Preparing for Weight Loss Surgery For those who
consider weight loss surgery, they are at the end of their ropes. Traditional
methods of diet and exercise have had no effect, and this procedure is a last
resort. But by no means is the leap from thinking about weight loss surgery to
the operating table a short one. "People need to be aware, in
great detail, of the risk and benefits of weight loss surgery so they understand
what it is all about," says Harvey J. Sugerman, president of the American
Society for Bariatric Surgery. "The procedure is not without risk, and there is
a great deal of anxiety that comes with it, so it takes considerable
preparation." From checking on insurance coverage to
psychological exams to support groups, preparing for this life-changing
procedure takes time, physical and mental readiness, and most of all,
commitment. First Steps "From the time a person first
thinks about having weight loss surgery, to the time they make the commitment to
have it done is typically about two years," says James Kolenich, a bariatric
surgeon at the University of Pennsylvania Medical Center, Horizon. "Most people
don’t rush into this, they talk to family and friends, they talk to the
hospital, they go home and they think about it more; it’s usually a very
thoughtful approach." More than 60 million obese people are
living in the U. S. , according to the American Obesity Association (AOA), and
about 9 million are severely obese. Weight loss surgery, also called bariatric
surgery, can be successful when diet and exercise have failed, and a person’s
health is on the line. Overweight is the second leading cause of preventable
death, after smoking, in the U. S. , according to the AOA. "The
first thing a person should do is contact his insurance company to learn if he
is covered for the surgery, and he should contact his primary care doctor to
find out if there is documentation of his struggle with obesity," says Kolenich.
"Many insurance companies want to know that a primary care doctor has tried to
help the patient lose weight with psychological counseling, diet, and an
exercise plan for five years, and for many patients, this is a big road
block." While there are other options, such as personally
financing the procedure, they are costly: The National Institute of Diabetes and
Digestive and Kidney Diseases web site states that this procedure can run from $
20,000 to $ 35,000. With such a hefty price tag on weight loss
surgery, it pays to ensure that your doctor documents your battle with obesity
early on, to open up options down the road. When you’ve crossed all your is and
dotted all your is in the insurance category, it is time to find a hospital or
center, and a surgeon, which are first-rate. Finding a Batiatric
Surgeon "When you’re looking for a surgeon, ask if he or she
is board-certified by the American Board of Surgery," says Kotenich. "Is he a
member of the American Society of Bariatrie Surgeons What is the mortality rate
of the surgeon, the morbidity rate, the success rate" Clearly,
the surgeon you find should be well experienced in the area of weight loss
surgery. "Make sure the surgeon you choose is an experienced and
qualified bariatrie surgeon," says Daniel Herren, chief of bariatric surgery at
Mt. Sinai Hospital in New York. "It’s clear that the more experienced the
surgeon, the lower the risk of mortality. Ideally, you would prefer to find a
surgeon who has performed at least 100 of these procedures."
What you are looking for doesn’t stop with numbers and statistics--you
will also need a support system, Look for a center or hospital that offers
educational seminars to those who are just beginning the process so you can
learn more about the actual procedure, the benefits, and the risks. Also look
for support groups, that can be utilized pre-and
post-operatively. Preparing for Weight Loss Surgery
"The single most important factor is that they have to realize the surgery
is not a cure for obesity," says Herren. "It’s a very powerful tool used in the
fight against obesity. It needs to be considered as part of a process, and a
lifelong commitment to follow up with physicians, a regular exercise program,
and healthy eating. If a person doesn’t understand that this is a lifelong
commitment, that it’s net a quick fix, then he or she is not a good
candidate." From a physical standpoint, the preparation for
weight loss surgery involves meeting with doctors--a lot of them.
A person also needs to meet with a nutritionist, to begin to better
understand the elements of healthy eating, and how eating habits need to change
before and after the surgery. "By getting into a proper nutritional mindset
before surgery, such as learning to eat smaller portions, eating Slowly, paying
closer attention to the nutritional make-up of meals, a person is better adapted
for the major changes in their lifestyle after the surgery," says Herron.
Understanding the Risks Understanding the possible
outcomes of weight loss surgery, including the risks, is an important part of
preparing for the procedure. "Education is a tremendously important part of the
preoperative process," says Herron. "There is no question that there are
major risks associated with the operation. However, those risks can be minimized
by having a thorough preoperative workup so there aren’t surprises during the
procedure, and by making sure the surgeon is experienced and
qualified." Nonetheless, dealing with the emotional toll of this
procedure can be difficult, especially when considering the possibility of
death. "There have been good studies looking at the risk of dying after weight
loss surgery, showing that although there is a risk of death with surgery, the
overall survival rate is improved with surgery compared to not having the
surgery at all, and living with obesity," says Herron. It helps
that most centers and hospitals and insurance companies, require psychological
evaluations prior to the allowing the procedure--which benefits both patient and
doctor. "You have to fill your mind with as much optimism and positive thinking
as possible," says Joe De Simone, PhD, a psychiatrist in private practice in N.
Y., who works with patients preparing for weight loss surgery. "Basically,
the preparation is to become more conscious of what you are thinking and
feeling, and start preparing yourself to think of food and your life in a
different way. This is a courageous step for people to take, and it’s not just
about weight changing--it’s about life changing." Pest-Op
Expectations While weight loss surgery does have a major
impact on a person’s life, it requires, like any surgical procedure, some
recovery time. "The recovery period is quite variable," says Herron. "I have
some patients who take a week off and are back full time, and others who take
three to four weeks to recover. While it’s certainly physically possible to be
back to 90% of capacity after a week, most people take longer to adjust to the
new lifestyle." New techniques have also helped to lessen
recovery time. Today, the procedure can be performed minimally invasively
via small incisions. In a few centers around the country it can even be done on
an outpatient basis. Patients also need to remember weight loss
surgery is not a cure. "It’s not a magic bullet, but is an amazingly powerful
weight-loss tool," says Herron. "A person will find they will lose about a pound
per day for the first month or so. Then they’ll lose between 50%-75% of their
excess body weight typically during the first 12 months after surgery." What
follows is dedication to a healthy diet and exercise regimen, continual
follow-up with doctors to monitor progress, and commitment to a new life. With the development of ______, the recovery period may become shorter and shorter.