Fair warning–Not all bariatric surgery requirements are the same. Your weight loss surgery requirements may look different from mine. That’s OK! Just follow what your doctor requires of you, and let me know how it all goes for you. You can always reach me on any of my social media channels or by emailing me at email@example.com. I love hearing from you, so please reach out to me with questions or comments!
My weight loss surgery process begins with a free information session offered at my local hospital. At the session, the surgeon discussed the different types of weight loss surgery available. He answered questions we had and thoroughly explained our options. They gave us a folder with more information and paperwork, as well as the opportunity to schedule our initial visit with the surgeon. I took advantage of the opportunity and scheduled my appointment that night. Many hospitals are now doing online information sessions, so you don’t even have to leave your house!
In the folder from the free information session, there was a packet of information for me to fill out and one for my primary care doctor. My packet discussed things like my medical history, my family’s medical history, my relationship to food and exercise, and why I want to lose weight. Filling out this packet was eye-opening and made me realize how big of an impact my obesity was making on my life. I dropped off the packet for my primary care doctor. When I picked it up, they informed me I needed blood work done before my initial appointment with the surgeon. Since I had to fast for the blood work, I arranged to go into work late and got it done on a Monday morning.
At this visit, my surgeon met with me to answer my questions and go over my medical history. He asked me a lot of questions, some were quite personal; some were the usual ones you’d expect. My doctor gave me some more information about weight loss surgery requirements, some instructions to start changing my habits and sent out a list of referrals required. He informed me I needed to lose 50 pounds before my bariatric surgery, and my insurance company requires a six-month waiting period before surgery.
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I attended six nutrition classes, one class per month, for the six-month waiting period before surgery. The classes teach us how to set realistic goals, how to eat better before and after surgery, exercise information and self-management skills. The dieticians who instruct these classes also gave us information about our liver-shrinking diets before surgery and the first few weeks of clear liquids, full liquids, pureed and soft foods after surgery.
The weight loss surgery requirements included a minimum of two support groups, but I attended more. I once did a weight-loss program that required weekly meetings and had a lot of success on it. This program has support groups that met once a month, so I attended monthly. They were so helpful, and it was nice to be surrounded by others going through the same process. I learned so much information and became so inspired, as a lot of post-op patients also attended. These groups are worth it! There’s something really special about gathering with a group of people who just understand what you’re doing, and why you’re doing it.
Since surgery can be tough on your heart, surgeons want a cardiologist to assess your heart function to see if it can handle surgery. It’s also a good idea to get your heart checked since obesity can cause several different heart problems. At the cardiologist, I received an EKG and spoke with the doctor about my medical history and my family’s medical history. He scheduled an echocardiogram to check the structure and function of my heart. Everything came back clear, so I was good to go from his standpoint.
The purpose of seeing a pulmonologist is to assess your lung function and check for sleep apnea. Being obese increases your risk of obstructive sleep apnea and other respiratory problems like pneumonia and respiratory failure after surgery. Additionally, untreated sleep apnea can be extremely dangerous, so your surgeon wants to make sure your lungs can handle the stress of surgery. The pulmonologist went over my medical history, and we discussed the issues with breathing I have after exercise. She prescribed an inhaler for me, which improved my symptoms greatly. She also sent me for an overnight sleep study for obstructive sleep apnea and a pulmonary function test to measure my lung function.
Because I have acid reflux, my surgeon wants to make sure the acid in my stomach has not done damage to my esophagus and stomach before surgery. Unfortunately, he found several ulcers in my stomach that I had to treat before getting surgery. I also had to have a repeat endoscopy to make sure the ulcers were gone before my bariatric surgery. Thankfully they were, and I am double thankful that he ordered this procedure for me. Had he not and attempted to do the bariatric surgery, he would have had to abort the procedure until the ulcers were healed.
After surgery, you can’t use your stomach muscles to move, so physical therapy teaches you how to strengthen your stomach muscles for better recovery and to use the surrounding areas to help you move after surgery. I went for four weeks and found the motivation and encouragement to continue exercising was worth the visits three times a week. It’s also a great way to learn how to strength train safely, and it gets you into a great exercise routine.
Many weight loss surgery requirements include a psychological evaluation. The reason they do the psych eval is that you are being asked to change your whole lifestyle. It can and does take a psychological toll, and they want to give you some tools to manage the stress. They also want to see if you have any underlying mental health issues that need to be addressed. Ultimately, your care team wants to give you the best shot they can to be successful after surgery. If you know that you have a mental health issue already, it doesn’t mean you’re disqualified from surgery. They just want to make sure that you’re treating your mental health issues adequately.
11. Halfway Visit
Halfway through my six-month program, my doctor wanted to check my progress. He wanted to evaluate what the specialists determined and check on my weight loss progress. He made sure I was on track to complete my weight loss surgery requirements and encouraged me to keep up with my lifestyle changes. I also chose gastric bypass as my surgery of choice at this appointment, which later was converted to the gastric sleeve procedure. Keep reading to find out why.
12. Pre-Op Consult
Once all of my weight loss surgery requirements are met, I met with my surgeon to discuss my liver-reducing diet, pre-op guidelines and what to expect the day of surgery. He also ordered final blood work, another EKG and gave me my supply of protein shakes that I’ll need to drink before the surgery. I signed my consent forms, received more paperwork to meet with my primary care physician before surgery and received special soap to wash my body before surgery.
While not an appointment per se, the liver-shrinking diet (LSD for short) is a common step on the bariatric journey. It’s also sometimes called a liver-reducing diet (LRD). I was required to be on a liquid diet for 10 days before surgery with four Bariatric Advantage protein shakes a day and a maximum of two cups of vegetables from an approved list. The day before surgery was clear liquids only. The purpose of this diet is to reduce your liver so that the surgeon can operate on your stomach without complication.
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After I completed all of my weight loss surgery requirements, I lost my required weight, and I’d been given the all-clear, I finally had my surgery on June 18, 2018. I initially went into surgery wanting RNY gastric bypass, however, my surgeon wasn’t able to move my intestines far enough to make the small pouch work. Before surgery, I consented to transition to a vertical sleeve gastrectomy if RNY wasn’t possible for whatever reason. He converted to a sleeve procedure instead, and I am 100 percent happy with the results!
Final Thoughts on Weight Loss Surgery Requirements
Remember those days when I thought weight loss surgery was the easy way out? I’m eating my words now. From the information session to surgery, the weight loss surgery requirements are numerous. Committing to these appointments and jumping through the necessary hoops can be a long, tedious process. However, it’s necessary to address all these aspects to ensure our long-term success. Weight loss surgery requirements include numerous consults, tests and doctor appointments. Stick with the process and keep all of your appointments. The results are worth it, and you are worth it.
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Each program is different, but most are pretty similar to the following:
1. Information Seminar
2. Pre-Visit Paperwork
3. Initial Visit with Surgeon
4. Nutrition Classes
5. Support Groups
8. Upper Endoscopy
9. Physical Therapy
10. Psych Eval
11. Halfway Visit
12. Pre-op Consult
13. Liver-Shrinking Diet
Many insurances in the United States require a three- or six-month waiting period before having bariatric surgery. Each hospital and insurance company is different, so be sure to check with yours for detailed information.