Is Bariatric Surgery Right for Me? Find Out with Dr. Stephanie Kerlakian!
We sat down with TriHealth Bariatric Surgeon Dr. Stephanie Kerlakian to learn more about weight loss procedures!
What originally got you interested in medicine and weight management more specifically?
I’m originally from Cincinnati, so it’s truly a privilege to be back serving the community that helped shape me. I’m a general and bariatric surgeon at TriHealth, where I also completed my training. This place has always felt like home — not just because of geography, but because of its deep commitment to excellence in patient care.
My father, Dr. George Kerlakian, established the TriHealth Weight Management Program here. We have held accreditation as a Bariatric Surgery Center of Excellence by the American Society for Bariatric Surgery for years under his leadership. His passion for helping patients reclaim their health was one of the key inspirations for my own path in medicine. I feel incredibly fortunate to be part of a program that prioritizes safety, compassion, and treating the whole person — values that have long been at the heart of TriHealth’s mission.
Outside the hospital, I focus on quality time with my husband and our kids. We’re usually outdoors — getting messy, chasing adventure, and soaking up fresh air whenever we can. I also enjoy running, cycling, and hiking to recharge.
What weight loss surgeries are offered at TriHealth?
The surgeries offered here at TriHealth include the Roux-en-Y gastric bypass (frequently termed the “bypass”), and the sleeve gastrectomy. We also frequently perform various revisional surgeries – this includes revising a previous surgery, removing laparoscopic adjustable gastric bands (aka “lap bands”), or converting from the band or the sleeve to the bypass. Bariatric surgery, which is typically thought of as surgery to make a person eat less, is so much more than that – it permanently increases a person’s metabolism. And ultimately, a slow, inefficient metabolism is the main issue when it comes to this disease.
Where do the surgeries take place?
The surgeries take place at TriHealth’s Good Samaritan Hospital, but we have various office locations to choose from for consultations, pre-operative appointments, and follow-up appointments.
Who is a candidate for Bariatric Surgery?
Candidacy for bariatric surgery is based on insurance requirements. This may vary depending on your insurance, but the general requirements are based on your body mass index (BMI) and the presence of medical problems related to the disease of obesity, a term known as “co-morbidities.” BMI, which is based on your weight and height, is certainly not the only indicator of health – but it’s one of the best tools we have to monitor weight. The typical requirements involve a BMI of 40 or more, or a BMI of 35 or more with an obesity-related co-morbidity such as high blood pressure, diabetes, sleep apnea, high cholesterol, or heart disease (to name a few).
We have seen advertising for GLP-1 treatments to avoid the surgery route. When should someone consider surgery over these treatments?
The GLP-1 medications, which were newly developed to treat the diseases of overweight and obesity, also increase a person’s metabolism – but to a much lesser degree. When we think about weight loss goals after surgery, we frequently use “excess body weight,” or the weight a person is OVER a “normal” weight (normal is in quotations because, well… you don’t have to have a “normal” BMI to be healthy). With bariatric surgery, we can typically achieve an excess weight loss of 50-80%, based on the surgery. That means if you are 100 pounds over a “normal” BMI of 25, you will lose 50-80 pounds. With the GLP-1 medications, total weight loss is typically anywhere from 5-15%. So, for a 5 foot, 5 inch woman, who weighs 250 pounds and is therefore 100 pounds over a “normal” BMI, she is expected to lose anywhere from 12-37 pounds with these medications. As you can see here, GLP-1 medications, even if they are well tolerated and affordable (which isn’t a guarantee), don’t lead to nearly the same amount of weight loss compared to bariatric surgery. And unfortunately, if these drugs are stopped for whatever reason, most of the weight comes back on within 2 years – because these drugs don’t permanently increase metabolism (in contrast to bariatric surgery, which does!). These drugs are a better option for those in the “overweight BMI” category, or potentially early classes of obesity (BMI 30-34) who might not qualify for bariatric surgery.
Is Bariatric Surgery Safe?
Bariatric surgery is extremely safe! The surgeries – bypass, sleeve, or revisions – are performed laparoscopic, or “minimally invasively.” This means that patients get 6 small incisions, or cuts, rather than one big cut down the middle. The surgery is done through these small incisions using a laparoscope (light and camera on a stick), and long instruments. These surgeries – both the bypass and the sleeve – are as safe as laparoscopic gallbladder surgery or laparoscopic hysterectomy. Long-term safety is frequently driven by patient factors – therefore it is very important that you follow a bariatric specific diet (small portions, high protein, high fiber, avoiding simple sugar – things we should all be doing anyway to maintain or lose weight!), take your vitamins every day, and avoid dangerous habits such as smoking, vaping, using nicotine products. When my patients (understandably) bring up concerns about their safety during surgery and recovery, I gently remind them of the much higher risks of continuing down the obesity pathway and the medical issues associated with it. Having obesity also increases your risk of developing some cancers by 30-40%. To me, this is much scarier than surgery.
