Surgical Weight Loss Education
The decision to have weight loss surgery is a big one, which is why the process takes time. We want to make sure you have the understanding and support you will need for a successful outcome. The following topics will provide you with some general surgical weight loss education. You’ll receive more detailed information as you embark upon your journey, and you are always welcome to call us if you have any questions.
The preoperative evaluation is similar for all bariatric surgery procedures. Each step is designed to determine if you meet the qualifications for surgery, identify issues that may interfere with the success of the surgery, and assess and treat related diseases. The steps include:
- Psychological Evaluation: All insurance companies require that you receive clearance for weight loss surgery after you undergo a psychological evaluation. If you are being treated for a psychological condition, it does not necessarily mean you will not receive clearance.
- Nutrition Consultation: All insurance companies require that you receive clearance after a nutritional consultation that includes a nutritional assessment, education regarding post-operative eating behaviors, and pre-operative weight loss efforts.
- Medical Evaluation: You will have a medical exam that includes a thorough history and physical examination to identify co-morbidities that may complicate the surgery. Our surgeon will also consult with your primary care provider to address medical conditions to reduce your pre-operative risk. For example, while we don’t require pre-operative weight loss, it may be useful to reduce your liver size and improve access for the operation.
For anyone who has considered a weight loss program, there is certainly no shortage of choices. In fact, to qualify for insurance coverage of weight loss 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, healthy living, 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 5 percent 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 90 percent 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.”
If surgery is your next option, it is important to understand that healthy nutrition 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 healthy eating and behavior modifications will determine your ultimate success.
The fact remains that morbid obesity is a complex, multifactorial chronic disease. For many patients, the risk of death from not having the surgery is greater than the risks from the possible complications of having the procedure.
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 most patients.
The most important step in weight loss surgery is getting all the information you need about the various surgical options. Ultimately, your surgeon and medical team are your best resource for information about the procedure. 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 with a surgeon and consultation with more than one doctor. If you research weight loss surgery on your own, be sure that your sources are recognized experts in the field. An excellent resource for weight loss surgery is the American Society for Metabolic and Bariatric Surgery.
Although the results of weight loss surgery can be drastic, there are potential risks and complications. Before making your decision, make sure you are well informed so you can “informed consent” for the procedure. Informed consent is a legal term meaning that a patient agrees that they have received and understood enough information about a procedure’s benefits and risks to allow them to make a decision that is right for them.
Your surgeon will require you to sign a consent form before performing the operation. Before you do, you should have a solid understanding of what is about to take place, including what you need to do to live well after the operation, and any signs or symptoms of complications to look for after your surgery.
Bariatric 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 risk and complications of the procedures versus not having the surgery.
- The ineffectiveness of current non-surgical approaches to produce sustained weight loss.
You should view weight loss surgery 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 a body mass index of 40 or greater.
Bariatric surgery may also be considered if you have a BMI of 35 or higher if your physician determines that obesity-related health conditions have resulted in a medical need for weight reduction and, in the doctor’s opinion, surgery appears to be the only way to accomplish the targeted weight loss.
You must make a commitment to required, long-term follow-up care, demonstrate serious motivation, and show a clear understanding of the extensive dietary, exercise and medical guidelines that must be followed for the remainder of your life after having weight loss surgery.
Weight loss surgery is a tool, not a treatment, so you must make a lifelong commitment to diet modification and regular 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 concluded 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 body’s 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 and increasing 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 slowly and build up. Attend a support group for 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.