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10 Steps to Prepare for Weight Loss Surgery

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Posted by Charis Ripley-Hager, MD

So, you’ve heard that weight loss surgery may be right for you. You may have already spoken to a physician who has confirmed that you meet the body mass index (BMI) requirements, where you've also discussed the pros and cons of surgery. And, even if you haven’t spoken to a physician yet, you may be curious about the bariatric surgery process. So, what is there to know?

Before you can schedule your procedure, you’ll need to spend some time preparing.

As a bariatric surgeon, I know just how impactful weight loss surgery can be. It can help patients achieve a healthier BMI when diet and lifestyle changes haven't worked, and most importantly, it can drastically improve their overall health and increase their quality of life. Conditions including type 2 diabetes, high blood pressure, sleep apnea, arthritis, metabolic syndrome, and non-alcoholic fatty liver disease become easier to manage, or are cured completely. Patients of child-bearing age may experience improved fertility, too.

In short, weight-loss surgery can be life-altering. But patients need to do their part to experience a successful outcome. Bariatric surgery is a long-term commitment, and there are many steps you need to take before the procedure. Here's a look at the process I discuss with my patients.

1. Learn about nutrition.

Healthy eating habits are the key to making weight loss surgery work. Meeting with a registered dietitian gives you an opportunity to learn about the necessary dietary changes you'll need to make both before and after your surgery. These include eating smaller portion sizes, chewing food completely, staying adequately hydrated, and tracking daily food intake.

You may also need to take vitamins and supplements to make sure your nutritional needs are met. If your blood sugar isn't currently well managed, you will work with your primary care doctor or endocrinologist to get it under control before your surgery.

Post-surgery, you'll start with a liquid diet and slowly transition to eating very soft foods. After a while, you can slowly start to re-introduce regular foods. This transition is crucial for helping your stomach and digestive system heal and adjust.

2. Commit to a weight loss and exercise plan.

With your care team, you'll define your weight loss goals and determine how you'll reach them. Having a documented plan makes you more likely to succeed. Outlining specific steps before surgery will give you a chance to put them into practice right now so they feel like second nature after your procedure.

Along with adjusting your diet, one of the most important components of your plan will be regular exercise. Regular exercise is so important to a successful surgery that I strongly encourage it well before surgery, since post-surgery, I recommend that my patients engage in at least 30 minutes of moderate activity daily after they have sufficiently recovered from surgery.

If you never exercise, don’t be intimidated – walking, and doing beginner workouts on YouTube or free workout apps are both good options. Even getting more incidental activity throughout the day, like taking the stairs or parking at the far end of the lot, counts as exercise.

3. Undergo a mental health assessment.

Bariatric surgery patients need to make significant lifestyle changes to reach and maintain their weight-loss goals. Losing weight after surgery can bring shifts to your social life, relationships, and emotions. Part of your care team's job is to determine if you’re mentally ready to undergo these adjustments and incorporate the nutritional and behavioral changes needed to support your health.

With a psychologist, you'll discuss your mental health history, including whether you've experienced depression or eating disorders and how you've managed prior attempts to lose weight. You'll also talk about social factors that could impact your ability to lose weight, such as employment or housing. Alcohol dependence will be reviewed to prepare patients post-surgery, since some patients may be at higher risk for alcohol use disorder after surgery.

4. Get medical clearance.

Excess weight can make any type of surgery, including weight loss surgery, riskier. Before being approved for bariatric surgery, your care team will assess your heart and lung function to make sure that your body is strong enough to withstand the stresses of the procedure. You'll also undergo bloodwork to check your metabolic and nutritional state.

Other tests may be needed, too, based on your health status and the type of surgery you're having. Some patients with gastrointestinal symptoms may need to have an endoscopy, for instance. Your surgeon may also recommend sleep apnea testing, radiology studies, or bone density tests.

5. Adopt other positive behaviors.

You don’t need to wait to incorporate other healthy lifestyle habits to support your weight loss goals. In fact, the more you can do ahead of time, the easier your post-surgery transition will be. I encourage patients to:

  • Focus on improving their sleep habits
  • Find techniques to manage their stress
  • Identify sources of support, including family, friends, or joining Temple’s bariatric surgery support group
  • Work on coping mechanisms to manage eating for emotional reasons and eating in social settings

For patients who smoke, you must quit well in advance of your surgery. Patients must also refrain from smoking after surgery to avoid serious surgical and health complications

6. Confirm insurance eligibility.

Many insurance plans offer full or partial coverage for bariatric surgery. You may be required to submit documentation proving your candidacy, including your BMI and any weight-related health conditions, such as diabetes or high blood pressure, that make you eligible for the procedure. Some patients also need to show proof that their prior weight loss attempts were unsuccessful.

7. Undergo pre-surgery anesthesia preparation

Weight-loss surgery is performed under general anesthesia. Since some risk factors associated with excess weight can affect the way anesthesia is administered, it's important to plan for those ahead of time. For instance, your anesthesiologist may need to consider airway management plans if you have obstructive sleep apnea, since the condition can make it more difficult to insert a breathing tube. They’ll also need to confirm that they can easily access veins to obtain a good intravenous (IV) line.

8. Do your homework.

My patients learn a lot about weight loss surgery and life afterward when talking with me and the other members of their care team. I also encourage them to attend educational classes and, if possible, speak with others who have actually undergone bariatric procedures at our monthly Bariatric Support Groups. There are also many videos on our website of patients’ life transformations after undergoing bariatric surgery.

The more information you can gather ahead of time, the more likely you'll go into surgery with accurate expectations. And who knows? You might even form new relationships and expand your support circle.

9. Rely on your care team.

At Temple, we’re proud to help our patients achieve the best possible results with the support of a strong, multidisciplinary team. From preparing for surgery to recovering and adjusting to life afterward, you’ll be guided by your surgeon, multiple physicians, nurse practitioners, physician assistants, nurses, dietitians, psychologists, and other coordinators. Together, they will deliver the personalized care you need to reach a healthier weight — and stay there.

10. Learn more about the bariatric surgery journey.

Sign up for a free Bariatric Surgery Seminar conducted by one of the expert Temple bariatric surgeons. These virtual seminars provide an opportunity to learn about bariatric surgery procedures and the lifestyle changes needed for success.

Helpful Resources

Looking for more information?

Charis Ripley-Hager, MD

Dr. Ripley-Hager is a board-certified surgeon at Temple's Bariatric Program and Assistant Professor of Surgery at the Lewis Katz School of Medicine at Temple University.

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