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Weight Loss Surgery in Hawaii

If you have more than 100 pounds to lose, weight loss surgery may be the right fit for your needs.

Our team at the Queen’s Comprehensive Weight Management Program is here to help you determine which weight loss option will work best for you.

Weight loss surgery, also called bariatric surgery, is often the best option when diet and exercise have not worked for you, if you have serious weight-related health problems, or if your body mass index (BMI) is 40 or more.

Carrying 100 pounds of extra weight or more can cause serious health problems from Type 2 Diabetes to hardened arteries to cancer.

Bariatric surgery changes your digestive system and helps you lose weight by reducing the amount you can eat and (for certain weight loss surgeries) how many calories you can absorb.

If you meet the criteria for surgical weight loss, Queen’s team of bariatric physicians and weight loss professionals will work to determine the best weight loss surgery for you.

Click here to begin your weight loss journey.

Frank Gouveia Jr. Success Story

“When I was overweight, I felt like my world was collapsing. I felt like I had no control. I knew if I didn’t do anything, I may not be on this earth in three years. Surgery is a tool you can use. Today, my sleep apnea is gone. And my heart, which was working at only 25 percent capacity before, is now at 90 percent. When I was big, I never smiled or talked to others because I was ashamed of myself. Now I say ‘good morning’ and ‘good afternoon’ and people start talking with me.”

Frank Before and After Gastric Bypass Surgery

Types of Weight Loss Surgery at The Queen’s Health System

You may know that stomach surgery for weight loss restricts the amount of food you can eat. But not all surgeries for weight loss are the same. Our team of specialists recommends different surgical procedures based on your current weight and health, among other important factors.

Queen’s Comprehensive Weight Management Program offers the following types of surgical weight loss procedures:

  • Gastric Bypass Surgery
  • Sleeve Gastrectomy
  • Adjustable Gastric Band

Keep reading to learn more about each surgery.

With Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) surgery, doctors create a small pouch (roughly the size of a golf ball) in your stomach so food bypasses most of your stomach and part of your small intestine.

This surgery restricts the amount of food you can eat and how many calories your intestines can absorb.

After Gastric Bypass surgery, you can expect to lose 50-80% of your excess body weight (or about 30-35% of your total weight).

Long considered the “Gold Standard” in bariatric weight loss surgery, gastric bypass is sometimes referred to as the “surgical cure” for Type 2 diabetes because it is one of the best and most common ways to surgically treat comorbidities related to obesity.

This is not to say that gastric bypass is for everyone. With any weight loss surgery, you will undergo a screening to determine what medical intervention is right for you.

Laparoscopic Adjustable Gastric Band procedures place an adjustable band around the upper portion of your stomach.

The Adjustable Gastric Band surgery restricts how much food you can consume at one time. Like Gastric Bypass surgery, it is intended as a standalone procedure for obesity.

Weight loss after the placement of an adjustable gastric band is typically between 40-50% of a patient’s excess body weight.

Gastric Band surgery is rarely performed at Queen’s due to its higher risk of complications compared to Gastric Bypass and Sleeve Gastrectomies. Gastric Bands also have the lowest predicted weight loss among Queen’s bariatric surgeries.

If you have a very high BMI, it is likely we would recommend another surgical method to maximize weight loss.

Laparoscopic Sleeve Gastrectomies involve removing a part of your stomach. With this surgery, bariatric physicians create a sleeve (or tube) in your stomach about the width of a garden hose.

Sleeve gastrectomies restrict the amount of food you are able to eat. This procedure can be done as a standalone surgery or as the first step for patients who are considered too high risk for other procedures.

After undergoing a sleeve gastrectomy patients can expect to lose 50-70% of their excess body weight.

With any weight loss surgeries, as a patient you must be willing to make significant lifestyle changes following any surgical weight loss procedure. Patients participate in aftercare programs and undergo regular medical evaluations to help them keep the weight off following surgery.

Weight Loss Surgery Requirements

Do you find yourself hopping back and forth between diets, or losing weight only to gain it again? Has your weight contributed to health problems? If you answered yes to either of those questions you may be a candidate for surgical weight loss.

Queen’s Comprehensive Weight Management Program assesses each individual patient to determine if they’re a candidate for weight loss surgery.

But as a general rule of thumb, you can calculate your Body Mass Index (BMI) to know if you might qualify for weight loss surgery.

Patients with a BMI of 40 or more, or those with a BMI of more than 35 with significant health problems, typically qualify for weight loss surgery.

For more information, see “Do I Qualify for Weight Loss Surgery?” below.

What to Expect from Bariatric Weight Loss Surgery

Our weight loss specialists will walk you through weight loss pre-surgery to make sure you are completely prepared for your procedure.

Pre-bariatric Surgery Evaluation and Education

Each patient in the Queen’s Weight Management Program will undergo an extensive medical, nutritional, and psychological evaluation by our team of professionals.

We will work closely with you to assist you in making the necessary lifestyle and behavioral changes to be successful in your weight loss surgery.

Initial Consultation: During your initial consultation you will meet with your medical provider, dietitian, and psychologist.

Nutritional Evaluation and Education: We will conduct a nutritional evaluation to assess your dietary knowledge and eating habits. Nutritional education teaches you to make healthier food choices to achieve a balanced diet.

Our program covers basic food groups, portion control, vitamin and nutritional supplements for after surgery, label reading, and your post-op diet.

Psychological Evaluation: Your psychological evaluation determines whether there are any psychological or social issues that would prevent you from being an appropriate surgical candidate.

