Bariatric Surgery FAQs
The National Institutes of Health have studied morbid obesity and determined that bariatric surgery is considered medically necessary in patients who have a body mass index (BMI) of 40 kg/m2. This is the equivalent of being about 100 pounds above your ideal body weight. Patients are also considered a candidate if they have a BMI between 35 and 40 kg/m2 if they suffer from a serious medical condition such as Type 2 diabetes, hypertension or sleep apnea.If you are considering bariatric surgery you should also be aware of and willing to make the necessary lifestyle changes.
All of the surgeries are tools to aid in weight loss and weight management. To be successful, it is necessary to change your lifestyle and eating habits. Without dedication to appropriate food choices and portions along with some type of increase in activity, you may not lose all of the weight that you would like to. It is also very important to maintain these lifestyle changes in order to be successful long term.
At this time patients with a BMI of less than 35 kg/m2 are generally not considered candidates for bariatric surgery. There is ongoing research looking at offering bariatric surgery to patients with a BMI of between 35 and 40 kg/m2.
There may be certain medical conditions that may prevent you from having bariatric surgery. Our surgeons evaluate each patient to determine if bariatric surgery is an option.
Bariatric surgery serves as a tool to assist you in weight loss. Many of the benefits of bariatric surgery are related to improvement in other medical conditions as a result of the weight loss. Conditions such as diabetes, hypertension, sleep apnea, and high cholesterol may be resolved or improved after surgery.
Our patients also describe to us an improved quality of life and the ability to participate in activities that were too difficult prior to their weight loss.
There are risks and potential complications associated with all surgical procedures. However there are many safe guards in place to decrease the risk of surgery. Morbid obesity may increase your surgical risks. It is important that your surgeon have as much information as possible about your medical and surgical history so that he can discuss your risks, benefits and alternative treatments with you, and thus allow you to make an informed decision about bariatric surgery.
To learn more visit our page on Bariatric Procedures.
The surgeon will discuss the benefits and risks of surgery for you personally at the educational seminars and again at your office consultation.
It is important that you are as healthy as possible prior to surgery. Please discuss your plans for bariatric surgery with your primary care physician to determine if you are medically stable. Having optimal control of conditions such as diabetes and hypertension may decrease your risk.
If you have a history of heart, lung, kidney or other problems, you will be asked to be cleared by a specialist before proceeding with surgery and we may have the specialist follow you post-operatively.
You will be asked to begin a diet prior to surgery. It typically runs two weeks. Our registered dietitian will discuss the length and type of diet with you. The rationale for this diet is to shrink the liver which lies in close proximity to the stomach. The liver stores fat, so pre-operative weight loss and shrinkage of the liver may make it easier for the surgeon to perform the surgery.
Stop smoking! Cigarette smoking or other tobacco usage increases your immediate post-operative risks for blood clots, bleeding, poor healing, and respiratory complications. It can also increase your long-term risk for ulcers. Our surgeons will not operate on current smokers due to the risk of post op complications. If you have questions regarding smoking cessation, please contact us. You can also discuss this with your primary care physician.
Begin an exercise program prior to surgery. Exercise may improve your cardiopulmonary status. Be sure to discuss an exercise program with your doctor before you begin to determine if the program is appropriate for your medical situation.
Surgery done by an experienced bariatric surgeon in a facility that is experienced in the care of the bariatric surgery patient and has proven outcomes by being named an American Society of Metabolic and Bariatric Surgery Center of Excellence may decrease your risks. Our team of surgeons have done thousands of bariatric surgical procedures. Saint Francis Hospital has an experienced team of nurses, medical consultants and ancillary staff to care for you before, during and after your hospital stay.
Many insurance plans do cover bariatric surgery. Let us verify your specific benefits. We will get your insurance information from the application that you fill out and send to us after attending the seminar. If it is determined that you do have benefits, we still must submit a pre-determination letter and documentation to prove medical necessity. Once we submit the letter it may take anywhere from a few days to a few weeks to receive a response. This is generally done after you have completed our program.
In the event that your insurance does not cover bariatric surgery, there are some alternatives to consider.
Does my employer offer more than one insurance plan at open enrollment? If so, does one of the other plans include coverage for bariatric surgery?
Does the plan that my spouse has include bariatric surgery coverage? If so, can I be added to that plan?
