Bariatric FAQs
Individuals interested in learning more about Piedmont’s bariatric program are encouraged to attend our free surgical weight loss seminar where attendees can hear more about our services and how to reach their weight loss goals and live a healthy lifestyle through bariatric surgery.
Effective for dates of service on and after September 25, 2013, CMS no longer requires that covered bariatric surgery procedures be performed in facilities that are certified.
How do I know if I am a candidate for surgical weight loss?
Most candidates for bariatric surgery are ages 18 years and above with a Body Mass Index (BMI) of 40 or higher or a BMI of 35 with risk of co-morbidities including the following health conditions:
- High blood pressure
- High cholesterol
- Family history of heart disease
- Type II diabetes
- Arthritis
- Joint pain
- Sleep apnea
- Asthma
- Infertility
Candidates have failed previous attempts at behavioral (diet/exercise) and medical weight loss therapies and are motivated, psychologically stable and have realistic expectations of how the procedure can assist them in weight loss. Candidates also have an understanding of weight loss surgery and accept the operative risks. In addition, candidates have a supportive environment that enables them to commit to long-term medical follow-up and making life-long behavioral changes to diet and exercise.
Each patient is unique; you and your physician will discuss your personal medical and nutrition history, risks, mental state and expectations following surgery to determine if you are a candidate for bariatric surgery.
How much weight can I expect to lose through weight loss surgery?
Today, most patients can lose between 50 to 75 percent of extra weight through the Roux-en-Y and laparoscopic vertical sleeve gastroectomy surgical procedures. The amount of weight lost varies related to your weight prior to surgery, your physical activity level and your commitment to diet and exercise recommendations. Most weight is typically lost during the first nine to twelve months following surgery. You will need to watch your diet very carefully after your weight stabilizes as failure to continue to monitor your food intake can result in some weight regain.
Why should I have my weight loss surgery at Piedmont Medical Center?
Our multi-disciplinary team is led by board-certified bariatric surgeons have performed more than 1000 surgical weight loss procedures at Piedmont Medical Center. Our dedicated post-surgical nursing unit is staffed by individuals specially trained in providing bariatric patients compassionate care tailored to their unique needs.
We offer patients long-term follow-up care with nutrition counseling, support groups, checkups, progress reports and education before, during and after their surgical procedure – providing support throughout each step of the lifelong surgical weight loss journey.
What are the requirements for Medicare patients qualifying for bariatric surgery?
Effective for dates of service on and after September 24, 2013, CMS no longer requires that covered bariatric surgery procedures be performed in facilities that are certified.
Will my insurance cover the cost of weight loss surgery?
Insurance coverage for bariatric surgery varies by state. We recommend you contact your provider to find out if your plan includes coverage for weight loss surgery and the medical documentation needed to begin the process.
Each insurance provider is different, however, below are some examples of information that many insurance carriers will require before certifying that weight loss surgery is “Medically Necessary.” Candidates will work with Piedmont’s surgical weight loss program coordinator and their surgeon’s and primary care physician’s offices to gather the necessary documentation for submission to your insurance.
- Documentation of at least a five-year history of obesity from your primary care physician’s medical records
- Documentation of obesity-related medical conditions from doctor’s medical records
- Documentation of diet history including documents from formal diet programs - usually required and must be within the last year
According to the Obesity Action Coalition, the following list includes questions that your insurance provider can help you answer as you determine your coverage for bariatric surgery.
- What are your health insurance benefits?
- What limits and/or requirements are stated in order to receive morbid obesity treatment?
- Is there a certain amount of required time you must document attempted weight-loss?
- Does the documented time have to be consecutive?
- Is your physician required to document your weight-loss attempts?
- Do you need to weigh a certain amount before treatment is performed and/or initiated?
- Are there weight limitations preventing coverage?
- Is there a maximum dollar limit on your benefits?
- What treatment options are excluded or specifically included?
- What is the co-payment for medical services?
- What testing is covered, such as nutritionist, psychologist, labs, sleep apnea study, ultrasounds, etc.?
- Does your insurer require weight-loss prior to surgery? If so, what percentage or number of pounds is required?
To find out if you are covered by insurance for a surgical weight loss procedure, we recommend you visit your insurance provider website and contact your managed care company directly.
