Weight Loss Surgery Info

Being a well-informed patient is good for you and good for your doctor. Here are some of the questions you should ask before deciding on a bariatric surgeon.

What types of weight loss surgery procedures have you performed

How many of each weight loss procedure have you performed

Can this surgery be performed using minimally invasive techniques

Can I be considered a candidate for surgery even though I have one or more associated health conditions related to my obesity

Which weight loss procedure is best for me Why What are the risks involved

How long will I be in surgery

What is the length of my anticipated hospital stay

How long will it be before I can return to pre-surgery levels of activity

How will my eating habits change

Do you have information about weight loss surgery costs and payment options

The actual weight a patient will lose after the procedure is dependent on several factors. These include.

Patients age

Weight before surgery

Overall condition of patients health

Surgical procedure

Ability to exercise

Commitment to maintaining dietary guidelines and other follow-up care

Motivation of patient and cooperation of their family, friends and associates

In general, weight loss surgery success is defined as achieving loss of 50pct. or more of excess body weight and maintaining that level for at least five years. Clinical data will vary for each of the different weight loss procedures mentioned on this site. Results may also vary by bariatric surgeon. Ask your doctor for the clinical data stating their results of the procedure they are recommending.

Clinical studies show that, following weight loss surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. Patients may lose 30 to 50pct. of their excess weight in the first six months and 77pct. of excess weight as early as 12 months after surgery. Another study showed that patients can maintain a 50-60pct. loss of excess weight 10-14 years after weight loss surgery. Patients with higher initial BMIs tend to lose more total weight. Patients with lower initial BMIs will lose a greater percentage of their excess weight and will more likely come closer to their ideal body weight. Patients with Type 2 Diabetes tend to show less overall excess weight loss than patients without Type 2 Diabetes. The surgery has been found to be effective in improving and controlling many obesity-related health conditions. A 2000 study of 500 patients showed that 96pct. of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved. For example, many patients with Type 2 Diabetes, while showing less overall excess weight loss, have demonstrated excellent resolution of their diabetic condition, to the point of having little or no need for continuing medication.

Weight Loss Success Stories and Surgery Patient Experiences

The experiences found here are from actual weight loss surgery patients. Their lives have taken new directions, and their success stories will fill you with hope if you are considering weight loss surgery for yourself or a loved one.

Hector

NO WAY.. Those were the words that came screaming from my mouth back in 1999 when my mother suggested that I look into a weight loss surgery procedure. I had just been through a divorce and was at my very heaviest. She had heard about stomach stapling and thought I should consider it.

CJ

At my eighth grade graduation I weighed 180 lbs. and was 3 inches shorter than I am now. This would be the first of many special occasions that I was not able to enjoy to the fullest because I was self-conscious about my weight.

Becky

Food was an addiction for me. I would compare myself to an Alcoholic. Food was my drug of choice. Every time something would happen, positive or negative, I would reward myself with food.

Colista

My bariatric story starts out like a big cliche - I was turning 40 years old. I knew without question that if I didnt find an answer to my weight problem, I was going to die young and unhealthy.

Kimberly

I couldnt bear to imagine our daughter becoming an overweight or obese child like I once was. I learned from experience how mean people can be, and I knew I had to spare her that. And I knew there was a good chance she would be obese - like me - if I didnt do something to promote healthier choices.

Caroline

The date. December 19, 2001, the day of my gastric bypass surgery. The day my life started moving in a healthier direction because I started caring about ME.

Brent

I didnt want someone else raising my kids....The reason I was so obsessed about losing weight was because my dad died of a heart attack when I was 18. I was a week out of high school, and he was only 44. I have two little kids - ages 9 and 3-1/2 - and I didnt want someone else raising them.

Stephan

Ive been big my entire life. In sixth grade, I weighed 275 pounds and wore a size 48 pants. I simply didnt understand it. my brother would eat the same things I did, but he never gained a pound. Life seemed unfair, and my weight problem seemed hopelessuntil the day I realized that I could either struggle through a profoundly unhappy existence, or decide to start living my life to the fullest. The choice was easy.