Do I want to pay for this surgery myself? If this is an option, please call our office at (901) 881-0600. We will be happy to discuss specific financial information with you.
The Saint Francis Center for Surgical Weight Loss Program will communicate with your insurance company to
determine if you have benefits for bariatric surgery.
Unfortunately, some insurance companies do not cover bariatric surgery due to an exclusion in the
plan. Listed below are some options to consider in the event you do not have benefits for weight loss surgery.
- Your employer may offer more than one insurance plan at open enrollment time. If so, do any of those plans provide coverage?
- You may have the opportunity to purchase benefits on a spouse’s plan. If your primary plan has an exclusion for weight loss surgery, your secondary plan may cover your surgery.
- You may pay for the surgery without insurance coverage. Call us for cash pay pricing information — (901) 881-0600.
Generally, patients who have the laparoscopic Roux-en-Y Gastric Bypass or the Sleeve Gastrectomy will spend two nights in the hospital. The Adjustable band is typically an outpatient procedure.
For patients who have Gastric Bypass or Sleeve Gastrectomy the average return to work is 2 weeks. Most patients who have the Laparoscopic Adjustable Gastric Banding can return to work after 1 week. Time off of work may vary depending on the type of work you do. Your bariatric surgeon will discuss your individual situation with you.
A multivitamin is recommended for all patients who have had bariatric surgery. Additional supplementation of Vitamin B12, calcium, iron and thiamine may be necessary depending on the surgical procedure. Your surgeon and the dietitian will discuss this with you prior to surgery.
Patients who have the bypass or sleeve gastrectomy are generally seen at 2 weeks, 6 weeks by the dietitian, 6 months and 1 year post-operatively and then annually. These follow-up visits will be with our nurse practitioner. You are welcome to request an appointment with your surgeon at any time. You may also call our program dietitian and meet with her anytime you feel like you need to.
For patients who have had a band, your first appointment will be at around 6 weeks after surgery at which you will have your first adjustment. You will need to be seen frequently to determine the need for further adjustments.
It is imperative that you continue to follow-up with your bariatric surgeon and/or the support staff including the nurses and dietitian. Bariatric surgery requires a long-term commitment between the patient, the surgeon and the program!
Weight loss will vary from patient to patient. There are a number of factors that can influence your weight loss including age, pre-operative weight, gender, and compliance with follow-up, dietary guidelines and lifestyle changes including exercise.
Patients who have the Roux-en-Y Gastric Bypass average a weight loss of 60- 80% of excess body weight. Most patients will lose most of their weight in the first year to 18 months. Some patients may experience about a 10% weight regain after several years but will generally maintain a 60-70% loss of excess body weight. In order to be successful long term, you must make permanent lifestyle changes.
Sleeve Gastrectomy patients average 50- 60% of excess body weight lost. As with the gastric bypass most of the weight is lost within the first year.
Please keep in mind that bariatric surgery is only a tool. Patients must learn to utilize that tool effectively. We are here to help you by providing ongoing educational classes with our registered dietitian and support groups to assist you with making the necessary lifestyle changes.
Significant weight loss may lead to excessive skin in areas such as the neck, abdomen, arms, and thighs. For some patients the excessive skin may cause problems with skin irritation and rashes. For others it may be bothersome from a cosmetic perspective. A plastic surgeon will be able to determine the type of procedure that is needed and if there is medical necessity. It is recommended that you wait until you have lost most of your weight before considering plastic surgery. Insurance companies generally do not pay for this type of procedure.
Morbidly obese women may often have problems with fertility and the ability to become pregnant. Obesity may also increase the risk of complications during pregnancy.
Pregnancy is not advised during the first year when the most rapid weight loss is occurring as it may deprive the fetus of essential nutrients that it needs to grow. Because weight loss may improve fertility it is imperative that a reliable form of birth control be used following surgery. Women who are contemplating bariatric surgery and future pregnancy should discuss this with their obstetrician/gynecologist however it is absolutely possible to have a healthy pregnancy and a healthy baby after weight loss surgery.
Hair loss after Bariatric surgery is common in the months immediately following surgery.
Telogen Effluvium is an emotional and physical stress response hormone that is unrelated to protein deficiency, malnutrition and/or vitamin & mineral deficiency.This usually occurs within the first 6 months
Signs of nutrition related hair loss including continued thinning or hair loss more than a year after surgery or hair loss that starts 6 months or later after surgery