Candidates for weight loss surgery

Weight loss surgery may be an option if you have been unsuccessful in losing weight through diet and exercise and if you are suffering from weight-related health problems.

Weight loss surgery is only a tool. Your ultimate success depends on your life-long commitment and adherence to recommended dietary, exercise and lifestyle changes. To be a good candidate for bariatric surgery, you should be well-informed and motivated. You should also have the capacity to ensure participation in treatment and long-term follow-up care.

Physical requirements for bariatric surgery

The National Institutes of Health offers these guidelines for weight loss surgery candidacy in adults 18 years old and older:

• Have a body mass index (BMI) higher than 40
• Have a BMI between 35 and 40 and at least two obesity-related, comorbid diseases (e.g.: diabetes, history of stroke, high blood pressure, heart disease or disabling pain in weight-bearing joints)
• BMI of 30 or higher with type 2 diabetes that does not respond to medication, exercise or diet changes

Other reasons you may be a good candidate for weight loss surgery include if you:

• Have not had success with nonsurgical methods of weight loss (such as diet, exercise and medication)
• Are not suffering from any other disease which could have caused you to be overweight
• Do not have a history of alcohol or substance abuse

These are simply guidelines. Ultimately, if you qualify medically, the final decision to have the procedure is up to you. After your initial consultation and learning more about the program and process, you can decide.

BMI calculator

BMI is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people. It is used to screen for weight categories that may lead to health problems.

The first thing we suggest you do is to attend one of our free, informational weight loss surgery seminars. It will introduce you to the basics of bariatric surgery and let our experts answer your questions.

Decide how you want to pay for surgery

Next, you will need to decide if you want to self-pay or use insurance to cover the cost of surgery. If you decide to self-pay, our facilities can help walk you through that process. If you decide to use insurance, we recommend the following approach:

• Call your insurance provider. Provide your ID number, and ask if bariatric surgery is a covered benefit. (Make sure you provide your ID number so they can check your employer policy if that applies to you.) Record the name and number of the person you are speaking to.
• Ask and record the answers to these questions:
  • Does my insurance require a referral from my primary care doctor before I see the bariatric surgeon? (If so, you will have to have this appointment before setting up your consultation.)
  • What procedures are covered? For example, are gastric bypass, gastric banding and sleeve gastrectomy covered?
  • Does my insurance require a "medically managed weight loss period"? If so, how long is it?
  • What are the out-of-pocket costs?

Completing a period of medically managed weight loss

Most health insurance providers require you to complete several months of a medically supervised diet before approving your weight loss surgery. Our goal is to help you during that process and answer any questions you have. To do that, each month, we will meet with you to discuss:

• How your health changes are going
• If you are completing the necessary steps for surgery
• If you are keeping up with your insurance-required doctor's appointments

Establish your record of nonsurgical weight loss methods

Especially if you are using insurance to pay for your surgery, you will need to try non-surgical weight loss methods before being considered for surgery. It is critical to have your physician document every step you take in your medical chart.

The typical process for this is as follows:

• Have your primary care physician recommend an exercise and/or diet regimen, and make sure they document these recommendations in your chart.
• Get weigh-ins at your physician’s office at least every four weeks. Have them document your weight in your medical chart along with your progress and make recommendations on how to improve your progress. A complete note must be written noting your progress and the recommendations given.
• If the diet and/or exercise regimen is not effectively helping you lose weight, go see your physician again and have them recommend an alternative program. Continue the physician weigh-ins, and ensure check-ins are frequent and consistent.
• Have copies of this record available when you come in to see your bariatric surgeon. If your primary care physician has questions for us, have them contact your bariatric surgeon.

Attend specialist appointments

The next step is to schedule appointments with specialists to ensure you are approved for surgery. The specialists you see may vary based on your health history, so we will help you identify them during your consultation with our bariatric surgeon. All potential patients will need to have a psychiatric evaluation and dietitian preoperative class.

After all the steps have been completed and you have been cleared for surgery, we can schedule your procedure at our bariatric clinic.