Bariatric surgery is typically reserved for those individuals 100 pounds or more overweight (Body Mass Index BMI of 40 or higher) who have not responded to other less invasive weight loss therapies such as diet, exercise, medications, etc.

In certain circumstances, less morbidly obese patients (with BMIs between 35 and 40) may be considered for bariatric surgery (patients with high-risk co-morbid conditions and obesity-induced physical problems that are interfering with quality of life).

Important Considerations

Bariatric surgery should not be considered until you and your doctor have evaluated all other options. The proper approach to bariatric surgery requires discussion and careful consideration of the following with your doctor.

These weight loss procedures are in no way to be considered as cosmetic surgery.

The surgery does not involve the removal of adipose tissue (fat) by suction or excision.

A decision to elect surgical treatment requires an assessment of the risk and benefit to the patient and the meticulous performance of the appropriate surgical procedure.

The success of bariatric surgery is dependent upon long-term lifestyle changes in diet and exercise.

Problems may arise after surgery that may require reoperations.

Success of surgical weight loss treatment must begin with realistic goals and progress through the best possible use of well-designed and tested operations.

document.write(In 2004 approximately 140,000 Americans had weight loss surgery. An estimated 173,000 will have weight loss surgery by year-end 2005.).

Complications and Risks of Bariatric Surgery

As with any surgery, there are operative and long-term complications and risks associated with weight loss surgical procedures that should be discussed with your doctor. Possible risks include, but are not limited to.

Bleeding*

Complications due to anesthesia and medications

Deep vein thrombosis

Dehiscence

Infections

Leaks from staple line breakdown

Marginal ulcers

Pulmonary problems

Spleen injury*

Stenosis

*Removal of the spleen is necessary in about 0.3pct. of patients to control operative bleeding.

What happens if the operation cannot be performed or completed by the laparoscopic method

In some patients the laparoscopic method does not work effectively. Factors that may increase the possibility of choosing or converting to the open procedure may include.

a history of prior abdominal surgery causing dense scar tissue

inability to visualize organs

bleeding problems during the operation

If bariatric surgery is performed laparoscopically and complications occur during the operation, your doctor may choose to perform open surgery.

The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. The decision to convert to an open (conventional) procedure is strictly based on patient safety.

Questions to Ask Your Doctor About Videoscopic and Bariatric Surgery

You can access a list of questions here to ask your doctor about videoscopic and bariatric surgery

The most important step in weight loss surgery is getting all of the information you need about the various surgical options. Ultimately your bariatric surgeon and other physicians are your best resource for information about the procedure they will recommend to you for weight loss. When you ask a question, make sure you understand the answer. Do not hesitate to ask for a clearer explanation given in simpler language. The decision to have a weight loss surgical procedure may take several visits to their offices and consultation with more than one doctor. Ask your doctor for names of other patients who have had similar weight loss surgeries and who are willing to discuss their experiences, good and bad, with you.

You may choose to research weight loss surgery on your own via the Internet or through your local library. As with any search for medical information, be sure that your sources are responsible, recognized experts in the field you are investigating. An excellent resource for weight loss surgery is the American Society for Bariatric Surgery. Youll find the information on how to contact the ASBS in the Additional Resources section of this site.

Although the results of weight loss surgery can be drastic, there are potential risks and complications. Before making your decision, you should be well informed. These steps are necessary if you are to give what is called informed consent for the surgical procedure. Informed consent is a legal term meaning that a patient agrees that they have received and understood enough information about a procedures benefits and risks to allow them to make a decision that is right for them. Your bariatric surgeon will require you to sign a consent form before performing your procedure. Before you sign a consent form, you should have a solid understanding of what is about to take place. You should know what you would need to do to live well after the operation. And you should be aware of the signs or symptoms of complications to look for which may occur after your weight loss surgery.

The following identifies areas that will be important for patients to follow after weight loss surgery.

Keep in mind that the information provided here is not intended as a substitute for the opinion and advice of a qualified physician. Your best source for information is an experienced bariatric surgeon. You can find a bariatric surgeon in your area today by using the Find a Surgeon feature.

