Surgical Weight Loss FAQs

Here at JSAPA, we offer the most advanced and effective Bariatric Surgery and Weight Loss Procedures in West Palm Beach. We know that losing weight is not as simple as eating less and exercising more. The 3-5 year success rates of conventional bariatric surgery are dismal, and Dr. Cywes desires more for his patients. When patients follow our unique approach the success rates have been incredible 5, 10, and even 15 years after the initial consultation. Dr. Cywes has had over 800,000 success stories. Below are answers to our patient’s frequently asked questions.

How much weight will I lose?

The amount of weight you may lose depends on several factors. The type of procedure or surgery: patients tend to lose most weight after Sleeve Gastrectomy, then LapBand, then intragastric balloons. It really depends on how much weight you need to lose. The most important criteria that determines not only the amount of weight you lose, but also keeping it off, is regular follow-up visits to the office to keep you on track.

You should lose weight rapidly at first then more gradually toward your goal weight. Weight loss of 2 to 3 pounds per week in the first year after surgery is possible, but one pound a week is more likely. Twelve to 18 months after the operation, weekly weight loss is usually less. Remember that your main goal is to have a weight loss that prevents, improves, or resolves health problems connected with severe obesity. One final point: It is important that you ask your surgeon all the questions you have about your surgery so that you are fully informed and have realistic expectations.

Return to top

Will I need plastic surgery for the surplus skin when I have lost a lot of weight?

That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after weight loss surgery. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery.

Return to top

Will I be sick a lot after the operation?

The surgeries all limits food intake. If you feel nauseated or sick on a regular basis, it may mean you are not chewing your food well. It could also mean you are not following the diet rules properly. Another reason you may get sick is if there is a problem with the the surgery. Never assume. Let your surgeon check and make sure all is well. So you should contact your doctor. Gallstones and stomach ulcers are also more common in obese people and they may be causing your symptoms. Vomiting should be avoided as much as possible. It may lead to slippage of part of the stomach through a LapBand. In some cases, it may require another operation.

Return to top

What about alcohol?


An alcoholic drink here and there is an excellent way to dissipate emotional distress and relax from time to time.

  • TIGHT CONTROL – no more than 1 or 2 per day. Disinhibition=permission=mistakes
  • BEER AND RED WINE ARE BEST –South African wine is BEST (shameless plug)
  • DON’T WORRY ABOUT THE CARB CONTENT OF BEER OR WINE – you are drinking it for the taste and alcohol value not the sugar value (Rule 1 applies).
  • NO CARB MIXERS FOR SPIRITS – use diet soda or crystal light with water/soda water as a mixer
  • DON’T DRINK ALONE if possible
  • DRINK OCCASIONALLY not every day
  • DON’T SNACK if you are having a drink
  • If you get drunk or drink to the point it’s not safe to drive BE ABSTINENT FOR 30 DAYS
  • You have an ADDICTIVE PERSONALITY. Do not do a drug transfer from CARBS TO ALCOHOL
  • If there is a cautionary voice in the back of your head, if it’s not PLEASURABLE or you have REGRETS – DON’T DRINK

Return to top

What if I go out to eat?

Order only a small amount of food, such as an appetizer. Underorder so that you do not overeat. Eat slowly. The restaurant is unlikely to run out of food while you are there – you can always order more. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.

Return to top

Will I suffer from constipation?

Constipation is NOT defined by how much or how often, it is defined by consistency – round hard painful stools=constipation. Expect to have smaller and fewer bowel movements. Less in = less out. That’s normal after a decrease in food intake. If difficulties do arise, check with your doctor. The best medication remedies are Magnesium Citrate 2 bottles to get you going and Miralax daily to keep the consistency soft.

Will I need to take vitamin supplements? All obese people are somewhat malnourished by definition. At your regular visits after surgery, your doctor will evaluate whether you are getting enough vitamin B12, folic acid, and iron and may advise you to take supplements.

Return to top

What about other medication?

You should be able to take prescribed medication. You may need to use capsules or break big tablets in half or dissolve them in water so they do not get stuck in the stomach pouch and make you sick. You should always ask the doctor who prescribes the drugs about this and if unclear you should contact your surgeon.

Return to top

Can surgery be revised or changed?

Although bariatric surgeries are not meant to be changed, they can be. In most cases this can be done laparoscopically. Indications and options should be discussed with your surgeon. Intragastric balloons are temporary by designed and should be removed after their intended time in your stomach to avoid complications.

Return to top

Will I need other surgeries?

We do not routinely remove the gall bladder since the incidence of gallstones is significantly lower than after malabsorption-type bariatric surgery (stomach stapling techniques). However, some patients with pre-existing gallstones may require cholecystectomy which we may perform at the same time as your bariatric surgery. We routinely repair hiatal hernias in all patients at the time of bariaitrc surgery to reduce the risk of reflux and stomach dilation.

Return to top

How is the LaBand adjusted?

Adjustments are done in the surgeon’s office under C-arm video x-ray visualization. A fine needle is passed through the skin into the reservoir to add or subtract saline. This process most often takes only a few minutes. Most patients say it is nearly painless.

Return to top

What about pregnancy?

Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular and PCOS (polycystic ovarian syndrome) improves or goes into remission. We recommend birth control until you PLAN to get pregnant. 12% of our fertile female patients have unplanned pregnancies in the first year after weight loss surgery.

Return to top