About Weight Loss Surgery

Depending on your insurance, you may need a referral from your PCP (primary care physician) before you can even make an appointment to see the bariatric surgeon. Depending on the surgeon, you may need to attend a group seminar to learn about the surgery and how his program works before making an appointment.

The length of time it will take to actually get to see the surgeon may vary greatly from one person to another. Depending on your geographic location, and many other variables, In my case, once I had the referral from my PCP, I was able to get an appointment to see the bariatric nurse and the surgeon in about a month from the time I called.

The surgeon's office will probably have lots of paperwork for you to complete before your consultation. They will want to know detailed information such as:

	your past and current health conditions
	list of all of the efforts you have made in the past to lose weight (the specific program you were on, dates, how much weight you lost and if you regained it, how much)
	specific information about any medically-supervised weight loss programs you have been on, dates, weight lost and/or regained
	list of any surgeries you have had in the past
	list of current medications you take
	information about exercise you have done in the past, and exercise you currently do
	a statement about why you are interested in weight loss surgery and how your struggle with weight has affected your life
	family medical history

The exact questions your surgeon asks may vary, but this is a general idea of what to expect.

Again, this will vary with the surgeon you are going to see. In my case, I will see the bariatric nurse one day and the surgeon the next day. The appointment with the nurse will be to go over the paperwork I've completed, calculate my BMI and ideal body weight.

She will also review preoperative and postoperative diet, vitamins, minerals, protein supplements, and exercise. She'll also talk to me about issues such as time off from work, going back to work, support from family and friends, emotional and psychological ramifications of gastric bypass surgery, and the patient support group.

Other topics discussed at the nurse consult will include if I would like to receive psychological counseling regarding the surgery. The surgeon I will be seeing has a psychologist on staff. In addition, I will have the opportunity to ask all the questions I've accumulated up to this point.

At this time, I will be given instructions about beginning an exercise program during the preoperative period. I will also be required to follow a specific low calorie/low fat diet, as well as a vitamin and mineral supplementation program.

My surgeon requires you to stop smoking or use of any other tobacco products at least one month prior to surgery (I do NOT smoke!)

My physician also requests that patients lose 10 pounds before surgery. This gives the surgeon better visibility for performing the surgery and shortens the length of the operation. Rapid preoperative weight loss has been shown to decrease the size of the left lobe of the liver.

When I see the surgeon, he will discuss and clarify my medical history, conduct a brief physical exam, and determine if I'm a good candidate for weight loss surgery. If he considers me a candidate, he will discuss the benefits, expected outcomes, risks, complications, and contraindications of the different procedures. He will also give me additional reading materials to help me make an informed decision.

If I decide at this time that I want to have surgery (I'm already sure I DO!), the process of getting insurance approval will now begin.

The surgeon's office will prepare and send a request for pre-approval to my insurance company within about a week of my consultation. Then the wait for approval will begin. The length of time before approval or denial may vary greatly, depending on the insurance company and the details of your coverage..

Some insurance companies require a psychological evaluation prior to approving this type of surgery.

In my case, my insurance does require this evaluation. The psychologist and I met and talked for about one hour. She then wrote a report and faxed it to my surgeon's office the next week.

My insurance also requires a consult with a nutritionist. Some surgeon's may also require this. In my case, the consult took about an hour, during which we talked about my current eating habits, as well as diets I've been on in the past.

The nutritionist will write up her report and fax it to my surgeon's office. I have also asked her to fax it directly to the insurance company, since this is the piece they are waiting on before they evaluate my information for approval or denial.

Once the insurance approval has been obtained, the surgeon's office will contact me with a surgery date. They will schedule the preoperative lab, and exams that are needed, and arrange for a preoperative visit with the hospital dietician, the surgeon, and the bariatric nurse.