Popular myths about bariatric surgery run the gamut from horror stories to fairy tales. In reality, this procedure is neither as awful nor as fantastic as it’s made out to be. Here are some facts to help set the record straight about weight-loss surgery (WLS).

Myth #1: People who get weight-loss surgery don’t have willpower.

Bariatric surgery patients have tried over and over to lose weight. Many have struggled for years, pushing themselves to extremes to lose weight and keep it off. They understand that surgery is a final option when everything else has failed. The surgery, recovery and lifestyle changes that accompany WLS require both courage and determination on the part of the patient.

Myth #2: Bariatric surgery is only for the morbidly obese.

Obesity is only one of the criteria that qualify patients for surgery. Overweight patients may also be candidates if they have one or more health problems that might be reduced or alleviated by weight loss. Diabetes, sleep apnea, hypertension, arthritis and high cholesterol are examples of such weight-related health conditions.

Myth #3: Insurance pays for WLS for all overweight patients.

Patients must go through an extensive pre-approval process before they qualify for insurance coverage on a bariatric surgery claim. This includes multiple health evaluations, a documented history of medically-supervised weight loss, a history of being overweight or obese for a long period of time and more. Even then, insurance will not pay for all types of weight-loss surgery. Some techniques are still considered experimental.

Myth #4: You should eat whatever you want now since you’ll be on a restricted diet after WLS.

It’s much better to start getting used to your post-surgery diet before you have the operation. This helps you lose some weight beforehand and lessens your risk of complications. Plus, you’ll be better prepared psychologically for the diet changes that are coming up. Patients are typically placed on a liquid diet for a period of time prior to surgery anyway, so that “last meal” the night before just isn’t going to happen.

Myth #5: You will finally be skinny after bariatric surgery.

Most patients do not lose all of their excess weight. Losing just 50 percent of excess weight and keeping it off is considered a success story. So, a patient who is 100 pounds overweight before surgery might only be 50 pounds overweight after they finish losing weight. That’s still going to be overweight in the eyes of most people. Plus, your skin isn’t necessarily going to tone up and be free of drooping after weight loss. However, the health benefits in reducing weight-related problems like sleep apnea often occur even in patients who don’t lose all the weight they would like.

Myth #6: Weight loss from bariatric surgery is permanent.

Unfortunately, even this one is not true. In fact, some regain is likely. A patient might lose 150 pounds and gain back 30 to 50 pounds. Part of this is simply the body adjusting to the “new norm” and learning to store fat even on a very restricted diet. In the best case, some of the gain might be muscle from getting more exercise. At other times, a patient’s failure to adhere to the post-surgery lifestyle recommendations plays a role.

Myth #7: You should only have WLS if you are done having kids.

It isn’t safe to get pregnant in the first year or two after bariatric surgery. You simply won’t be getting enough nutrients to support a growing fetus. After you are done losing weight (if you are taking all your supplements and monitoring your health carefully), getting pregnant should be okay. This is something to discuss with your bariatric surgeon.

Myth #8: After bariatric surgery, you won’t be able to eat anything that tastes good.

Patients who undergo gastric bypass may need to avoid very sweet foods because it can cause side effects like dizziness and nausea. Patients who have a duodenal switch typically need to keep fatty foods to a minimum. However, many patients can and do eat their favorite foods after they recover from surgery. They just eat very small portions. Even if you can’t eat whatever you used to l