FAQs

If you answer "Yes" to any of the following questions, weight loss surgery might be the right answer for you at this time"

Do you have a BMI of 35 or more plus an obesity-related health problem (diabetes, high blood pressure, or sleep apnea, etc.)?

Do you have a BMI of 40 or more?

Does your weight cause physical problems that interfere with family or work-related activities?

 

The best way to prepare for surgery is to make sure you are well informed about your procedure. We are here to help you achieve your goals and to support you as you prepare for this exciting change in your life.

Here are some suggestions that you can begin to work on right away:

If you drink carbonated beverages, now is the time to stop. Why? When a cold compressed gas (carbonation) hits a your stomach it expands. That can be very problematic, especially after surgery.

Start a program of physical activity such as walking or swimming for 20 minutes, four times a week. Be sure to receive a physician's approval before starting any program involving physical exertion.

Stop smoking. Cigarettes interfere with your lung's ability to exchange oxygen, and nicotine can impair circulation, which can impede healing after surgery and increase the chance of infection.

Reduce the amount of refined carbohydrates you consume. Refined carbohydrates include foods such as white rice, pasta and cookies.

Review this helpful checklist to ensure that your surgery will be approved by your insurance provider.

Almost immediately after surgery we will require you to get up and move about. When you leave the hospital, you will be able to care for all your personal needs, but will need help with childcare, shopping, lifting, and transportation.

Many patients experience some hair loss or thinning after surgery. This usually occurs between the fourth and fifth month after surgery. Most patients experience natural hair re-growth after the initial period of weight loss. A diet plan which provides a consistent intake of protein at mealtime is the most important method of reducing hair loss.

 

Your doctor will determine whether medication for blood pressure, diabetes, and other medical conditions can be stopped when the conditions for which they are taken improve or resolve after weight loss surgery. For medications that need to be continued, the vast majority can be swallowed, absorbed, and work the same as before weight loss surgery. Usually no change in dosage is required.

 

Several things happen to allow your weight to stabilize:

Your ongoing metabolic needs decrease as the body sheds excess pounds.

There will be a natural, progressive increase in calorie and nutrient intake over the months following weight loss surgery.

The stomach pouch and attached small intestine will learn to work together better and there will be some expansion in ouch size over a period of months.

The bottom line is that, in the absence of a surgical complication, you are very unlikely to lose weight to the point of malnutrition. Eventually, your caloric intake will equal the amount of calories your body needs to function and your weight loss will stop.

 

Most insurance carriers cover bariatric surgery. When you come for your consultation, we will contact your insurance company and make sure that we know exactly what your coverage is and what their pre-operative requirements are.

WHY DOES IT TAKE SO LONG TO GET INSURANCE APPROVAL?

After your telephone interview consultation is completed, it usually takes your doctor 1-2 days to send a letter to your insurance carrier to start the approval process. The time it takes to get an answer can vary from about 3-4 weeks or longer if you are not persistent in your follow-up. Most treatment centers have insurance analysts who will follow up regularly on approval requests. It may be helpful for you to call the claims service of your insurance company about a week after your letter is submitted and ask about the status of your request.

HOW CAN THEY DENY INSURANCE PAYMENT FOR A LIFE-THREATENING DISEASE?

Payment may be denied because there may be a specific exclusion in your policy for obesity surgery or "treatment of obesity." Such an exclusion can often be appealed when the surgical treatment is recommended by your surgeon or referring physician as the best therapy to relieve life-threatening obesity-related health conditions, which usually are covered.

Insurance payment may also be denied for lack of "medical necessity." A therapy is deemed to be medically necessary when it is needed to treat a serious or life-threatening condition. In the case of morbid obesity, alternative treatments - such as dieting, exercise, behavior modification, and some medications - are considered to be available. Medical necessity denials usually hinge on the insurance company's request for some form of documentation, such as 1 to 5 years of physician-supervised dieting or a psychiatric evaluation, illustrating that you have tried unsuccessfully to lose weight by other methods.

WHAT CAN I DO TO HELP THE PROCESS?

Gather all the information (diet records, medical records, medical tests) your insurance company may require. This reduces the likelihood of a denial for failure to provide "necessary" information. Letters from your personal physician and consultants attesting to the "medical necessity" of treatment are particularly valuable. When several physicians report the same findings, it may confirm a medical necessity for surgery.

When the letter is submitted, call your carrier regularly to ask about the status of your request. Your employer or human relations/personnel office may also be able to help you work through unreasonable delays.

 

It is strongly recommended that women wait at least 18-24 months after the surgery before a pregnancy. At 18-24 months after surgery, your body will be fairly stable (from a weight and nutrition standpoint) and you should be able to carry a normally nourished fetus. When you begin contemplating pregnancy, you should consult your family physician or gynecologist to evaluate your health and discuss special considerations PRIOR to becoming pregnant.