Post-Surgery Diet

The modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss. Post-surgery dietary guidelines will vary by bariatric surgeon. You may hear of other patients who are given different guidelines following their weight loss surgery. It is important to remember that every bariatric surgeon does not perform the exact same weight loss surgery procedure and that the dietary guidelines will be different for each surgeon and each type of procedure. What is most important is that you adhere strictly to your surgeons recommended guidelines. The following are some of the generally accepted dietary guidelines an weight loss surgery patient may encounter.

When you start eating solid food it is essential that you chew thoroughly. You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.

Dont drink fluids while eating. They will make you feel full before you have consumed enough food.

Omit desserts and other items with sugar listed as one of the first three ingredients.

Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.

Avoid alcohol.

Limit snacking between meals.

Studies show that most people are able to keep off 48pct. -74pct. of their excess weight after surgery.

Going Back to Work

Your ability to resume pre-surgery levels of activity will vary according to your physical condition, the nature of the activity and the type of weight loss surgery you had. Many patients return to full pre-surgery levels of activity within six weeks of their morbid obesity procedure. Patients who have had a minimally invasive laparoscopic procedure may be able to return to these activities within a few weeks.

Birth Control andamp. Pregnancy

It is strongly advised that women of childbearing age use the most effective forms of birth control during the first 16 to 24 months after weight loss surgery. The added demands pregnancy places on your body and the potential for fetal damage make this a most important requirement.

Long-Term Follow-Up

Although the short-term effects of weight loss surgery are well understood, there are still questions to be answered about the long-term effects on nutrition and body systems. Nutritional deficiencies that occur over the course of many years will need to be studied. Over time, you will need periodic checks for anemia (low red blood cell count) and Vitamin B12, folate and iron levels. Follow-up tests will initially be conducted every three to six months or as needed, and then every one to two years.

Weight Loss Surgery Support Groups

The widespread use of support groups has provided weight loss surgery patients an excellent opportunity to discuss their various personal and professional issues. Most learn, for example, that weight loss surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on their emotional well-being. Most surgeons have support groups in place to assist you with short-term and long-term questions and needs. Most bariatric surgeons who frequently perform weight loss surgery will tell you that ongoing post-surgical support helps produce the greatest level of success for their patients.

From online support groups trading success stories and recipes to government health sites reporting on treatments, the web is a great source to research the causes and effects of morbid obesity. Look for Useful Links here on this site that will help you in your search for additional information.

Free Morbid Obesity Treatment Information

Learn more about the only proven, long-term treatment to morbid obesity. We offer a variety of resources that will help as you continue to research your options for weight loss surgery.

I would like to order the Patient Education Brochure. This brochure can help you make an informed decision about weight loss surgery.

I would like to register to receive WeightLossSurgeryInfo.com updates and free Newsletter Subscription. Here youll find the latest newsletter articles, patient stories and information updates (i.e. new treatment options, medical updates) you can use if you are considering weight loss surgery.

Bariatric surgeons first began to recognize the potential for surgical weight loss while performing operations that required the removal of large segments of a patients stomach and intestine. After the surgery, doctors noticed that in many cases patients were unable to maintain their pre-surgical weight. With further study, bariatric surgeons were able to recommend similar modifications that could be safely used to produce weight loss in morbidly obese patients. Over the last decade these procedures have been continually refined in order to improve results and minimize risks. Todays bariatric surgeons have access to a substantial body of clinical data to help them determine which weight loss surgeries should be used and why.

Restrictive Procedures

Malabsorptive Procedures that Alter Digestion

The Gastrointestinal Tract

Today, the American Society for Bariatric Surgery describes two basic approaches that weight loss surgery takes to achieve change.

