If you lose weight too quickly, you are at risk for muscle loss, hair loss, and nutritional deficiencies.
On average, weight loss will continue for 12 to 18 months after surgery. The expected excess weight loss goal for each surgical procedure ranges from 55 to 80%, more specifically:
- 50-60% for sleeve gastrectomy (VSG)
- 60-70% for gastric bypass (RNY)
- 70-80% for single anastomosis dudeno-ileal bypass with sleeve gastrectomy (SADI-S)
- 80% for biliopancreatic diversion – duodenal switch with sleeve gastrectomy (BPD-DS)
Once you have reached your lowest weight after surgery, it is normal to regain some weight. Most people's weight will stabilize at about 10% higher than their lowest post-surgery weight.
It is normal to experience weight plateaus where your weight may not change for a few weeks. During this time, your body adjusts to the amount of food and exercise. Continue to follow your nutritional guidelines and exercise routine to facilitate weight loss.
For 70-80% of patients, most weight loss is maintained for many years. However, up to 30% of patients will regain the weight. As with other methods of managing weight, weight loss will not be permanent without lifestyle changes. You will likely regain weight if you do not maintain healthy eating habits, exercise regularly, monitor your intake and manage stress.
Watch this video on how long it takes to recover by Dr. Yorke
Frequently Asked Questions
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Is bariatric surgery right for me?
If you're considering weight-loss surgery, you'll meet with specialists to help you decide if weight-loss surgery is an option for you.
When other methods have not succeeded
Many patients with obesity have tried to treat this on their own, with diet and exercise. Many have had some success, only to have weight regain. More often, patients have little to no success with diet and exercise alone. This is not a result of a lack of willpower or the wrong diet. When a patient has a body mass index (BMI) greater than 35, their chances of reaching a normal body weight for a lasting period is less than 1%. That's why surgery is an option for patients with severe obesity.
If non-surgical methods for treating obesity have not succeeded, bariatric surgery could be considered. Before considering surgery, non-surgical means must have been tried and found to be ineffective in the long term. This may include weight loss medication, physical activity, dieting, and behavioural modification techniques. Surgery is an addition to treatment strategies, not a replacement.
To reduce health problems related to obesity
Morbid obesity is a severe health problem with high disease risk and death. Weight loss surgery does not just treat the disease of obesity, but it treats other conditions like diabetes, heart disease, high blood pressure, arthritis, and acid reflux. In addition, surgery dramatically reduces the risk of death from cancer, diabetes, heart disease, and other diseases. Learn more about risks related to severe obesity.
Benefits of weight loss (image)
Potential benefits are greater than the risks
Although bariatric surgery can provide benefits, as with any surgery, there are risks. Risks may vary from one patient to another. It is essential to discuss all your concerns with your bariatric surgeon and ensure they have all your health information to make the best decision. Your bariatric surgeon will explain all potential risks in your consultation.
Watch that video of common problems and complications after bariatric surgery.
Other considerations
It is not recommended to become pregnant within 18 months after surgery. This is a strict recommendation from the Obstetrical societies to ensure that >98% of women's weight has stabilized at that time point after bariatric surgery, thereby likely also achieving a balance of nutrition at the same time. Getting pregnant within 18 months of bariatric surgery can risk the healthy development of your baby as you are still losing weight during this period. Please refer to the RMBS Manual for further pregnancy and birth control details.
Non-Steroidal Anti-Inflammatory drugs (NSAIDs) must be avoided after bariatric surgery as they can damage the new stomach pouch or sleeve, which may result in gastric ulcers.
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Is there a cost for metabolic and bariatric surgery?
If you are a resident of British Columbia, the BC Medical Services Plan (MSP) covers the consultation and bariatric operations offered by our program.
If you had bariatric surgery elsewhere, please inquire about coverage through your family physician.
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What is the intake process for metabolic and bariatric surgery?
You will be required to participate in an assessment to determine if surgery is the right option for you. It is essential to take time to work on lifestyle changes and determine if surgery is the correct step for you. At any point, you may opt out of the program if you decide surgery is unsuitable for you.
The assessment process consists of several appointments with our multi-disciplinary team. You are encouraged to ask questions and learn as much about surgery as possible.
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Attend orientation.
This session will inform the patient about the RMBS program, eligibility criteria, surgeries offered through RMBS, the multidisciplinary team and their roles, and the impact of bariatric surgery on lifestyle and program expectations in terms of nutrition, physical activity and stress management. -
Complete candidacy package
After orientation, the patient will have two weeks to confirm if he or she is still interested in proceeding with the program and will then need to consent to our contract if they wish to proceed. -
Pre-operative assessment
It is important to note that admission into the general orientation session and completing the candidacy package does not guarantee surgery. Beyond minimal NIH criteria, to qualify for bariatric surgery, surgical time must be available, the patient must be physically and medically fit for surgery, and complete all necessary investigations. The patient must also demonstrate to the multidisciplinary team that they are compliant and competent with sustainable lifestyle changes (problem-solving around nutritional, activity, and mental health challenges). Surgery times vary by person, and patients cannot expect a surgery date within a pre-determined time. -
Schedule surgery
Once cleared by our team (including the bariatric surgeon), surgery arrangements are made.If you are scheduled for surgery, you must watch the nutrition for bariatric surgery presentation beforehand, which will be reviewed with your RD at your mandatory pre-surgery appointment.
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Post-surgery support
The patient will be followed for up to 2 years by our multidisciplinary team following surgery to support successful outcomes . However, patients referred to our program from medical weight management programs may return to their referring physicians sooner.
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Attend orientation.
The four types of bariatric surgeries
We offer four types of bariatric surgeries: VSG, RNY, BPD-DS and SADI-S. Learn more about the different types of bariatric surgeries performed at Richmond Metabolic and Bariatric Surgery Clinic.
Contact
Richmond Metabolic and Bariatric Surgery Clinic
Unit 120 – 6091 Gilbert Road, Richmond, B.C. V7C 5L9
Phone: 604-675-3505
Fax: 604-279-1784
Before you inquire about the waitlist, find out when your family physician submitted your referral.
- If it's been under 2.5 years, do NOT call our clinic about your referral, as this is the current waitlist length of time.
- If it's been over 2.5 years, you may call us at 604-273-4447, extension 8, to inquire about your referral.
Our staff are busy, so calling the clinic will disrupt their work. The best way to get the answer is to contact the physician who sent the referral and wait for our phone call. Please note that the bariatric surgeon's office stamps the referral and sends it back to where it came from as confirmation that it was received.
Choose a location below to learn how to access this service.
Preparing for surgery
Remember, bariatric surgery is just a tool and durable lifestyle modifications are necessary for long-term success. Take advantage of this time to optimize your health and make the lifestyle changes necessary to achieve and sustain weight loss after surgery.
Post-surgery information
Information about nutrition after your surgery.