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FAQs (Pre-Surgical)

Pre Bariatric Surgery Requirements FAQ

Q: How do I know which weight loss procedure is right for me?

A: Your surgeon will review your medical history with you and help you determine the weight loss surgery that is appropriate for your lifestyle and medical history. It is best to review our website to get more information about what we offer.

Q: How do I know if I’m a candidate for weight loss surgery?

A: You may qualify for surgery if your body mass index (BMI) is 40 or more (about 100 pounds overweight for men and 80 pounds for women) or if your BMI is 35 to 39.9 with a serious obesity-related health problem such as type 2 diabetes, coronary artery disease, sleep apnea, acid reflux or hypertension. More recently, patients with BMI between 30-35 also are candidates, only if they chose the lap band surgery. You also need to be able to commit to lifetime follow up, vitamin supplementation and healthy lifestyle changes.

Q: What is BMI?

A: B.M.I. or body mass index is a number that we calculate to give significance to the relationship between your height and weight. It means something very different for a 7 foot tall man to weigh 300 pounds as opposed to a 5 foot tall woman weighing 300 lbs. This number helps us to account for these issues and to put people into categories that indicate how sick the extra weight is making them.

Q: How can I figure out my BMI?

A: You can visit our website and click on the BMI calculator.

Q: How do I know if my insurance company or employer covers weight loss surgery?

A: Your Human Resources or Employee Benefit office should be able to provide that information to you. However, our team contacts your insurance agency to determine available coverage and any costs not covered under your plan. Our team will make every attempt to work with your insurance provider or employer to obtain approval for the chosen weight loss surgery.

Q: Is private financing available if my insurance company or employer does not cover weight loss surgery?

A: Yes, your Patient Advocate will provide you with alternative funding sources and guide you through the process.

Q: Who do I need to talk to regarding the final cost of surgery?

A: During your visit with BMI of Texas please ask to visit with one of our billing specialists.

Q: Why do I have to see a dietitian and have a psychiatric evaluation?

A: While your operation is a very important piece of the puzzle that will help you get healthier, they are by themselves incomplete. You will soon have an incredible tool at your disposal to help you fight a disease that has been to this point overwhelming. In order for you to achieve success, you must know how to best use that tool. This is where the team comes into play. The dietitians and psychology staff will help you to understand how food choices and behavioral changes have in the past led you into trouble, but in the future will lead you to success that you may have thought impossible. Most insurance companies will require that patients meet with these individuals before approving the surgery. We feel that the team approach is critical to you getting the most out of your surgery.

Q: Is there an age requirement to have weight loss surgery?

A: Surgery is usually safest at the age groups between 16 and 70. If you are interested in surgery and/or weight loss and are out of this age group, please call the office to make an appointment with our doctors  to hear about your options.

Q: What medical problems does weight loss surgery improve?

A: Surgery can improve or cure most obesity related illnesses such as diabetes, sleep apnea, hypertension, high cholesterol, acid reflux, depression, stress incontinence, muscle/joint pain and osteoarthritis. Weight loss is also associated with favorable pregnancy outcomes, improves fertility and decreases cancer risk. Bariatric surgery also increases total life expectancy.

Q: Why do I have to be placed on a pre-op liquid diet?

A:  It is imperative that you strictly follow your liquid protein diet for 14 days prior to your operation to help reduce complications during your operation. A pre-op liquid diet helps reduce the size of your liver making it easier to perform surgery on your stomach.

Q: Why do I need to take vitamins for life?

A: Vitamin supplementation is important to maintaining lifelong health. Since portion sizes will be significantly smaller after weight loss surgery, it is imperative that you attain adequate nutrition with vitamin supplementation. Your body may also not adequately absorb many of the vitamins in food, therefore it is necessary to supplement. Vitamin deficiencies can cause severe nutritional problems and devastating symptoms which can be prevented by taking daily vitamins for life.

Q: What type of vitamins do I need to be taking?

A: There are special formulated vitamins for weight loss surgery patients and we recommend chewable Bariatric Fusion vitamins. These are sold at our office. If you cannot tolerate the vitamins we recommend, Gastric Band patients need to take a multivitamin and 1600 mg of calcium with vitamin D daily and vitamin B12 (can be taken oral daily, injection monthly, or nasal spray weekly). Sleeve gastrectomy and Gastric bypass patients need two multivitamins daily, 1600mg of calcium citrate daily with vitamin D, iron and vitamin B12. Ask your dietitian for further guidance when choosing vitamins.

