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After having a consultation with a surgeon, most patients will require anywhere from 6 weeks to several months before they actually have the operation. During that period of time, it allows them to see all the various specialists like the dietician and the psychologist and the gastroenterologist. Sometimes they also need to see a cardiologist or a pulmonologist (which is a lung doctor) to make sure that that patient is optimized for that operation.
After having a consultation with a surgeon, most patients will require anywhere from 6 weeks to several months before they actually have the operation. During that period of time, it allows them to see all the various specialists like the dietician and the psychologist and the gastroenterologist. Sometimes they also need to see a cardiologist or a pulmonologist (which is a lung doctor) to make sure that that patient is optimized for that operation.
Weight loss surgery is for anyone that is what we would consider morbidly obese. It's not for someone that is only 20 or 30 pounds overweight. It's generally for people that are roughly 100 pounds overweight and those patients definitely need to lose weight because of all the different medical problems that can develop as a result of them being morbidly obese.
Most insurance companies cover weight loss surgery. However, it varies from plan to plan, so it's important for you to contact your insurance company to ask if the plan that you have covers weight loss surgery.
Prior to surgery, we do not require patients to go on any specific or special diet to lose weight. However, early on in the process (in fact, right after I have my consultation with a patient) we begin working with them to help them to change their lifestyle and start eating healthier foods and to start exercising. In general, we expect to see patients lose some degree of weight prior to having surgery. If a patient continues to gain weight or gains a tremendous amount of weight prior to having surgery, that really tells us that they're probably mentally not prepared and not ready to have surgery at that time. We'll hold off until we are sure that that patient is ready to have surgery.
Patients come to me to have weight loss surgery for all different reasons. Sometimes it's the patient themselves who realize that one day they look in the mirror and say, "you know what? I am way too heavy, I have too many medical problems and it's time for me to lose weight." Other times it's that patient's doctor who tells them that they need to lose weight because of all of their medical problems. Other times, it's somebody like an orthopedic surgeon or a spine surgeon who tells their patient: "Look: before I can fix your back or I can fix your knees or hip, you need to lose a significant amount of weight and therefore you need to say a weight loss surgeon."
Because weight loss surgery is a major operation and can be complicated and has significant effects on your health, it is important for you to see multiple specialists when being considered for weight loss surgery. That usually includes seeing the surgeon, a gastroenterologist, a dietician, and a psychologist, to start. These specialists will determine if both your body and your mind are healthy enough to undergo the rigors of weight loss surgery.
One of the most common questions I get from patients is: "which operation should I have?" That is actually one of the tougher questions to answer. There's no one right answer for everybody, but there are guidelines that we go by and suggestions that we may give the patient. For instance, if somebody has fairly significant type 2 diabetes or they have horrendous heartburn and reflux, we may suggest the gastric bypass to them. Why? Because the gastric bypass is the most effective operation in treating type 2 diabetes and it is also an anti-reflux operation and usually cures an individual of their heartburn and reflux. On the other hand, if a patient has a strong family history of stomach cancer, let's say that their mother or their father or their brother or some other relative has had stomach cancer and they are at an increased risk of that, we may suggest performing a sleeve gastrectomy because we are removing 85% of that patient's stomach and that in turn reduces their risk of getting stomach cancer. It is also much easier to monitor a patient that has had a sleeve gastrectomy for screening with an upper endoscopy to check and see if they do have stomach cancer. With the lap band, that is generally a choice that the patient makes. Lap bands are the safest operation when it comes to the weight loss operations and it is also reversible. Because of that fact, patients often select the lap band because of those features. However, it's important to note that the lap band does result in the least amount of weight loss when compared to the sleeve gastrectomy and the gastric bypass. When considering weight loss surgery, it's important to have a lengthy discussion with your weight loss surgeon to decide which operation fits you best.
When you come into our office for a consultation, you generally first see myself or one of my colleagues that are weight loss surgeons. After that evaluation, if we feel that you are an adequate surgical candidate, we then have you see our dietitian for an evaluation. Then we have you see our psychologist for a mental evaluation. Then after that, we also have you see a gastroenterologist who performs and upper endoscopy at some point to look inside of your stomach and make sure that your stomach is healthy enough to undergo an operation. Patients that are old enough will be sent for a stress test to evaluate their heart and if there are any other tests that need to be done to evaluate a patient's health in regard to being prepared for surgery, we will order those tests as well. Once all of these evaluations are completed, we meet with the various other specialists and if everybody agrees that a patient is a good candidate for surgery, we then go ahead and schedule the patient for surgery.
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