Preparing for Bariatric Surgery

Any bariatric procedure, like any other surgery, carries with it the need for preparation on the part of the patient. That reduces the risks of post-surgical complications and optimizes the chance of the best outcome. But weight loss surgery entails more than the norm, even though it’s less risky than most. It requires that the patient becomes a full partner in the process, not just the surgery.

Your first steps begin long before the anesthesia is administered. You’ll need to consider whether bariatric surgery is appropriate at all and, if so, what type. Any surgery has some risk ó post-op infection, minor bleeding, and others. Bariatric surgery may mean removing or relocating a portion of the gastrointestinal tract, carrying its own unique risks. Big changes to the body carry special risks. Weighing the pros and cons ó in consultation with your bariatric team ó is the first step.

Simultaneously, be sure to check with your insurance company to see what ó if any ó portions of the total process are covered. Few men or women of the many thousands who choose bariatric surgery each year can afford the entire $20-$35,000 tab. Often they don’t need to, either.

Finding the right bariatric team is important, too. Not all bariatric specialists perform all procedures. Even those that do will often have more experience in one method than another. Careful, probing questions are essential to maximize the odds of the best outcome. Don’t be shy about asking; bariatric specialists expect that and will generally give frank and honest answers. Business is good in that field and they don’t need to lie to attract more.

Once chosen, your bariatric specialist will review with you many personal specifics, but here are some anyone can expect:

Smoking cessation at least six weeks before surgery is a must. Patients will be strongly urged to stop permanently. Also, you’ll be limited to clear liquids, starting the day before the surgery. Starting again on a solid diet depends on the procedure, but is usually a couple of weeks after the end of your hospital stay.

A 2-3 day stay at the hospital is average, but some procedures require only a half-day. Those suffering from sleep apnea should bring any gear to the hospital. Your doctor will discuss with you what to do about taking any of your regular medications before or after.

Some tests are standard as part of the process. They include a CBC (Complete Blood Count), Chemistry Panel (which measures 20 different blood chemistry values), Urinalysis, and often a Glucose Tolerance Test to check for diabetes. Some bariatric physicians will look for gallstones by ultrasound. Taking an EKG (Electrocardiogram) reading is common, as are chest X-rays.

There are post-operative care tasks, as well. A Lap Band procedure, for example, (as do the others) always requires a post-surgery follow up. The total process is typically 1-2 years. Frequent visits to the doctor occur early in that period, then taper off.

You’ll meet with a nutritionist, part of the team. He or she will outline a diet that must be followed. Those guidelines need to be adhered to well before the first incision. Your nutritionist may recommend smaller portions and will lay out a meal plan. Learning about better nutrition is part of the process.

Patients will be counseled in possible post-op life changes. Apart from the dietary changes, that covers everything from advice about your love life to adjusting to modified relationships with family and friends.

The psychological aspects of the total bariatric process ó ranging from pre-surgery to prep, surgery, and long-term behavior ó are just as important as the physical ones. Anyone who loses between 50-75% of excess weight in a year, starting with a pound per day the first month, experiences dramatic changes in many ways. Having a positive outlook is important for success.