Preparing Weight Loss for Surgery

Weight loss surgery takes thorough mental and physical preparation, but most important, it takes commitment

By Heather Hatfield
WebMD Weight Loss Clinic - Feature

Reviewed By Michael Smith, MD

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, MD, 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, MD, 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."

sonally 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 t's and dotted all your i's in the insurance category, it is time to find a hospital or center, and a surgeon, that are first-rate.

Finding a Bariatric Surgeon

"When you're looking for a surgeon, ask if he or she is board-certified by the American Board of Surgery," says Kolenich. "Is he a member of the American Society of Bariatric 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 bariatric surgeon," says Daniel Herron, MD, 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.

The preparation, both physical and mental, comes next, and is as crucial to the entire process as the actual procedure.

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 Herron. "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 not a quick fix, then he or she is not a good candidate."

"You have to fill your mind with as much optimism and positive thinking as possible."