What is “Obesity” and what is “Morbid Obesity?”
What causes obesity?
What health conditions does morbid obesity contribute to?
What is BMI?
What factors determine whether or not an individual is morbidly obese?
- If you are more than 100 lb over your ideal body weight
- If you have a Body Mass Index (BMI)* of greater than 40
- If your BMI is more than 35, and is accompanied by serious co-morbidity.
I am morbidly obese. What are my best treatment options?
I’m considering weight loss surgery. Is there anything I should know first and foremost before finalizing my decision?
- Weight loss surgery is major surgery. Although most patients enjoy an improvement in obesity-related health conditions (such as mobility, self-image and self-esteem) after the successful results of weight loss surgery, these results should not be the overriding motivation for having the procedure. The goal is to live better, healthier and longer. You should make the decision to have weight loss surgery only after careful consideration and consultation with an experienced bariatric surgeon or a knowledgeable family physician. A qualified surgeon should answer your questions clearly and explain the exact details of the procedure, the extent of the recovery period and the reality of the follow-up care that will be required. They may, as part of routine evaluation for weight loss surgery, require that you consult with a dietitian/nutritionist and a psychiatrist/therapist. This is to help establish a clear understanding of the post-operative changes in behavior that are essential for long-term success.
- It is important to remember that there are no ironclad guarantees in any kind of medicine or surgery. Weight loss surgery will only succeed when the patient makes a lifelong commitment. Surgery is only a tool. Your ultimate success depends on strict adherence to the recommended dietary, exercise and lifestyle changes.
What is the difference between a “restrictive” surgical procedure for weight loss and a “malabsorptive” surgical procedure? Is there a procedure that combines both methods?
- Restrictive procedures only restrict the amount of food that can be eaten at one time. This restriction takes place through either the placement of an adjustable gastric band or by the creation of a small stomach pouch as with the Sleeve gastrectomy and Gastric Bypass.
- Malabsorptive procedures involve the rearrangement of the intestinal tract so that the digestive enzymes are diverted away from the food stream until very late in its passage through the intestine. The effect is to selectively reduce the absorption of fats and starches, while allowing almost-normal absorption of protein and sugars. Although such procedures are quite powerful, patients are subjected to the increased risk of nutrient deficiency in protein, vitamins, and minerals. Vitamin supplements must be taken, intake of fat must be extremely limited, and dietary intake of protein must be maintained.
- Roux-en-Y gastric bypass, still considered the “gold standard” of modern obesity surgery, combines both restrictive and malabsorptive components. In this procedure a small stomach pouch is created at the top of the stomach to restrict food intake. Then, a section of the small intestine is attached directly to the pouch. This allows food to bypass the lower stomach and a portion of the small intestine.
How does the insurance process work?
- Insurance coverage varies for weight loss surgery procedures. It is crucial that you call your insurance provider to determine if your policy covers surgical weight loss. As an integral part of our team, the insurance coordinator can answer questions and give you guidance when working with your insurance company to acquire approval. It is a team effort between you and our insurance coordinator to ensure everything is done to gain approval to undergo one of the surgical weight loss procedures.
- Insurance companies often require medically supervised diets that span 3 months or greater. If this is the case with your insurance and you do not have prior documentation, you will be required to obtain this information before your paperwork is sent for approval.
How long does the insurance approval process take?
What if my insurance carrier denies the request for coverage of a weight loss surgery?
What are some of the risks involved in weight loss surgery?
- Complications due to anesthesia
- Wound infections
- Deep Venous Thrombosis (DVT) – clots in the lower extremities
- Pulmonary Embolism (PE) – clots that travel to the lungs
- Pneumonia – infection of the lung
- Atelectasis – collapse of part of the lung and decreased lung volume. Most often due to the patient taking incomplete breaths. It is prevented by encouraging deep breathing and early ambulation
- Stroke or heart attack
- Intra-abdominal infections
- Injury to intra-abdominal organs or structures
Some risks are specific to the type of weight loss procedure performed. Please refer to the explanation of each of these procedures to review the risks associated with them.
Is there anything I can do before surgery to reduce the risks of complications?
- Stop smoking
- Stop drinking alcohol
- Increase physical activity
- Lose 10% of body weight
Doing these can not only help to reduce your risk but will also help to optimize your recovery.