Are there other payment options available for bariatric surgery?
In addition to traditional insurance coverage, there are other options that may be available to cover costs associated with bariatric surgery.
How can I get started?
The first step in the surgical weight loss process is attending Piedmont Medical Center’s free surgical weight loss seminar. During this program, you will meet surgeons, hear stories from previous patients, learn about the weight loss process, surgical procedures, risks of surgery, tips for working with your insurance provider, lifestyle changes you will need to make and long-term health benefits you can experience by making the lifelong commitment to the surgical weight loss approach. To register for the next Piedmont surgical weight loss seminar, call 803-329-1234.
How long will it take for me to have bariatric surgery?
Each patient is unique but depending on your insurance provider and overall health, it can typically take between 3-6 months from beginning the process to undergoing a surgical weight loss procedure. Your insurance carrier and surgeon can provide you with information regarding your personal bariatric surgery timeline.
What do I need to know before I begin the bariatric surgery the process?
The most important thing to know is that bariatric surgery is not a “quick fix” but a tool to be used for long-term, maintained weight loss and overall health. Most patients’ success with weight loss surgery is determined by their commitment to healthy eating and exercise habits and regular attendance at surgical weight loss patient support groups. In addition, a supportive environment including encouraging family and loved ones is also an important factor in bariatric surgery success.
Which surgery is right for me?
The board-certified bariatric surgeons at Piedmont Medical Center have performed more than 1,000 minimally invasive surgical weight loss procedures – Roux-en-Y gastric bypass and adjustable vertical sleeve gastroectomy. Today, patients can typically experience a 50 to 75 percent loss of “extra” weight through these procedures. You and your surgeon will determine the surgical weight loss approach that is right for you.
There are two approaches to surgical weight loss: Restriction restricts the physical amount of food that can be eaten through surgical procedures that make the stomach smaller in size. Patients who have had a restrictive bariatric procedure feel full faster and eat less, resulting in weight loss. Malabsorption limits the absorption of calories from food that is eaten by altering the digestion process, changing where food is absorbed with the goal of patients absorbing fewer calories.
Roux-en-Y gastric bypass is a permanent procedure that combines both restriction and malabsorption approaches. In this procedure, a surgeon creates a small stomach pouch, connecting it to the middle of the small intestine through bypassing the larger portion of the stomach and upper part of the small intestine.
The American Society for Bariatric Surgery and the National Institutes of Health consider Roux-en-Y gastric bypass as the current gold standard in surgical weight loss procedures.
Patients can learn more about the surgical weight loss procedure that meets their health needs by attending a Piedmont Medical Center surgical weight loss seminar where surgeons will present detailed information about each surgery. Register for our next seminar by calling 803-329-1234.
How can I prepare for my bariatric surgery?
After you are approved for your surgical weight loss procedure, we recommend you strictly follow your surgeon’s instructions related to eating, drinking liquids, taking medications and additional recommended preparation activities. Many patients also find it helpful to educate themselves about the weight loss journey ahead, including attending surgical weight loss support group meetings to hear the real-life challenges and triumphs faced by bariatric patients.
As the day of surgery nears, you may also wish to plan ahead with activities such as purchasing any nutritional supplements or supplies you will need following surgery. You may also wish to recruit a close friend or relative to drive you home after surgery and possibly stay with you to ensure you recover smoothly – and in comfort.
What are the tests that I will need before surgery?
Your surgeon will provide you with a list of the necessary medical tests and screenings that you will need to have performed before surgery. Many times, these tests can include the following:
- Physical health exam
- Complete blood count
- Metabolic profile
- Cholesterol and triglyceride tests
- Vitamin B level evaluation
- Iron profile
- Thyroid tests
- Hemoglobin tests
- Electrocardiogram
- Echocardiogram
After you receive the results of the tests above, your selected bariatric surgeon will likely perform a surgical evaluation and recommend you visit nutritionist for a nutritional consultation and a mental health expert for a psychological evaluation.
What can I expect immediately following surgery?
After the procedure, you will be taken to the recovery room for observation. Once your blood pressure, pulse and breathing are stable and you are alert, you will be taken to your hospital room.
