So you have been thinking about having weight loss surgery but are not sure where to start. The first step is to make an appointment with your primary care physician. You will need to get a referral from your primary care physician for an appointment with a bariatric surgeon. During the appointment with your primary care physician, you will want to discuss a few things.
- What other weight loss methods have you tried?
- What kind of success did you have with those methods?
- What is your goal for your weight loss?
If you’re happy with your primary physician you will also want to see if they are able to continue with you after your surgery. The first year or so you will be under the care of your bariatric surgeon. Most primary care physicians can handle your regular annual physicals and any additional follow-ups that you may need after you have been cleared from your bariatric surgeon’s care.
If you are not comfortable with your primary care physician or if they’re not able to continue with your follow-up care, it is a good idea to get a referral. They may know another primary care doctor who is experienced and comfortable dealing with any aftereffects of bariatric surgery. Your primary care doctor will need to be aware of the increased blood work and yearly tests that you will need for the rest of your life.
Before the Appointment
There are a few things that you should do before your first appointment with your bariatric surgeon. This includes reviewing their records that are online. You can find good reviews of doctors on many different sites including HealthGrades and RateMDs. You want a doctor that matches your personality. Patient reviews will give you a good idea if your doctor is clinical and brusque or more conversational and slow-paced. You need to know what fits best with your personality.
The doctor I chose was very clinical and the appointments were short and to the point. That is what works best for me. I wanted to get in, get weighed, have my questions answered, and get out with the next steps that I needed for this process. Others need someone who is going to spend more time talking with you and who is comfortable with a lot of emotion. This is a personal preference and is definitely something you want to know about your bariatric surgeon before you walk in the door.
Doing some research before your appointment will help you feel more prepared for something that is a major step in your life. This is a decision that will affect the rest of your life and normally the first year is pretty tough. You need to make sure you are comfortable with your decision and with your surgeon.
At the Appointment
Before the first visit with your bariatric surgeon, you will be asked to fill out all of your pre-visit paperwork. This will give you a good idea about some of the questions that your bariatric surgeon will be asking you. When you get to your appointment, you will have a few more pages for you to fill out in case there have been any changes since you filled out your initial paperwork. You will also be discussing if your insurance will be covering the surgery or if you will be a self-pay patient.
Then comes the dreaded scale. Between the referral from my primary care physician and seeing the bariatric surgeon was about six months. The last time I saw my primary care physician I was at about 450 pounds. Seeing 494 pounds come up on the scale just six months later was jarring, to say the least.
It’s important to remember that that number on the scale doesn’t define you as a person. You’re more than a dress size. How much space your body takes up does not define your self-worth. You need to look at it as a starting point, not as an ending point.
Your vitals will all be taken and then it is time to sit down and have an in-depth discussion with the surgeon. You will go over all of the same questions that you went over with your primary care physician and more.
Some questions may be hard to answer but it is important that you’re honest. I had spent so long lying about my weight, the amount I ate, and how much I exercised that this was a very difficult part for me. You have to remember that your surgeon is there to help you and no matter what you say they are going to be compassionate and give you some good advice. They need you to be honest so they are able to choose the best surgical option for you.
Your bariatric surgeon will review your medical and diet histories, and discuss all surgical options. Together you will determine what would be the best course of action for your weight loss journey. You will be given a list of pre-op clearances that you will need to have done before your surgery. This can be a very short list or a very long list depending on additional medical issues that you have.
During this initial consultation, you will also have the opportunity to ask questions. It’s important that you are prepared with your questions ahead of time. So often when we are getting a lot of new information thrown at us we will forget to ask certain things. Some of the most important questions that you should discuss with your bariatric surgeon can be found on my bariatric preop questionnaire.
After your Appointment
After your appointment, you may have a pretty long list of pre-op appointments that you will need to schedule. Some of these could include a cardiology consult and a psychological evaluation. Don’t worry just because you are obese does not mean that you’re crazy. Most doctors will also order an upper endoscope to make sure there are no underlying conditions with your stomach. This is also necessary if you are planning on having laparoscopic surgery.
There is usually a waitlist for surgery and most doctors require you to lose some weight before surgery. Many will give you a pre-surgery diet that will help you lose some weight to make sure you are as healthy as possible going into your surgery. A preoperative diet must be followed 7-14 days before gastric bypass surgery in order to reduce the amount of fat around the liver and spleen. Depending on your medical history you may have additional appointments including physical therapy or instructions to attend nutrition classes.
Now that you’ve made it through your first bariatric consult and you have all of your information it’s time for you to make your decision. There are many things to consider when deciding if this is right for you. After my first visit with the bariatric surgeon, I was filled with hope more than fear. I’d never had surgery before so I was terrified of going under the knife. At the time and at my weight I would not qualify for laparoscopic surgery so I had to have an open procedure. There were two things that helped most in my decision: the confidence in my surgeon and my hope for a child.