December 19, 2023

From fertility to appearance, we answer women’s biggest questions from surgical weight-loss consultations.

About 80% of surgical weight loss patients are women. This is often a complicated battle against genetics and metabolism. Bariatric surgery is a tool that allows people the weight-loss success they weren’t able to achieve before, but surgery can be an intimidating thought.

Anyone considering the surgery should talk through their questions with their doctor when deciding whether to undergo this procedure. Here are common questions women have at the Vanderbilt Surgical Weight Loss Program that are wise to discuss:

Are people typically happy with the procedure?

A year after the procedure, often patients say they wish they had the surgery sooner. Many women get off medications for conditions like type 2 diabetes and hypertension.

Will surgical weight loss affect fertility?

Bariatric surgery has the potential to restore fertility. Menstrual cycles and fertility can be affected by polycystic ovarian disease. For women who did not have normal cycles before surgery, up to 70% of them will develop normal cycles after surgery.

To avoid nutrient deficiencies and other concerns, the surgical team at Vanderbilt typically recommends waiting 12 to 18 months after the procedure before trying to get pregnant. This waiting time allows the body to adapt.

The good news is, after surgery, pregnancy risks associated with obesity tend to decrease. Gestational diabetes, preeclampsia, preterm labor or having a baby that is either too small or too large for its gestational age are all risks that go down with weight loss.

How will surgical weight loss affect other conditions?

Bariatric surgery can ease or eliminate other symptoms of polycystic ovarian disease as well, such as excess facial hair and thickening of the skin. Bariatric surgery is not cosmetic; it is a treatment for obesity-related comorbidities (other illnesses or conditions that tend to happen with obesity).

Another condition that often improves with weight loss surgery is type 2 diabetes. Some people eliminate their type 2 diabetes; and some are better able to control their blood sugar using fewer medications after bariatric surgery.

Medications that patients will typically remain on long-term, however, include those for depression and anxiety. Surgery can be stressful, so doctors do not recommend stopping those types of medications during or after a procedure.

How will weight loss surgery alter appearance?

Weight loss will change one’s body shape, and some women have concerns about where the weight will come off. Doctors can’t predict where inches will be lost, but the excess fat tends to shed fairly uniformly from all over the body.

Sagging skin is another concern, but each person’s situation is unique. Some women choose to undergo plastic surgery after losing weight, while others don’t experience sagging skin or aren’t bothered by it. Some bariatric surgery patients also experience thinning hair, a common phenomenon called telogen effluvium. The hair thins and falls out after a stressful situation, in this case a surgery, but if patients take in enough protein, vitamins and minerals, the hair loss reverses.  

What are the risks associated with surgical weight loss?

Some people fear complications and death from surgery, even while having a strong desire to be healthier. The risk of death with the surgery is the same as for gallbladder surgery; it’s very small. There are risks with with any surgery, and risks that come with obesity also. Statistically, someone’s chance of dying from any cause goes up about 10% for every five Body Mass Index points above normal weight (a BMI below 25). Thus, having a BMI of 40 or 45 carries a greater risk of death than having weight loss surgery.

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Advanced care for weight loss

The Vanderbilt Surgical Weight Loss program offers advanced care to help you lose weight and improve your overall health. If you’ve been unable to reach a healthy weight with nutritional and lifestyle improvements alone, surgery might be a better and safer option for achieving your weight loss goals. The team will work with you to develop a personalized care plan combining surgery, nutrition, exercise and psychological support.


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