What is the full process of weight loss surgery like?
At your initial consultation with your bariatric surgery, if you are a good candidate and you desire to proceed, you can join the surgical weight loss program. Our program takes 3-6 months to complete, which is based on meeting the requirements determined by your insurance. These requirements involve dietician visits, support group meetings, evaluation by our mental health counselors, and clearances from other providers. Each patient must be cleared by a heart doctor, and some require clearances from lung doctors, sleep doctors, or other providers based on your health history. Once all is complete, which takes 3-6 months, we can schedule your surgery.
What support is provided for a patient after surgery is complete, and recovery has begun?
After surgery, patients typically stay in the hospital for only one night. In the hospital, we make sure patients are up and moving that same day – this really helps decrease the risk of blood clots. Our team – made up of nurses, nurse practitioners, resident physicians, and your surgeon – will frequently check up on you during your stay in the hospital. You will be working on drinking liquids and protein shakes, making sure that before you leave, you are able to keep up with the requirements needed to stay hydrated. When it comes to pain control, these surgeries are generally well tolerated on several pain medications that all work differently, generally not needing narcotics! This is important because it helps our patients avoid constipation and helps them stay awake and alert to keep moving. After discharge, you will see your surgeon and dietician at every single postoperative visit moving forward – and these are very frequent visits! You’ll see us at 1 week, 3 weeks, 6 weeks, 3 months, 6 months, 1 year, and then yearly thereafter. At 1 week, you can start eating some foods (such as eggs) along with your liquids, slowly advancing your diet at each visit until week 6, where you reach the final “advanced” stage. This is the “diet” you will follow forever (diet is in quotations – because ultimately, you will be eating real foods and normal textures, focusing on protein, fiber, and fluids!). A frequent misconception that we hear is that after bariatric surgery, you are stuck drinking liquids forever. This is not true, thankfully!
What are the Benefits of Having Bariatric Surgery?
Bariatric surgery, as stated before, obviously leads to great weight loss – but more importantly, if you stay active and stick to your high protein, high fiber diet, you will be able to MAINTAIN this great weight loss. This is what is unique to surgery, rather than lifestyle changes or some medications. However, weight loss isn’t the only goal – our goal is to get you to a happier, healthier lifestyle. That means getting off some of your medications, decreasing your risk for many cancers, having less pain, or being able to do the things you used to do… or have always wanted to do, but couldn’t. THAT is our hope for you.
Does Insurance Cover Weight Loss Surgery?
As stated before, many insurances do cover bariatric surgery, as long as you meet specific requirements. These requirements may differ slightly depending on your insurance provider. But typically, this requires a BMI of 40 or greater, or a BMI of 35 or greater with at least one obesity-related medical problem such as diabetes, sleep apnea, or high blood pressure (to name a few).
What to Expect Immediately Before and After Surgery?
During the 3-6 months before surgery, while you’re in our program, you will be seeing various providers to get you ready for the big day (see #6). You typically do not see your surgeon again until 2 weeks before surgery – but rest assured, you can absolutely see us again if you would like! 2 weeks before surgery, we go over the surgery consent form and sign it together. We talk over any questions you have, talk about the medications you will need after surgery, and make sure you have everything you need. You will then start your “pre-surgical” diet, which is a diet high in protein and low in fat and sugar. During this time, you will probably lose weight – but that’s not the goal! The goal is to shrink your liver to make your surgery as safe as possible (big livers can make surgery more complicated and increase your risk for complications), so it is very important you follow this diet strictly. As stated in #6, immediately after surgery, you will go to recovery and then move to our surgical floor. Here, we make sure your pain is controlled, help get you up and moving, and support you as you work on drinking liquids.
Now That I Have Had Surgery What is Life Like?
Surgery is not a quick fix, but the effort and time you put in before and after will absolutely pay off. From potentially stopping many of your medications, to being able to move around easier and without pain, to decreasing your risk for many different cancers… surgery has the potential to change your life in many, many ways. But ultimately, our goal is to help you live a longer, healthier, happier life – surrounded by providers that care deeply about you and your success. We want you to know that we are there for you every step of the way. When life happens and you slip up – that’s ok! We are here to guide you through to get you back on track. Our entire team, from the office to the operating room, has seen how bariatric surgery changes lives, time and time again. We want you to know that you are not stuck. We are here for you, and we are ready to meet you.
TriHealth is a comprehensive accredited surgical program through The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, providing multidisciplinary, high quality, patient-centered care. Our surgeons are the most experienced weight loss surgery team in Cincinnati with more than 3,000 bariatric procedures performed. For more information visit us here.