During your evaluation, your psychologist will also assist you in gaining insight into your eating patterns and coping mechanisms, facilitating and reinforcing positive behavioral change.

Functional Assessment: Your medical provider will conduct a functional assessment to determine your ability to participate in an exercise program. When necessary, we will refer you to a physical therapist.

All patients must be able to walk 5,000 steps a day or perform an equivalent alternative exercise, such as water-based exercise, prior to weight loss surgery.

Pre-Op Treatment Plan: Your medical provider will oversee your pre-op treatment plan and medically supervised exercise program.

Your provider will work with you on your obesity-related medical issues to help you prepare for anesthesia and surgery.

The following tests and standard criteria guidelines may be used to determine an individual patient’s readiness for surgery:

  • Initial laboratory screening tests: chest X-ray, EKG, complete blood count with platelets, comprehensive metabolic profile (fasting), HbA1c (if diabetic), urine hCG (for child-bearing women), thyroid stimulating hormone, ferritin and iron studies, vitamin D and parathyroid hormone, nicotine and drug screen, as needed, and H. pylori as needed
  • Cardiac screening criteria are utilized to determine cardiac risk and recommended cardiac studies
  • Epworth Sleepiness Scale, along with other measures are used to screen for possible obstructive sleep apnea (OSA) and the need for a sleep study
  • Consultations will be requested as needed from a Cardiologist, Pulmonologist, Oncologist, Neurologist, Endocrinologist or other specialist
  • Pre-op visit with a medical provider for preoperative history and physical examination
  • Pre-op visit with the surgeon to sign consent forms
  • Consultations with one of our bariatric surgeons is scheduled after the patient has completed the pre-op evaluation and education program

What to Expect After Weight Loss Surgery

Following your surgery, you should experience significant weight loss.

In addition to losing weight, bariatric surgery may improve many of your medical conditions, including Type 2 diabetes, high cholesterol, high blood pressure, Polycystic Ovary Syndrome, nonalcoholic fatty liver disease, sleep apnea, urinary incontinence, and orthopedic problems and joint pain, among other conditions.

At the same time, it is important to realize that surgery is not a quick fix. Whatever type of weight loss surgery you have, your weight reduction will be ongoing and require you to commit to long-term changes to your lifestyle and diet.

Thankfully, our team will be with you every step of the way. After your surgery Queen’s Comprehensive Weight Management Program is here to provide ongoing (and even lifelong) support on your weight loss journey.

Psalms and Kehau Before and After Weight Loss

Psalms & Kehau’s Success Story

“We’re skinny for the first time ever!”

After researching their options, Hilo residents Psalms and Kehau decided to have Gastric Bypass Surgery through Queen’s Comprehensive Weight Management Program.

Since their surgeries, the couple’s lives have improved dramatically. Both Psalms and Kehau each lost over 100 pounds, and their previous medical problems—high blood pressure, prediabete, high cholesterol, heel spurs, and gout—are now under control.

Frequently Asked Questions about Surgical Weight Loss

Laparoscopy refers to the surgical technique of making small incisions to the abdomen or pelvis with the aid of a camera. When you’re looking for the best weight loss surgery options, you want a doctor who performs laparoscopic surgeries.

At Queen’s, all of our bariatric surgeries are laparoscopic. Compared to open procedures, hospitalization for laparoscopic surgery is only 1-2 days, and overall recovery time is greatly diminished.

Every surgical procedure carries some risk of complications. That said, bariatric surgery is one the safest compared to other elective procedures.

The reason Roux-En-Y Gastric Bypass and Sleeve Gastrectomy are safe procedures is due to the laparoscopic approach Queen’s takes to reduce complications.

You may qualify for surgical weight loss:

  • If your body mass index (BMI) is 40 or more
  • If your BMI is 35 or more and you have other significant negative health issues related to your weight, such as sleep apnea or diabetes
  • If your BMI is 30 or more and you have Type 2 diabetes

You may also be a candidate if you are more than 100 pounds over your ideal body weight or you have been unable to achieve your ideal body weight for an extended period of time.

You might be wondering if your insurance will cover the cost of weight loss surgery. Does private insurance cover it? Does Medicaid cover it?

Medicaid covers weight loss surgery if you meet certain criteria (a BMI of 35 and one comorbidity as a general rule). Private insurance will also pay for surgical weight loss if you meet certain criteria.

But the type of weight loss surgery covered by private insurance or Medicaid varies. Queen’s Comprehensive Weight Management Program recommends that you check your policy so we can more accurately discuss your weight loss options.

Every insurance plan has specific requirements for weight loss treatments including bariatric surgery. We suggest that you contact your insurer to inquire about the following:

  1. What are the requirements to be eligible for medically managed weight loss or Bariatric Surgery?
  2. What portion of the expenses are covered?
  3. If I reside on a neighboring island, what transportation fees are covered?
  4. Does my plan cover benefits for Medical Nutrition Therapy?

When speaking with a representative from your health insurance company, they may need something called a Current Procedural Terminology or CPT code. The CPT codes for weight loss surgery are:

  • 43644 Laparoscopic Roux-en Y Gastric Bypass
  • 43770 Laparoscopic Placement of an Adjustable Gastric Band
  • 43775 Laparoscopic Sleeve Gastrectomy

Surgical Weight Loss Customized for You

Our patient-centered approach to surgical weight loss offers compassionate presurgical screenings, the latest laparoscopic techniques during surgery, and the best in aftercare across the islands.

When you become a patient at Queen’s Comprehensive Weight Management Program, you will be treated as a person first and foremost.

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