Q: What are the potential risks and/or complications of weight loss surgery?

A: Most of the risks of bariatric surgery are similar to any other surgery in the abdomen. Bleeding, infection, need for corrective procedures, hernias, wound problems are all very low risks.
Mortality risk after having a weight loss procedure of a rny bypass or a sleeve gastrectomy are less than 1%. Leak after a gastric bypass has a 1% risk and a sleeve operation has a 2% risk nationally. Our leak rate at BMI of Texas is <1/1000. A leak with a band operation is extremely rare since no new connections or resections are being done. There is an increased risk of lap band slippage or shifting over the life of the band. These can usually be surgically corrected without need for removal of the band. The risk of an erosion of the band into the stomach is 1%. This, while rare, does require removal of the band. There are also risks of ulcers or swallowing problems. There is a risk of a blood clot forming in the legs or in the pelvis. If a blood clot breaks free and lodges in the lungs this is called a pulmonary embolism. This is uncommon, but is something all surgeons worry about as it is difficult to manage. Failure to lose weight, while rare, is risk as well. It usually involves a compliance problem however. There may be other risks of these operations that we don’t yet know as weight loss surgery is a new field of medicine and some of the operations are very new. This list is a partial list of risks; a more complete description is available at our seminar.

Q: How long does it take after I watch a seminar to get on the surgery schedule?

A: This depends almost entirely on the requirements of your insurance company. Many carriers require extended physician monitored diet appointments for 3 or 6 consecutive months. As soon as you are approved for bariatric surgery, we will be ready to proceed. If you do not have to go through your insurance company, the time can be very short (even a week or 2).

Q: Why do I have to quit smoking if I want my surgery done by BMI of Texas?

A: Smoking will increase all potential risks of surgery including death. Tobacco increases the risk for blood clot formation in your legs (deep venous thrombosis) which could lead to a pulmonary embolus, poor tissue and wound healing leading to a leak and infections, and anesthesia complications such as acute respiratory distress syndrome and pneumonia. Smoking will also cause gastric ulcerations and erosions in your new stomach pouch. You must quit smoking at least 6 weeks prior to your surgery or your surgery will be postponed. A smoke-free lifestyle must be maintained after surgery too.

Q: Do I need to take a bowel preparation before surgery?

A: It is not mandatory that patients take a bowel preparation prior to surgery.
Since patients are placed on a liquid diet prior to surgery, bowel cleansers (laxatives) are not needed for weight loss surgery.

Q: What is body composition analysis and how do you measure it?

A: Body composition analysis is measured by an iDexa machine. The iDexa analyzes a person’s body composition by distinguishing body fat from muscle mass from water weight. The body fat calculation measures peripheral fat versus the fat inside the abdomen called visceral fat. This machine, which we have at BMI of Texas, helps determine whether the weight loss is metabolically significant then truly keeping you healthy. We are able to track on what areas of the body that fat was lost and muscle was gained.

Q: How often is the iDexa body composition analysis done?

A: We recommend it done before surgery, at 6 months after surgery, at one year after surgery and every year to follow. This will help us track the weight loss results accurately ensuring that our patients are maintaining their muscle mass and keeping the fat off.

Q: What is metabolic syndrome?

A: Metabolic syndrome is a phrase to describe a series of risk factors that cause diseases such as heart disease and diabetes. Metabolic syndrome can be diagnosed with the risk factors of elevated blood sugars, elevated triglycerides (cholesterol in the blood), low HDL (good cholesterol particles), high blood pressure, and large waist lines.

Q: How do you treat metabolic syndrome?

A: Commitment to weight loss and healthy dietary lifestyle changes can help treat metabolic syndrome.

Q: What is metabolic surgery and surgery for diabetes?

A: There are two operations that are classified by metabolic surgery and that is the gastric bypass and the sleeve gastrectomy. These surgeries alter hormones in your body to help make you healthier by tackling metabolic syndrome (type II diabetes, insulin resistance, and cholesterol abnormalities). These surgeries help your health prior to any significant weight loss has started. Surgery for diabetes is metabolic surgery in that the procedure is performed to improve your insulin and glucose function.

Do you qualify for weight loss surgery? Take the Quiz!