 

Every attempt is made to control pain after surgery to make it possible for you to move about quickly and become active. This helps avoid problems and speeds recovery.

 

 

Most lap band surgeries are same-day surgeries. However, because of health risks or other concerns, your surgeon may choose to keep you overnight. The laparoscopic gastric bypass and the sleeve gastrectomy are done on an inpatient basis and may require several nights hospital stay.

 

Not very often. If necessary, it is usually given after surgery to promote healing. You must understand a blood transfusion is a possibility with any surgical procedure. If you have any objections to the use of blood you should discuss it with your surgeon before the surgery is scheduled.

 

Patients are strongly encouraged to stop smoking at least six months before surgery. Smoking is always discouraged at any time, but is especially important around the time of your surgery.

 

Depending on the procedure, you may have blood work, EKG, chest X-ray and pregnancy text immediately prior to surgery. Pulmonary function tests, sleep studies, GI evaluations, or a cardiology evaluation, may be requested if required due to your health status.

 

Adhesions are scar tissues formed inside the abdomen after surgery or injury. Adhesions can form with any major surgery in the abdomen. In general, this is not a significant problem after laparoscopic weight loss surgery.

 

Gather all the information that your insurance company may require. Letters from your primary care physician and consultants attesting to the "medical necessity" of treatment are very valuable.

 

Most pills or capsules are small enough to pass through the new stomach pouch. Initially your doctor may suggest that medications be crushed or taken in liquid form.

 

The actual weight a patient will lose after the procedure is dependent on several factors. These include:

• Patient's age
• Weight before surgery
• Overall condition of patient's health
• Surgical procedure
• Ability to exercise
• Commitment to maintaining dietary guidelines and other follow-up care
• Motivation of patient and cooperation of their family, friends and associates

In general, weight loss surgery success is defined as achieving loss of 50% or more of excess body weight and maintaining that level for at least five years. Clinical data will vary for each of the different procedures mentioned on this site. Results may also vary by surgeon. Ask your doctor for the clinical data stating their results of the procedure they are recommending.

Clinical studies show that, following surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. Patients may lose 30 to 50% of their excess weight in the first six months and 77% of excess weight as early as 12 months after surgery. Another study showed that patients can maintain a 50-60% loss of excess weight 10-14 years after surgery.

Patients with higher initial BMIs tend to lose more total weight. Patients with lower initial BMIs will lose a greater percentage of their excess weight and will more likely come closer to their ideal body weight.

Patients with Type 2 Diabetes tend to show less overall excess weight loss than patients without Type 2 Diabetes.

The surgery has been found to be effective in improving and controlling many obesity-related health conditions. A 2000 study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved. For example, many patients with Type 2 Diabetes, while showing less overall excess weight loss, have demonstrated excellent resolution of their diabetic condition, to the point of having little or no need for continuing medication.

WHY DOES IT TAKE SO LONG TO GET INSURANCE APPROVAL?

After your telephone interview consultation is completed, it usually takes your doctor 1-2 days to send a letter to your insurance carrier to start the approval process. The time it takes to get an answer can vary from about 3-4 weeks or longer if you are not persistent in your follow-up. Most treatment centers have insurance analysts who will follow up regularly on approval requests. It may be helpful for you to call the claims service of your insurance company about a week after your letter is submitted and ask about the status of your request.

HOW CAN THEY DENY INSURANCE PAYMENT FOR A LIFE-THREATENING DISEASE?

Payment may be denied because there may be a specific exclusion in your policy for obesity surgery or "treatment of obesity." Such an exclusion can often be appealed when the surgical treatment is recommended by your surgeon or referring physician as the best therapy to relieve life-threatening obesity-related health conditions, which usually are covered.

Insurance payment may also be denied for lack of "medical necessity." A therapy is deemed to be medically necessary when it is needed to treat a serious or life-threatening condition. In the case of morbid obesity, alternative treatments - such as dieting, exercise, behavior modification, and some medications - are considered to be available. Medical necessity denials usually hinge on the insurance company's request for some form of documentation, such as 1 to 5 years of physician-supervised dieting or a psychiatric evaluation, illustrating that you have tried unsuccessfully to lose weight by other methods.

WHAT CAN I DO TO HELP THE PROCESS?

Gather all the information (diet records, medical records, medical tests) your insurance company may require. This reduces the likelihood of a denial for failure to provide "necessary" information. Letters from your personal physician and consultants attesting to the "medical necessity" of treatment are particularly valuable. When several physicians report the same findings, it may confirm a medical necessity for surgery.

When the letter is submitted, call your carrier regularly to ask about the status of your request. Your employer or human relations/personnel office may also be able to help you work through unreasonable delays.