Surgery: Preparing for Weight Loss Surgery (cont.)

From a physical standpoint, the preparation for weight loss surgery involves meeting with doctors -- a lot of them.

"There are a number of different aspects to preparing for weight loss surgery," says Herron. "The physical is making sure they are meeting with a number of medical doctors, including cardiologists, pulmonologists, and other physicians, to make sure their health status is optimized before surgery."

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 makeup of meals, a person is better adapted for the major changes in their lifestyle after the surgery," says Herron.

And, in many cases, it will mean they lose weight before the procedure, which helps their cause, and underscores his or her commitment to change.

"Some surgeons request that a person try to lose 15-30 pounds prior to the surgery as demonstration of their commitment, if they can," says Kolenich. "A person also might be required to quit smoking, both for their health, as well as to improve the outcome of the operation."

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."

Post-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.

Quick Questions

Ask yourself these questions, from the National Institute of Diabetes and Digestive and Kidney Diseases, if you are considering weight loss surgery. If you answer yes to many or all of them, start by calling your primary care doctor and insurance company.

Are you:

  • Unlikely to lose weight or keep weight off long term with nonsurgical measures?
  • Well informed about the surgical procedure and the effects of treatment?
  • Determined to lose weight and improve your health?
  • Aware of how your life may change after the operation (adjustments to the side effects of the operation include the need to chew food well and inability to eat large meals)?
  • Aware of the potential for serious complications, dietary restrictions, and occasional failures?
  • Committed to lifelong medical follow-up and vitamin/mineral supplementation?

Published Feb. 25, 2005.

SOURCES: Daniel Herron, MD, chief, bariatric surgery, Mt. Sinai Hospital, New York City. James Kolenich, MD, bariatric surgeon, University of Pennsylvania Medical Center, Horizon, Pittsburgh. Joe De Simone, PhD, psychiatrist, private practice, New York City. Harvey J. Sugerman, MD, president, American Society for Bariatric Surgery, Sanibel, Fla. American Obesity Association web site. National Institute of Diabetes and Digestive and Kidney Diseases web site.

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Last Editorial Review: 3/6/2005 4:50:49 PM