Preparing for Bariatric Surgery

Team Approach
Most surgeons and insurance providers recommend and support a team approach to bariatric surgery. An ideal program would have at least four components: medical, nutritional, psychological, and surgical.¹⁷ This multidisciplinary team evaluates the patient before surgery and provides education and treatment after surgery. This team delivers medical, nutritional, and psychological care, and looks at lifestyle changes following surgery.

Most bariatric programs require that patients participate in support groups before surgery. This group setting is helpful for patients before surgery, as they discuss their concerns and hear from other patients who have gone through bariatric surgery.

Selecting a Procedure
After you have completed the presurgery medical, nutritional, and psychological evaluations and have adequate metabolic control, your bariatric surgeon will discuss the benefits and risks of the different surgical procedures, and together you will choose the most appropriate surgery for you. Once you and your surgeon have agreed upon a procedure, your next step will be to set a date.


What Can I Do to Prepare?
Bariatric surgery is like other major surgeries. You can best prepare by knowing the benefits and risks of surgery and by closely following your doctor's instructions.

To mentally prepare yourself:

• Understand the surgical process and what to expect afterward.

• Keep in mind that you’ll never be able to eat the way you did before, and that you’ll have to watch the way you eat for the rest of your life.

• Talk to people who have had bariatric surgery.

• Write a letter to yourself and your surgeon explaining your reasons for having bariatric surgery and outlining your plans to maintain your weight loss after surgery.

• Start a journal. Record how you feel now, the challenges you face, and the things you hope to be able to do after bariatric surgery.

• Get a letter of support from your family. It helps to know you have people behind you, waiting to help.

To prepare for your insurance approval:

• Consult your insurance company regarding your benefits.
• Consult with your medical doctor and ask to be placed on a six month supervised diet and ask for a letter of medical necessity.
• Obtain your diet history:
  Most insurance companies are looking for a five year history of morbid obesity.  This is simply a record of weight each year for the past five years.  This can be obtained from your regular doctor or other supervised weight loss programs such as Weight Watchers or Jenny Craig.  Logs from supervised diet programs or journals can also be helpful.
  
  

To prepare yourself physically, follow the guidelines that your doctor or the exercise physiologist will give you. The guidelines will be based upon your procedure, your personal profile, and other factors. You want to ensure your best outcome, and the guidelines will help you accomplish that.

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References

17 Kushner RF. Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion—Assessment and Management of Adult Obesity: A Primer for Physicians (Booklet 7: Surgical Management). Chicago, IL. American Medical Association 2003.