Brandon Fadner, MDSurgery · Sugar Land, Texas

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Patient education

Obesity is a disease. Not a willpower problem.

If you've tried every diet and the weight keeps coming back, that isn't a personal failure. Your body is fighting to hold on to it. Surgery and modern medications change that fight.

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The short version
  • Obesity changes the hormones that control hunger and fullness.
  • Diets alone rarely beat that biology long term.
  • Surgery resets those signals, which is why the results last.
  • I'm trained in obesity medicine too, so medication is always on the table.

What's going on

Your brain and gut talk constantly about hunger, fullness and how much energy to store. With obesity, those signals get stuck. You stay hungry, you feel full later, and when you lose weight your body slows down and pushes you to regain it.

That's why "eat less, move more" so often fails over the long run. It's not that people don't try. It's that they're fighting their own hormones.

In plain EnglishBariatric surgery isn't just making the stomach smaller. It changes the signals between your gut and your brain, so you feel full sooner and stay satisfied. That's what makes the weight loss stick.
BEFORESLEEVEBYPASS
Two common operations. A sleeve removes most of the stomach, leaving a narrow tube. A bypass makes a small pouch and connects it further down the intestine.

Am I a candidate?

Current national guidelines (ASMBS and IFSO, 2022) recommend surgery for a BMI of 35 or more, and say it should be considered from a BMI of 30 when you also have a weight-related condition like type 2 diabetes. Check where you are:

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37.2
BMI

Your options

Sleeve gastrectomy

About three quarters of the stomach is removed, leaving a banana-shaped sleeve. You feel full sooner and hunger drops. The most common weight-loss operation in the U.S.

Most common

Roux-en-Y gastric bypass

A small stomach pouch is connected further down the intestine. Very effective for diabetes, and the best choice if you also have significant reflux.

Best with reflux

SADI-S

A sleeve plus a single intestinal connection. A more powerful metabolic effect for higher BMIs or for some patients after a sleeve.

More powerful

Revision surgery

If weight has returned or reflux has started after a prior operation, it can often be revised or converted.

After prior surgery

Medication

GLP-1 and related medications can be a great first step, a bridge to surgery, or added after surgery. As an obesity medicine diplomate, I prescribe them too.

Non-surgical

Combination

Many patients do best with surgery plus ongoing nutrition support and, when needed, medication.

Long-term plan

How the process works

Consult

We meet, review your history and goals, and talk through options. No commitment.

Preparation

Nutrition visits, labs, and any needed tests. Your insurance may require a few months of documented visits.

Surgery day

Laparoscopic or robotic surgery at St. Luke's Health–Sugar Land. Most patients stay one night.

First month

Liquids, then pureed and soft foods. Walking from day one. Back to desk work in about 2 weeks.

For life

Regular follow-up, vitamins, and support. This is a long-term partnership.

Common questions

Is weight-loss surgery safe?

Today's bariatric operations are about as safe as having your gallbladder or appendix removed. St. Luke's Health–Sugar Land is accredited as a Comprehensive Center by MBSAQIP, which means it meets national standards for safety and outcomes.

How much weight will I lose?

It varies, but most patients lose a large share of their excess weight in the first 12 to 18 months, and many conditions like diabetes, sleep apnea and high blood pressure improve or go away.

Why surgery instead of the new weight-loss shots?

Medications work well for many people, and I prescribe them. They usually need to be taken long term, and weight often returns when they stop. Surgery is a one-time change with durable results. We'll decide together which fits you.

Will insurance cover it?

Many plans cover bariatric surgery when you meet the guidelines. Requirements vary, so the office will check your plan before anything is scheduled.

General information to help you understand your options. It isn't a diagnosis. The right plan for you comes from an in-person visit.

Your first visit

Come talk it through. No pressure, and no surgery you don't need.

A consult is a conversation. You'll leave knowing what's going on, what your options are, and what I'd do in your shoes. Whether you have surgery is your decision.

  1. We go through your symptoms, history and goals. Bring your medication list and any scan or scope reports.
  2. I explain what's happening in your body, usually with a drawing, and we decide whether any tests are needed.
  3. You leave with a clear plan: medication, lifestyle, a procedure, or a mix. We check insurance before anything is scheduled.
281-637-9000

Call the office and ask for a consultation with Dr. Fadner.

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Please don't include detailed medical records here. We'll go over everything at your visit.

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