Restrictive procedures that decrease food intake

Malabsorptive procedures that alter digestion, thus causing the food to be poorly digested and incompletely absorbed so that it is eliminated in the stool

Restrictive Procedures

The theory is simple. When you feel full, you are more likely to have reduced feelings of hunger and will no longer feel deprived. The result is that you are likely to eat less. Restrictive weight loss surgery works by reducing the amount of food consumed at one time. It does not, however, interfere with the normal absorption (digestion) of food. In a restrictive weight loss procedure, the surgeon creates a smaller upper stomach pouch. The pouch, with a capacity of approximately 1/2 to 1 oz. (15 to 30 ml), connects to the rest of the stomach through an outlet known as a stoma. In a cooperative and compliant patient, the reduced stomach capacity, along with behavioral changes, can result in consistently lower caloric intake and consistent weight loss.

During recovery, patients must adhere to the strict specific dietary guidelines and restrictions their bariatric surgeon prescribes. While these guidelines may vary from one surgeon to the next, it is important for each patient to follow the surgeons guidelines. When the time comes to resume eating regular food, the patient must learn to adapt to a new way of eating. At each meal, they are restricted to consuming approximately 1/2 to a full cup of food before feeling uncomfortably full. Patients who see the best results from a restrictive weight loss procedure are those who learn to eat slowly, eat less, and avoid drinking too many fluids, particularly carbonated beverages. If the patient fails to follow these guidelines, they can stretch the stomach pouch and/or the stoma outlet and defeat the purpose of the surgery. The effectiveness of a restrictive procedure is reduced by constant snacking or by drinking high-calorie, high-fat liquids. Failure to achieve the expected level of weight loss is usually the result of a patient failing to comply with the recommended dietary and behavior modifications, such as increased exercise and regular support group attendance.

Malabsorptive Procedures that Alter Digestion

It can be said that some of the restrictive approaches discussed above have not always achieved the excess weight loss surgeons and patients anticipated. For this reason, weight loss procedures that alter digestion, known as malabsorptive procedures, were developed to work in conjunction with restrictive approaches. Some of these techniques involve a bypass of the small intestine, thus limiting the absorption of calories. On balance, malabsorptive or malabsorptive/restrictive procedures have resulted in an overall increase in the loss of excess weight. The risk of complications and side effects generally increases with the lengthening of the small intestine bypass. You and your bariatric surgeon must determine the risks and benefits over your lifetime with the type of weight loss surgery you choose.

Basically, weight loss operations fall into three categories.

Restrictive procedures make the stomach smaller to limit the amount of food intake.

Malabsorptive techniques reduce the amount of intestine that comes in contact with food so that the body absorbs fewer calories.

Combination operations take advantage of both restriction and malabsorption.

The Gastrointestinal Tract

To better understand how weight loss surgery works, it is important to understand how your gastrointestinal tract functions. As the food you consume moves through the gastrointestinal tract, various digestive juices and enzymes are introduced at specific stages that allow absorption of nutrients. Food material that is not absorbed is then prepared for elimination. A simplified description of the gastrointestinal tract appears below. Your doctor can provide a more detailed description to help you better understand how weight loss surgery works.

The esophagus is a long muscular tube, which moves food from the mouth to the stomach.

The abdomen contains all of the digestive organs.

The stomach, situated at the top of the abdomen, normally holds just over 3 pints (about 1500 ml) of food from a single meal. Here the food is mixed with an acid that is produced to assist in digestion. In the stomach, acid and other digestive juices are added to the ingested food to facilitate breakdown of complex proteins, fats and carbohydrates into small, more absorbable units.

A valve at the entrance to the stomach from the esophagus allows the food to enter while keeping the acid-laden food from refluxing back into the esophagus, causing damage and pain.

The pylorus is a small round muscle located at the outlet of the stomach and the entrance to the duodenum (the first section of the small intestine). It closes the stomach outlet while food is being digested into a smaller, more easily absorbed form. When food is properly digested, the pylorus opens and allows the contents of the stomach into the duodenum.

The small intestine is about 15 to 20 feet long (4.5 to 6 meters) and is where the majority of the absorption of the nutrients from food takes place. The small intestine is made up of three sections. the duodenum, the jejunum and the ileum.

