Cheat Sheet

Weight Loss Surgery For Dummies

From Weight Loss Surgery For Dummies, 2nd Edition by Marina S. Kurian, MD, Barbara Thompson, Brian K. Davidson, Al Roker (Foreword by)

Weight loss surgery is a life-altering step, one that can dramatically improve your quality of life. But it’s not a quick fix or an easy answer to obesity. If you’re thinking about weight loss surgery, you’re probably wondering about the benefits. You’re also probably not sure what your insurance will cover or what’s involved in the surgery itself. You may be wondering if weight loss surgery is right for you or how to find a surgeon. All these questions are important ones to ask — and answer — as you consider the pros and cons of this important step.

The Benefits of Weight Loss Surgery

Weight loss surgery is not for everyone, but it does offer many benefits. Losing a significant amount of weight — and keeping it off — can impact numerous medical and physical aspects of your life. Here’s a quick rundown on some of the things that improve after weight loss surgery:

  • All patients see a significant decrease in joint pain. Every pound you lose is like taking 3 pounds off your knees!

  • Up to 90 percent of patients see a remission of or improvement in their type 2 diabetes.

  • Up to 80 percent of patients see a remission of or improvement in their high blood pressure.

  • Up to 70 percent of patients see a remission of or improvement in their sleep apnea.

  • Some patients see a lessening of their gastroesophageal reflux disease (GERD) symptoms.

  • Some patients see an improvement in their fertility.

  • On average, patients experience greater weight loss than with diet, exercise, and medication.

Weight Loss Surgery and Insurance

So, you’ve decided to go ahead with weight loss surgery. One of your first steps should be to check your insurance policy to make sure you’re covered for the procedure you want to undergo. You can do this online or by calling your insurance company’s customer service number.

Here are a few additional steps you can take to help improve your chances of getting your insurance company to cover the procedure:

  • Write down all the different diets you’ve been on, how much weight you lost, and how much you regained.

  • Document whether you’ve ever taken any weight loss medication.

  • Get office notes from any doctors or dietitians you’ve seen to help you lose weight.

  • If you know your insurance company wants a six-month doctor-supervised diet, get started! Ask your doctor to see you every month and document your weight, what kind of diet you’re on, and what kind of behavior modification or exercises you’re undertaking. If you can’t exercise because of physical limitations, have your doctor document your physical disabilities.

Types of Weight Loss Surgery

Weight loss surgery is just a broad category for several different weight loss procedures. Here are some basic descriptions of the most common weight loss surgeries:

  • Roux-en-Y (pronounced roo-en-why) gastric bypass: A procedure in which the stomach and intestines are divided and rearranged to make a new small stomach (known as a pouch) and bypass part of the stomach and the intestines. Initially after the surgery, you’ll eat very small portions. This procedure is the most common weight loss procedure being done today.

  • Adjustable gastric banding: A procedure in which an inflatable silicone band or ring is placed around the upper part of the stomach. The band has a port that is placed under the skin, which is used to inflate the band. The port is accessed with a needle through the skin, and saline is added or removed; this is known as a fill or adjustment. Adjustments are given to reduce hunger and portion size and increase weight loss. The procedure is usually done laparoscopically.

  • Sleeve gastrectomy: A procedure in which up to 70 percent of your stomach is removed. The pylorus, which regulates the entry of food into the intestine, is not removed, and food enters the intestine normally. Initially after the surgery, you’ll feel less hungry and eat a lot less. This procedure has been increasing in numbers.

  • Biliopancreatic diversion: A procedure in which part of the stomach is removed and a significant intestinal bypass is performed. The biliopancreatic diversion can be performed in two ways, and the difference between the two procedures lies in which part of the stomach is removed. In the first version, known simply as biliopancreatic diversion, the lower part of the stomach is removed, and the remaining stomach is hooked up to the part of the small intestine that is closer to the colon, known as the ileum. In the second version, biliopancreatic diversion with duodenal switch, the outer curve of the stomach is removed, and the first part of the small intestine is hooked up to the ileum. Approximately 90 percent of the small intestine is bypassed in both the surgeries, resulting in significantly fewer calories and nutrients being absorbed. Weight loss is maximized, but nutritional deficiencies can occur more frequently than with the other weight loss procedures, so you need to take nutritional supplements for the rest of your life.

Is Weight Loss Surgery Right for Me?

So, you want to explore the option of weight loss surgery. You’ve tried diets in the past and regained all the weight you lost. This type of yo-yo dieting is common — you’re not alone. Here are some ways to get more information about the different types of procedures that are out there:

  • Tell your primary-care doctor or gynecologist that you’re thinking about weight loss surgery. Your doctor may have other patients who’ve undergone weight loss procedures and be able to share with you the results. Your doctor also may be able to refer you to a respected weight loss surgeon in your community.

  • Read as much as possible about the different procedures. Exercise caution when it comes to what you read online — some sites are more accurate than others. You may want to start with the website of the American Society for Metabolic & Bariatric Surgery (www.asmbs.org), where you can get info about risks and benefits of weight loss surgery.

  • Attend an information session at a local hospital or at a weight loss surgeon’s practice. Here you can hear firsthand how the surgeries are done and get your questions answered.

  • If you know someone who has had weight loss surgery and if he or she is open to talking about it, ask about the experience. Find out what kind of procedure the person had and what the pros and cons have been.

Finding a Weight Loss Surgeon

You’ve decided to have weight loss surgery — or at the very least, look into it further. Finding a surgeon is one of the most important steps in this process. Here are some ways to find a reputable weight loss surgeon:

  • Go to the website of the American Society for Metabolic & Bariatric Surgery (www.asmbs.org) or the American College of Surgeons (www.facs.org). Both of these websites have a “Find a Surgeon” tool that you can use to find surgeons in your area who are board certified and have experience in weight loss surgery.

  • Ask your primary-care doctor or gynecologist for a referral to a weight loss surgeon. They’ll likely have patients who have undergone weight loss surgery, seen their success, and can help guide your choice of surgeon.

  • Go to ObesityHelp (www.obesityhelp.com) and the websites of the weight loss surgeons you’re considering. Read patient testimonials about surgeons to find the one that’s best for you.

  • Ask family, friends, and acquaintances for referrals. If you know people in your area who’ve had weight loss surgery, ask about their experiences with their surgeons, the hospitals where they had their surgeries, and their surgeons’ staffs.

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