Undergoing bariatric surgery is one of the most life-changing decisions you’ll ever make. Although some weight-loss surgeries (WLS) are advertised as “reversible,” they aren’t designed to be short-term solutions. You must commit completely to the process if you expect to achieve significant, long-lasting weight loss while avoiding health problems associated with WLS. Here are some of the ways you will need to prepare before you have any form of bariatric surgery.
Initial Consideration of Bariatric Surgery
Most obese and significantly overweight patients spend several years thinking about weight-loss surgery before they make a decision. That’s a smart approach. Gastric bypass, sleeve, duodenal switch and banding procedures all have many risks. Complications are not uncommon. Even if you avoid serious complications, there are plenty of side effects that will alter how you interact with food forever. Some of the changes in your gastrointestinal system may be permanent even if the surgery is reversed. Here are a few of the questions you must answer for yourself when you are deciding whether WLS is right for you:
- Is my quality of life suffering substantially because of my excess weight?
- Am I less mobile than I want to be because of how much I weigh?
- Am I at greater risk from obesity and related medical conditions than I would be from bariatric surgery?
- Have I tried every other reasonable option for losing weight and keeping it off?
- Have I asked my doctor to help me find a way to lose weight without surgery?
- Has my doctor documented my weight loss efforts and my level of obesity through the years?
- Am I prepared to give up an attachment to favorite foods or unhealthy eating habits?
- Do I have any unresolved emotional issues stemming from childhood abuse that affect my body image or my relationship with food? If so, am I ready to seek help for these issues now?
- Will my loved ones support me in making the changes necessary to follow a post-surgery lifestyle?
- Will my job and/or family commitments leave me with too little time to manage my health needs after WLS?
- Am I willing to accept that my body may still look overweight to others even if I lose a large number of pounds?
- Can I accept that my skin may not tighten up after I lose weight?
- Will I be tempted to give up if my weight plateaus or if I face other obstacles to success in losing weight after surgery?
- Am I responsible enough to take supplements daily and have frequent lab testing to ensure that I am getting adequate nutrition for the rest of my life?
- Am I basing my decision on information from a seminar, or am I willing to look at all the pros and cons based on the clinical evidence available for this procedure?
- Is there a local or online WLS support group to help me get through my recovery process?
Physical Preparation for Bariatric Surgery
You don’t have to wait until you have bariatric surgery to start losing weight. In fact, adopting a healthier lifestyle before you have the surgery is essential. For example, you absolutely must stop smoking to be eligible for WLS. Smoking is the leading preventable cause of complications for surgery. You should already be practicing the eating habits you will be expected to adopt after the procedure. That includes:
- Limiting meal size
- Chewing your food thoroughly
- Restricting simple carbohydrates and fats
- Drinking water throughout the day to stay hydrated
- Staying away from alcohol, caffeine and carbonated beverages
This helps you understand what life will be like after the operation and whether you will find it tolerable. Your surgeon may place you on a liquid diet for as long as two weeks prior to your surgery.
Begin a fitness routine. Exercising regularly so your body is as strong and healthy as possible increases your chances of doing well after the surgery. You want exercise to be a habit that’s well engrained so you don’t lose your motivation to work out later. The less you weigh going into bariatric surgery, the lower risk you will have for serious complications. The dramatic weight loss following WLS can place a lot of strain on your system. So, losing some of the excess fat gradually beforehand can make things easier on your body.
Preparing Financially for Bariatric Surgery
If you have insurance, follow your provider’s instructions for bariatric surgery pre-approval to ensure that your procedure is covered. This may include obtaining health records from your primary care physician, a nutritionist, a mental health counselor and your prospective surgeon. If you are paying out of pocket, you may wish to access a line of credit specifically for medical expenses. Most bariatric surgery centers can recommend one or more financing options.
Preparing for Bariatric Surgery Recovery
The recovery time varies depending on the extent of the surgery, overall patient health and complications. You might need just a week or two if you have a less invasive form of WLS. But it’s a good idea to plan for at least a few weeks off work. Even if you are feeling better from the surgery, you will still be getting used to the changes in your digestive system. This means you may need to be near a bathroom to deal with the side effects of your new diet regimen. Be sure to budget for the supplies you will need during recovery as well. The longer you can have someone stay with you and help you out, the better. You will at least need someone to drive you home. It’s best if they can stay with you for a few days.
Choosing a Bariatric Surgeon
Currently, there are no restrictions in the United States regarding what type of physician is permitted to perform bariatric surgery. Any doctor can take a short course and begin offering the procedure. This means you need to find someone who is well qualified. Your surgeon should be ABS or AOBS certified. Preferably, they should also be certified by the American Society for Metabolic and Bariatric Surgery. A bariatric surgeon who has performed over 200 WLS procedures (with a low complication rate) is usually your best option. Generally, surgeons who are affiliated with the best bariatric surgical centers are the most likely to meet all of these criteria.
Bariatric Surgery Consultation Time
You may consult with a number of health care professionals in the weeks and months leading up to your weight-loss surgery. This means you need to have a good grasp of all your own medical history. You will be asked to provide information such as:
- Any serious illnesses, hospitalizations or surgeries (including any complications)
- Any prescription drugs, OTC medications, herbs, supplements, vitamins or other substances you are taking
- History of pregnancies and whether you plan to become pregnant in the near future
- History of any allergies to anesthesia, pain medications, antibiotics, etc.
- History of weight loss attempts
- Names and phone numbers of your other healthcare providers
Your bariatric surgeon will advise you of any steps you need to take prior to your procedure. This may include:
- What medications to take or discontinue
- What to eat or drink or when to start fasting for the procedure
- How to bathe yourself with special antibacterial soap before surgery
- What supplies and medications to purchase in advance for use during recovery
- Other lifestyle changes to make prior to your procedure
Preparing for the Day of Surgery
This stage is similar to preparing for any other major surgery. Wear comfortable clothing that will be easy to get on and off after the operation. Don’t wear makeup, perfume, lotion, nail polish or other cosmetics. Leave valuables, jewelry and credit cards at home. Only bring the identification, insurance and other cards you will need to complete transactions at the hospital or bariatric surgery center. If you will be staying for a few days, bring extra changes of clothing, personal hygiene items and entertainment to keep you comfortable.