The duodenum is the first section of the small intestine and is where the food is mixed with bile produced by the liver and with other juices from the pancreas. This is where much of the iron and calcium is absorbed.

The jejunum is the middle part of the small intestine extending from the duodenum to the ileum. it is responsible for digestion.

The last segment of the intestine, the ileum, is where the absorption of fat-soluble vitamins A, D, E and K and other nutrients are absorbed.

Another valve separates the small and large intestines to keep bacteria-laden colon contents from coming back into the small intestine.

In the large intestines, excess fluids are absorbed and a firm stool is formed. The colon may absorb protein, when necessary.

For anyone who has considered a weight loss program, there is certainly no shortage of choices. In fact, to qualify for insurance coverage of a weight loss surgery like gastric bypass surgery, many insurers require patients to have a history of medically supervised weight loss efforts.

Most non-surgical weight loss programs are based on some combination of diet/behavior modification and regular exercise. Unfortunately, even the most effective interventions have proven to be effective for only a small percentage of patients. It is estimated that less than 5pct. of individuals who participate in non-surgical weight loss programs will lose a significant amount of weight and maintain that loss for a long period of time.

According to the National Institutes of Health, more than 90pct. of all people in these programs regain their weight within one year. Sustained weight loss for patients who are morbidly obese is even harder to achieve. Serious health risks have been identified for people who move from diet to diet, subjecting their bodies to a severe and continuing cycle of weight loss and gain known as yo-yo dieting.

Weight Loss Surgery

Diet andamp. Behavior Modification

Exercise

Over-the-Counter andamp. Prescription Drugs

The fact remains that morbid obesity is a complex, multi-factorial, chronic disease.

For many patients, the risk of death from not having the weight loss surgery is greater than the risks from the possible complications of having the procedure.

That is the key reason that in 2003, approximately 100,000 weight loss surgical procedures (such as gastric bypass surgery) were performed and why the American Society for Bariatric Surgery estimates that 140,000 weight loss surgical procedures will be performed in 2004. Patients who have had the procedure and are benefiting from its results report improvements in their quality of life, social interactions, psychological well-being, employment opportunities and economic condition.

In clinical studies, candidates for the procedure who had multiple obesity-related health conditions questioned whether they could safely have the surgery. These studies show that selection of surgical candidates is based on very strict criteria and surgery is an option for the majority of patients.

Weight Loss Surgery

Weight loss surgery is major surgery. Its growing use to treat morbid obesity is the result of three factors.

Our current knowledge of the significant health risks of morbid obesity

The relatively low bariatric surgery risks and complications of the procedures versus not having the surgery

The ineffectiveness of current non-surgical approaches to produce sustained weight loss

Surgery should be viewed first and foremost as a method for alleviating debilitating, chronic disease. In most cases, the minimum qualification for consideration as a candidate for the procedure is 100 lbs. above ideal body weight or those with a Body Mass Index of 40 or greater. Occasionally a weight loss procedure will be considered for someone with a BMI of 35 or higher if the patients physician determines that obesity-related health conditions have resulted in a medical need for weight reduction and, in the doctors opinion, surgery appears to be the only way to accomplish the targeted weight loss.

In many cases, patients are required to show proof that their attempts at dietary weight loss have been ineffective before weight loss surgery will be approved. More important, however, is the commitment on the part of the patient to required, long-term follow-up care. Most bariatric surgeons require patients to demonstrate serious motivation and a clear understanding of the extensive dietary, exercise and medical guidelines that must be followed for the remainder of their lives after having weight loss surgery (see Life After Weight Loss Surgery).

Diet andamp. Behavior Modification

There are literally hundreds of weight loss diets available. Moving from diet to diet in a cycle of weight gain and loss yo-yo dieting that stresses the heart, kidneys and other organs can also be a health risk.

Doctors who prescribe and supervise diets for their patients usually create a customized program with the goal of greatly restricting calorie intake while maintaining nutrition.

These diets fall into two basic categories.

Low Calorie Diets (LCDs) are individually planned so that the patient takes in 500 to 1,000 fewer calories a day than he or she burns.

