Bariatric surgery from a doctor and patient’s view:

Q&A with Dr. Ursula McMillian

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Ursula McMillian, MD, director of bariatric surgery at Cooley-Dickinson Hospital, provides a special kind of support for patients seeking weight loss. With firsthand experience as both a bariatric surgeon and a patient, she offers unique insights and support to those on their weight loss journey. Regarding her own experience, she says:

“Getting bariatric surgery literally saved my life—it was the best thing I ever did. Today, my quality of life is so much better: I’m healthy, diabetes-free, and my blood pressure is under control. And because my PCOS disappeared after bariatric surgery, I am now a mother to two children. I’m 46 right now, but I look and feel better now than I ever did in my 20s.”

In this Q&A, Dr. McMillian shares more about her personal journey with bariatric surgery, the comprehensive approach to surgery at Cooley-Dickinson Hospital, and strategies for ensuring a successful result following surgery.

Why did you choose to get bariatric surgery?

Like my parents, I had been overweight my whole life. They both passed away due to weight-related issues. I knew that if I wanted to live a long life, I had to get my weight under control. However, any diet or lifestyle changes I tried only led to the weight coming right back. At the time, I also had high blood pressure, type 2 diabetes, and polycystic ovarian syndrome (PCOS).

It wasn’t until I started my residency that I began to consider bariatric surgery for myself. I was blown away by the patients’ before and after transformations. Some even stopped taking medication for diabetes or other weight-related diseases following surgery.

In May 2010, I underwent gastric band surgery, a procedure that is no longer common. I achieved the results I was looking for: since then, I have lost over 110 pounds and kept the weight off, and I feel better than ever.

Another reason I chose bariatric surgery was to set a positive example for my kids. I wanted to show them that despite your genetics, you can take control of your weight and live a healthy life if you make the right choices.

What are the different types of bariatric procedures available at Cooley-Dickinson?

At Cooley-Dickinson Hospital, we offer several types of laparoscopic, or minimally invasive, bariatric procedures. The most common one is a sleeve gastrectomy, which is a very safe procedure with few risks. It’s great for weight loss without the complications associated with other procedures.

We provide gastric bypass surgery for patients who do not qualify for sleeve gastrectomy. We also perform successful revisional surgeries for those who have already had bariatric surgery elsewhere and may need adjustments or revisions. Additionally, we provide a “sleeving” procedure specifically designed for gastric bypass patients to shrink the pouch created during a previous surgery.

How are patients supported, both physically and mentally?

At every step of the weight loss journey, our team is available to provide information, support, or guidance. Most of our office staff at the Center for Weight Management have undergone their own bariatric surgeries, so we’re each able to serve as a resource for our bariatric patients and show that no matter who you are, you can do it.

It starts with an online information session, where patients gain a better understanding of what bariatric surgery is, qualifications, and the expected results. If patients choose to move forward, we meet with them to understand their medical history and why they want to get bariatric surgery. We also conduct tests and blood work to evaluate their health.

Next, patients work with our dietician and behavioral health specialist to make eating changes to ensure a positive outcome after surgery. We ask patients to lose 10% of their current body weight to show they are committed to making the lifestyle changes essential for long-term success after surgery. During this process, our team meets with the patient every 2-4 weeks, providing pre-surgical guidance and resources.

Lastly, we help patients get insurance approval for surgery and schedule a date. We meet with them two weeks after the procedure and continue with monthly check-ins for the next year to teach them about nutrition, exercise, strength training, and other key aspects to maintain their weight loss. Our patients become family, and we’re committed to supporting them for life.

What is the recovery process like?

Most patients go home the next morning and manage their pain with over-the-counter painkillers. We follow up with them regularly to monitor their recovery.

Recovering from surgery is often the easy part—the eating and lifestyle changes present the bigger challenge. Following surgery, patients start with a liquid-only diet and progress to a puree food diet. After a month, patients will gradually start to eat solid foods again.

Patients should avoid lifting anything over 10 pounds for the first two weeks following surgery, gradually working their way up to 15 pounds of push/pull resistance training, with the goal of returning to normal exercise after one month.

It’s critical for patients to follow the eating schedule and diet plan. It’s common to not feel hungry, so they may need to remind themselves to eat.

Who is a good candidate for bariatric surgery?

Patients who have a BMI over 35 with at least one of the following weight-related conditions qualify for bariatric surgery: high blood pressure, type 2 diabetes, high cholesterol, sleep apnea, or heart disease. Patients with a BMI over 40 will qualify regardless of weight-related conditions.

My recommendation is that if you meet the criteria, you should have bariatric surgery. You’ve probably already tried managing your weight through diet and exercise, so you know that this alone likely won’t lead to sustained weight loss. Bariatric surgery can be the tool that helps you live a healthy life.

How successful is bariatric surgery in the long-term?

Bariatric surgery is a successful tool for weight loss, but its long-term success depends on the patient’s dedication to following the diet and exercise plans. You have to choose this for yourself and be committed to living a healthy lifestyle after surgery. Obesity is a chronic disease that requires constant effort to manage it effectively.

You won’t go through this journey alone. Our team is here to be your guide and accountability partner to help you keep the weight off.

What are some common misconceptions about bariatric surgery?

One common misconception is that bariatric surgery is the easy way out. Many patients think people will look at them like they cheated, or they may think that surgery will be the “magic bullet” that cures their obesity. The reality is that a patient must still make the lifestyle changes needed to lose excess weight: bariatric surgery is just a tool that makes the process a little easier.

For patients interested in bariatric surgery, we recommend first speaking with your primary care doctor to see if weight loss surgery is right for you. If so, please register for our free online information session to ask questions and learn more about the options.