The Preoperative Process and Bariatric Surgery for Weight Loss
Bariatric Surgery is a major, life changing commitment that is an effective and safe method of weight loss for those who are desperately seeking answers. However, surgery should not be considered the first line of therapy. Patients must show extensive effort with diet, exercise, and other natural alternatives before considering bariatric surgery. Although the procedure has major long term benefits of reducing weight related health problems (such as hypertension, diabetes, sleep apnea, and heart disease), it also carries procedural risks as any medical procedure does. Patients must go through a medical process to determine if they are candidates for the procedure they choose. Procedures include: Roux en Y Bariatric Procedure,
Lap Band Surgery and Sleeve Gastrectomy. This includes determining if the patient is physically fit for surgery, psychologically prepared for the commitment and compliance of therapy, as well as determining if the patient has proper social support. Recently there has been discussion of weight loss surgery improving chances of fertility as well; reproductive endocrinologists are referring patients for weight loss surgery as well.
Body Mass Index (BMI) is measured for all patients as well as evaluation and determination of possible concurrent health conditions. These conditions include:
- Diabetes Mellitus
- Obstructive Sleep apnea
- Heart Disease
- Obesity related psychosocial stress
- Venous stasis
- Non-alcoholic steatohepatitis (“fatty liver”)
- Dyslipidemia (“high cholesterol”)
Consult with your primary care physician:
After various attempts at losing weight, consult with your primary care physician to discuss if bariatric surgery is in your best interest medically. This should be a collaborative effort between patients and their various medical providers. If the decision is made that this would be in the best interest of the patient from a health standpoint, a series of tests will be done to assure that the patient is qualified for surgery. Remember, this is an elective procedure, and your primary care provider must assure that you are healthy enough for surgery. If you arrive for a bariatric consultation and do not have a primary care physician, your surgeon will help coordinate a medical team to be in place. Patients can expect to go through a physical examination to prepare for surgery. This may include a cardiac evaluation, pulmonary evaluation, psychiatric evaluation, blood tests, and dietary consultation depending on the procedure and the patient’s prior medical history. Tests to expect can include the following:
- Heart Health:
- Echocardiogram (If indicated)
- Lung Health:
- Pulmonary Function Tests (if you suffer from COPD or Asthma)
- Mental Health:
- Evaluation by a mental health professional to assure you are mentally prepared for the required commitment and compliance, and to determine if the patient has the proper social support at home. Some bariatric practices also provide support groups to aid patients to cope through the various emotional changes of having weight loss surgery.
- Blood Tests:
- To rule out any underlying physiological causes of weight problems that could be readily corrected medically.
- Dietary Consult:
- Consulting with a certified dietician to discuss pre-operative and post-operative diet regimens will be helpful for your success and long term health outcomes. An extensive diet plan will be made for you to best enhance results.
Of note a mental health and/or nutritional evaluation may not be required in pre operative workups for all patients but can be very informative, helpful and supportive to the patient. It is required on a case to case basis for many bariatric practices.
A great Resource for Florida Bariatric Surgeon is Dr. Shillingford in Boca Raton, FL.
Talk with your friends and family:
Bariatric surgery is a major life changing commitment, and the process can be emotionally and physically challenging to some. Talk with your close friends and family to get their opinions, and assure that you have their support and encouragement before initiating this process. Patients will require help, compassion, and support from those closest to them to ensure the best possible results. Post-operatively, patients must have someone helping them physically, encouraging diet compliance, and being supportive of new lifestyle changes. This process can lead to a much higher quality of life, but patients must have proper social support to guide them through this life changing process.
Consult with your bariatric surgeon:
After establishing that you are healthy enough physically and mentally for surgery, and that you have proper social support, consulting with your bariatric surgeon is the next step. Your surgeon will educate you on all of the available procedure options. After discussing the risks and benefits of each procedure, together you will collaborate to decide which weight loss surgery best suites you. Although the surgeon will give you his medical opinion and recommendation, the decision to proceed with surgery is ultimately up to you as the patient. Bring all questions and concerns to the consult, and be sure to that you are clear on all aspects before making decisions.
Diet and exercise:
After making the commitment of getting a procedure done, one of the most important steps is preparing you as the patient for the lifestyle change commitments post operatively. Patients will start a low calorie, higher protein, low carbohydrate diet to instill healthy eating habits before surgery. This is done because this is how the patient will be eating for the rest of their life. Pre-operatively is the best time to start making healthy food choices, because it is essential after surgery. Patients must also exercise regularly, because although bariatric surgery will show weight loss, results may plateau if the patient is not doing their part by exercising. These factors are crucial for the best results.
Pre-operative preparation is a very important aspect of bariatric surgery. Although it seems quite extensive, these are all very important steps to assure the best possible health outcomes for all patients. Bariatric surgery is a lifelong commitment that requires much compliance and dedication. Whether you choose bariatric, sleeve gastrectomy surgery or the lap band procedure this pre-operative process is crucial, and is the beginning towards your new life of happiness, health, and well-being.
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