Very Low Calorie Diets (VLCDs) typically limit caloric intake to 400 to 800 a day and feature high-protein, low-fat liquids.

Many patients on Very Low Calorie Diets lose significant amounts of weight. However, after returning to a normal diet, most regain the lost weight in under a year. Ninety percent of people participating in all diet programs will regain the weight theyve lost within two years.

Behavior modification uses therapy to help patients change their eating and exercise habits. Like low-calorie diets, behavior modification, in most patients, results in short-term success that tends to diminish after the first year.

If diet and behavior modifications have failed you and surgery is your next option, it is important to understand that diet and behavior modification will be instrumental to sustained weight loss after your surgery. The surgery itself is only a tool to get your body started losing weight -- complying with diet and behavior modifications required by most surgeons would determine your ultimate success.

Exercise

Starting an exercise program can be especially intimidating for someone suffering from morbid obesity. Your health condition may make any level of physical exertion next to impossible. The benefits of exercise are clear, however. And there are ways to get started.

A National Institutes of Health survey of 13 studies concludes that physical activity

results in modest weight loss in overweight and obese individuals.

increases cardiovascular fitness, even when there is no weight loss.

can help maintain weight loss.

New theories focusing on the bodys set point (the weight range in which your body is programmed to weigh and will fight to maintain that weight) highlight the importance of exercise. When you reduce the number of calories you take in, the body simply reacts by slowing metabolism to burn fewer calories. Daily physical activity can help speed up your metabolism, effectively bringing your set point down to a lower natural weight. So when following a diet to attempt to lose weight, exercise increases your chances of long-term success.

Examples to get you started.

Park at the far end of parking lots and walk.

Take the stairs instead of the elevator.

Cut down on television.

Swim or participate in low-impact water aerobics.

Ride an exercise bike.

Overall, walking is one of the best forms of exercise. Start out slowly and build up. Your doctor, or people in a support group, can offer encouragement and advice. Incorporating exercise into your daily activities will improve your overall health and is important for any long-term weight management program, including weight loss surgery. Diet and exercise play a key role in successful weight loss after surgery.

Over-the-Counter andamp. Prescription Drugs

New over-the-counter and prescription weight loss medications have been introduced. Some people have found them effective in helping to curb their appetite. The results of most studies show that patients on drug therapy lose around 10 percent of their excess weight and that the weight loss plateaus after six to eight months. As patients stop taking the medication, weight gain usually occurs.

Weight loss drugs can have serious side effects. Still, medications are an important step in the morbid obesity treatment process. Before insurance companies will reimburse/pay for weight loss surgery, you must follow a well-documented treatment path. Some medical professionals believe that the estimated USD30-50 billion spent yearly on diet clubs, special foods and over-the-counter remedies for weight loss is wasted, since many people cannot permanently lose weight or retain their loss no matter how hard they seem to try.

The following identifies areas that will be important for patients to follow after weight loss surgery.

Keep in mind that the information provided here is not intended as a substitute for the opinion and advice of a qualified physician. Your best source for information is an experienced bariatric surgeon. You can find a bariatric surgeon in your area today by using the Find a Surgeon feature.

Post-Surgery Diet

The modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss. Post-surgery dietary guidelines will vary by bariatric surgeon. You may hear of other patients who are given different guidelines following their weight loss surgery. It is important to remember that every bariatric surgeon does not perform the exact same weight loss surgery procedure and that the dietary guidelines will be different for each surgeon and each type of procedure. What is most important is that you adhere strictly to your surgeons recommended guidelines. The following are some of the generally accepted dietary guidelines an weight loss surgery patient may encounter.

When you start eating solid food it is essential that you chew thoroughly. You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.

Dont drink fluids while eating. They will make you feel full before you have consumed enough food.

Omit desserts and other items with sugar listed as one of the first three ingredients.

Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.

Avoid alcohol.

Limit snacking between meals.

Studies show that most people are able to keep off 48pct. -74pct. of their excess weight after surgery.

