Your weight loss surgery journey, stage by stage
Deciding, choosing a procedure, the operation itself, the first year, and the years after it. Written by the practice that has walked patients through it for more than 30 years — with the patients’ own accounts attached to each stage.
Book a free consultationMedically reviewed by David G. Davtyan, MD, FACS, FASMBS · Last reviewed August 23, 2026
Stage 1 — Deciding whether surgery is the right route
Most people arrive here after years of dieting, not after a single bad weigh-in. The first question is not which operation — it is whether a surgical or endoscopic route is appropriate at all, or whether a medically supervised programme should come first.
Eligibility has changed, and a lot of what is still written online is out of date. The 2022 joint statement from the American Society for Metabolic and Bariatric Surgery and IFSO replaced the 1991 National Institutes of Health criteria that most older pages still quote. Under the current indications, metabolic and bariatric surgery is recommended for people with a BMI of 35 or above regardless of whether they have an obesity-related condition, and should be considered for people with a BMI of 30–34.9 who have metabolic disease. Thresholds are also adjusted for patients of Asian descent. See 2022 ASMBS/IFSO Indications for Metabolic and Bariatric Surgery (Obesity Surgery, 2023) and ASMBS — Is Metabolic and Bariatric Surgery Right for You?.
A BMI figure is a starting point for a conversation, not a verdict. Dr. Davtyan's consultation looks at your weight history, the conditions you are carrying, previous attempts, and what you actually want your life to look like afterwards.
- Obesity: causes, health risks and treatment options — the clinical background, including what excess weight does to the rest of the body.
- Types of bariatric surgery — the full menu of options side by side.
- How much should I walk according to my BMI? — a practical starting point if you are not ready for a surgical conversation yet.
Stage 2 — Choosing between the procedures
There is no single best operation. There is the one that fits your anatomy, your health, your tolerance for permanence, and how much support you want afterwards. Some of these are surgical and some are not — the Allurion and Orbera balloons are placed without an incision, and medication is a route in its own right.
Lap-Band
An adjustable silicone band placed around the upper stomach. Adjustable and removable, which is exactly why some patients choose it and others rule it out.
Gastric sleeve
A large portion of the stomach is removed, leaving a narrow sleeve. Permanent, and the most commonly performed bariatric procedure in the United States.
Gastric bypass
Reroutes food past part of the small intestine as well as reducing stomach volume. Often considered where reflux or type 2 diabetes is part of the picture.
Gastric balloon
A balloon placed in the stomach for a set period, then removed. No incision, no permanent change to the anatomy.
Allurion balloon
Swallowed as a capsule and passed naturally at the end of its term — no endoscopy for placement or removal.
Weight-loss medication
GLP-1 medication under medical supervision, on its own or alongside a procedure.
The ASMBS maintains plain-language descriptions of each procedure independent of any one practice: ASMBS — Bariatric Surgery Procedures.
Two comparisons patients ask for constantly, answered by Dr. Davtyan in his own words: Lap-Band versus gastric sleeve, and why he still recommends the Lap-Band for particular patients.
Stage 3 — The consultation, cost and insurance
The first consultation is free and carries no obligation. You should leave it knowing three things: whether you are a candidate, which procedures are realistic for you, and what each one would cost in your circumstances.
Bring your weight history, a list of current medications, and any conditions you have been diagnosed with — sleep apnoea, type 2 diabetes, hypertension, reflux and joint problems all change the recommendation. If you are planning a pregnancy, say so at this appointment: timing after bariatric surgery is an individual clinical decision and it should be made with your surgeon and your obstetrician, not from a number found online.
Stage 4 — Preparing for the procedure
Preparation is where a good outcome is set up. Depending on the procedure that can include a pre-operative diet, stopping particular medications, arranging time off, and organising who is driving you home.
- What to pack for bariatric surgery — a practical hospital checklist.
- Lap-Band after-care — worth reading before the date, not after, because it tells you what the first weeks ask of you.
Stage 5 — Surgery and the first weeks
Recovery differs sharply between procedures. A swallowed balloon is not an operation and the recovery reflects that; a bypass is major surgery. What is common to all of them is a staged return to eating — liquids, then puréed, then soft, then solid — on a timetable your surgical team sets for you.
- Lap-Band recovery
- Gastric sleeve recovery
- Gastric balloon recovery
- Bariatric surgery recovery in general
One patient's account of this stage, recorded at the practice: a post-surgery patient interview.
Stage 6 — The first year: the habits that carry the result
The procedure changes what your stomach does. It does not change what you reach for when you are tired, bored or upset — that part is learned, and the first year is when it is learned. Dr. Davtyan recorded seven short pieces of guidance he gives every patient. They are deliberately unglamorous:
- Eat only when you are hungry
- Eat slowly and chew thoroughly
- Stop as soon as you feel satisfied
- Be active
- Do not eat between meals
- Eat high-quality food
- Drink only no-calorie liquids
Follow-up appointments matter more than any single rule on that list — they are where a Lap-Band gets adjusted, where nutrient levels get checked, and where a problem gets caught while it is still small. The ASMBS covers what long-term follow-up involves: ASMBS — Life After Bariatric Surgery.
Stage 7 — Living with it, years out
Weight regain, revision surgery, nutrition, pregnancy, ageing — these arrive years after the date circled on the calendar, and they are the part of the journey that gets written about least.
- Why nutrient deficiencies happen after bypass, and how they are prevented
- Gastric bypass revision: reasons, options and what to expect
- The long-term health benefits of a gastric sleeve beyond the scale
- Getting through the holidays after bariatric surgery
Dr. Davtyan on running a Lap-Band practice over two decades, and what he has learned from following patients that long: The Lap-Band in a private practice.
Patients’ own accounts
41 patients have written up their own journey — what pushed them to it, what the first months were like, and what they would tell someone at the start. These are their words, not the practice’s. Individual results vary.
Before-and-after photography for a further 34 patients is in the success stories gallery.
Short testimonials
Interviews, in full
En español
Toda la información de esta página está disponible en español, incluida una guía de más de 300 preguntas frecuentes sobre cirugía bariátrica.
Where Dr. Davtyan sees patients
Spanish is spoken at all four offices. The first consultation with Dr. Davtyan is free and commits you to nothing.
Start with a conversation, not a decision
The first consultation is free and there is no obligation attached to it. You leave knowing whether you are a candidate, which routes are open to you, and what each would cost.
Sources
- 2022 ASMBS/IFSO Indications for Metabolic and Bariatric Surgery (Obesity Surgery, 2023)
- ASMBS — Is Metabolic and Bariatric Surgery Right for You?
- ASMBS — Bariatric Surgery Procedures
- ASMBS — Life After Bariatric Surgery
This page is general information about how bariatric care is delivered, not medical advice, and it does not describe what any individual should expect. Eligibility, procedure choice and outcomes are individual and are decided in consultation with a qualified surgeon.