You may receive pain medication as needed, either by a nurse or by administering it yourself through a device connected to your intravenous line. You will be encouraged to move around as tolerated while you are in bed and, as your strength improves, to get out of bed and walk around.
Depending on the type of surgery you have, many people stay in the hospital anywhere from a one-two days and resume normal activities between one to five weeks.
At first, patients receive fluids through an IV. The day after surgery, you will be given liquids to drink, such as broth or clear juice. As you are able to tolerate liquids, you will be given thicker liquids, followed by foods that you do not have to chew. Your doctor will instruct you about how long to eat pureed foods after surgery. By one month after your procedure, you may be eating solid foods.
During your recovery at Piedmont Medical Center, the bariatric program coordinator will also visit you to help you with any concerns or questions you may have about the next steps in your surgical weight loss journey. Once you are approved to go home, a discharge nurse will provide you with instructions for self-care and any prescriptions your physician has written for your treatment.
Once you are home, it will be important to keep your surgical area clean and dry. Your doctor will give you specific bathing instructions. You may be instructed to avoid lifting heavy items for several months in order to prevent strain on your abdominal muscles and surgical incision. The incision and abdominal muscles may ache, especially with deep breathing, coughing and exertion. You may take a pain reliever for soreness as recommended by your doctor. Be sure to take only recommended medications.
Weight loss surgery can be emotionally difficult because you will be adjusting to new dietary habits and a body in the process of change. You may feel especially tired during the first month following surgery. You will be able to gradually increase your level of physical activity as tolerated but it may take several weeks to return to your previous levels of stamina. Exercise and attending a support group may be helpful at this time.
What is the typical recovery time after surgery?
Every patient is unique but typically, recovery for the Roux-en-Y gastric bypass procedure is between two to four days, with many individuals returning to their normal routine by two to three weeks after surgery.
How will weight loss surgery improve my health?
Measured by an individual’s Body Mass Index (BMI), obesity is a lifelong, progressive disease in which the body stores excess fat. As BMI increases, so do the health risks. Morbid obesity prevents individuals from engaging in their normal activities and may cause additional health problems, known as co-morbidities.
Weight loss surgery is a tool for long-term weight management. In addition to improving mobility and overall quality of life in patients, bariatric surgery has been proven to offer health benefits to individuals with a Body Mass Index (BMI) equal to or greater than 40, or equal to or greater than 35 with a high risk of co-morbidities. Although every surgery has considerations, the surgical approach to weight loss may resolve or improve weight-related health conditions, including the following:
- Type II diabetes
- Gastroesophageal reflux, heartburn
- Hypertension
- Pulmonary conditions
- High cholesterol
- Heart disease
- Sleep apnea
- Depression
- Joint pain
- Urinary stress incontinence
- Menstrual irregularities
- Infertility
When accompanied by dietary changes and increased physical activity, bariatric surgery can help patients reach long-term weight loss goals and enjoy healthy, active lifestyles.
What kind of physical changes can I expect after surgery
In order to achieve long-term weight loss success, patients need to commit to a lifelong, healthy lifestyle, which includes making changes to daily diet and exercise habits. Eating a balanced diet with increased physical activity will enable patients to reach weight loss goals and over time, improve their health. In addition to losing weight patients may experience improvement of existing weight-related health conditions such as Type II diabete,s joint pain, high cholesterol, blood pressure, sleep apnea and other co-morbidities. Best of all, most patients share that they not only look better but feel better about themselves.
Are there psychological changes that I can expect following surgery?
For several weeks following weight loss surgery, many patients experience emotional ups and downs. Some patients feel like they are on an emotional roller coaster. These feelings are completely normal and usually subside after several weeks. If these feelings continue to worsen or you feel you may benefit from speaking to a professional, we will be happy to arrange for you to meet with our psychologist.
Resources
In addition to Piedmont’s surgical weight loss educational course, there are number of helpful online resources that may assist and inspire you on your journey to weight loss success, including the following websites.
National Organizations
- Obesity Help
- American Society for Metabolic & Bariatric Surgery
- American Obesity Association
- Obesity Action Coalition
Physicians & Medical Resources
Diet & Lifestyle
- Barbara Thompson’s Weight Loss Center
- Bariatric Eating
- Carb Smart Cooking
- Chef Dave, the Worlds Finest Bariatric Chef