Going Back to Work

Your ability to resume pre-surgery levels of activity will vary according to your physical condition, the nature of the activity and the type of weight loss surgery you had. Many patients return to full pre-surgery levels of activity within six weeks of their morbid obesity procedure. Patients who have had a minimally invasive laparoscopic procedure may be able to return to these activities within a few weeks.

Birth Control andamp. Pregnancy

It is strongly advised that women of childbearing age use the most effective forms of birth control during the first 16 to 24 months after weight loss surgery. The added demands pregnancy places on your body and the potential for fetal damage make this a most important requirement.

Long-Term Follow-Up

Although the short-term effects of weight loss surgery are well understood, there are still questions to be answered about the long-term effects on nutrition and body systems. Nutritional deficiencies that occur over the course of many years will need to be studied. Over time, you will need periodic checks for anemia (low red blood cell count) and Vitamin B12, folate and iron levels. Follow-up tests will initially be conducted every three to six months or as needed, and then every one to two years.

Weight Loss Surgery Support Groups

The widespread use of support groups has provided weight loss surgery patients an excellent opportunity to discuss their various personal and professional issues. Most learn, for example, that weight loss surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on their emotional well-being. Most surgeons have support groups in place to assist you with short-term and long-term questions and needs. Most bariatric surgeons who frequently perform weight loss surgery will tell you that ongoing post-surgical support helps produce the greatest level of success for their patients.

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The form below will help you better understand if you probably meet the National Institutes of Health primary guidelines for weight loss surgery. It may also serve as a guide in speaking with a bariatric surgeon in your area.

At some point, after you have spent a considerable amount of time exploring the option of weight loss surgery, you will need to determine how to pay for the surgical procedure. A growing number of states have passed legislation that requires insurance companies to provide benefits for weight loss surgery for patients that meet the National Institutes of Health surgical criteria. And while insurance coverage for weight loss surgery is widespread, it often requires a lengthy and complicated approval process. The best chance for obtaining approval for insurance coverage comes from working together with your bariatric surgeon and other experts.

Here are some of the key steps you should take to obtain insurance coverage for weight loss surgery.

Read and understand the certificate of coverage that your insurance company is required by law to give you. If you do not have one, consult your companys benefits administrator or ask your insurance company directly.

You may be required to start with your primary care physician. In some cases, he or she is the only one you can ask for a referral to a qualified bariatric surgeon. Even if you are not required to get a referral, it is a good idea to have the support of your primary care physician.

Before visiting the bariatric surgeon, organize your medical records, including your history of dieting efforts. They will be valuable documents to have at every stage of the approval process.

Document every visit you make to a healthcare professional for obesity-related issues or visits to supervised weight loss programs. Document other weight loss attempts made through diet centers and fitness club memberships. Keep good records, including receipts.

If your bariatric surgeon recommends weight loss surgery, he or she will prepare a letter to obtain pre-authorization from your insurance company. The goal of this letter is to establish the medical necessity of weight loss surgery and gain approval for the procedure. The following information is generally included in the pre-authorization letter.

Your height, weight and Body Mass Index and any documentation you might have as to how long you have been overweight.

Simply describing your condition as morbid obesity is not enough. A full description of all your obesity-related health conditions, including records of treatment, a history of medications taken and documentation of the effects these conditions have had on your everyday life is necessary.

A detailed description of the limitations your excess weight places on your daily activities, such as walking, tying shoes, or maintaining personal hygiene.

A detailed history of the results of your dieting efforts, including medically and non-medically supervised programs, medical records and records kept of payments to and meetings attended with commercial weight loss programs.

A history of exercise programs, including receipts for memberships in health clubs.

Ask your doctor to include information from medical journals regarding the effectiveness of weight loss surgery, particularly information showing the control or elimination of obesity-related health conditions.

Thirty days is the standard time for an insurance provider to respond to your request. You should initiate a follow-up if you have not heard from your insurance company in that time.

The Appeals Process

Even if your initial request for pre-authorization is not approved, you still have options available. Insurers provide an appeal process that allows you to address each specific reason they have given for denying your request. It is important that you reply quickly. It is also recommended that, at this point, you enlist the help of an experienced insurance attorney or insurance advocate to properly navigate the complexities of the appeal process. Some insurers place limits on the number of appeals you may make, so it is important to be well prepared and that you clearly understand the appeal rules of your specific plan.

This web site is a good place to start. It has been created to give you a thorough understanding of the risks and benefits of this weight loss procedure. Talking to your primary care physician, physician specialist, or family physician is a good next step. Finding a local Bariatric Surgeon and support group is another good step. Chances are there is a bariatric or weight loss clinic in or near your community that specializes in weight loss surgery. You can locate a surgeon in your area by visiting Find a Bariatric Surgeon . Call them to see if they offer seminars or free information sessions for the public. You can also order a patient education brochure about weight loss surgery by visiting our Additional Resources area.

Remember, there is much misinformation about weight loss surgery that you may encounter from unqualified sources. Talking to others who have taken the path you are now considering may help you understand what you need to know to make a decision you can be comfortable with. In the end, your best source of information is an experienced bariatric surgeon who knows how to handle your special needs before, during and after weight loss surgery.

Choosing Weight Loss Surgery

Weight loss surgery is major surgery. Although most patients enjoy an improvement in obesity-related health conditions (such as mobility, self-image, and self-esteem) after the successful results of weight loss surgery, these results should not be the overriding motivation for having the procedure. The goal is to live better, healthier, and longer.

That is why you should make the decision to have weight loss surgery only after careful consideration and consultation with an experienced bariatric surgeon or a knowledgeable family physician. A qualified surgeon should answer your questions clearly and explain the exact details of the procedure, the extent of the recovery period and the reality of the follow-up care that will be required. They may, as part of routine evaluation for weight loss surgery, require that you consult with a dietician/nutritionist and a psychiatrist/therapist. This is to help establish a clear understanding of the post-operative changes in behavior that are essential for long-term success.

It is important to remember that there are no ironclad guarantees in any kind of medicine or surgery. There can be unexpected outcomes in even the simplest procedures. What can be said, however, is that weight loss surgery will only succeed when the patient makes a lifelong commitment. Some of the challenges facing a person after weight loss surgery can be unexpected. Lifestyle changes can strain relationships within families and between married couples. To help patients achieve their goals and deal with the changes surgery and weight loss can bring, most bariatric surgeons offer follow-up care that includes support groups, dieticians and other forms of continuing education.

Ultimately, the decision to have the procedure is entirely up to you. After having heard all the information, you must decide if the benefits outweigh the side effects and potential complications. Weight loss surgery is only a tool. Your ultimate success depends on strict adherence to the recommended dietary, exercise and lifestyle changes.

The most important step in weight loss surgery is getting all of the information you need about the various surgical options. Ultimately your bariatric surgeon and other physicians are your best resource for information about the procedure they will recommend to you for weight loss. When you ask a question, make sure you understand the answer. Do not hesitate to ask for a clearer explanation given in simpler language. The decision to have a weight loss surgical procedure may take several visits to their offices and consultation with more than one doctor. Ask your doctor for names of other patients who have had similar weight loss surgeries and who are willing to discuss their experiences, good and bad, with you.

You may choose to research weight loss surgery on your own via the Internet or through your local library. As with any search for medical information, be sure that your sources are responsible, recognized experts in the field you are investigating. An excellent resource for weight loss surgery is the American Society for Bariatric Surgery. Youll find the information on how to contact the ASBS in the Additional Resources section of this site.

Although the results of weight loss surgery can be drastic, there are potential risks and complications. Before making your decision, you should be well informed. These steps are necessary if you are to give what is called informed consent for the surgical procedure. Informed consent is a legal term meaning that a patient agrees that they have received and understood enough information about a procedures benefits and risks to allow them to make a decision that is right for them. Your bariatric surgeon will require you to sign a consent form before performing your procedure. Before you sign a consent form, you should have a solid understanding of what is about to take place. You should know what you would need to do to live well after the operation. And you should be aware of the signs or symptoms of complications to look for which may occur after your weight loss surgery.