Your first bariatric surgery consultation is generally very overwhelming. It’s what determines you as a candidate (and which types of surgery will be offered, and how it’ll go). Most patients enter the meeting with great anticipation and some fear, unsure of how long this first appointment will take and what’s expected.
Therefore, here’s everything you need to know about your first appointment and how to navigate it as best as possible.
Table of Contents
Initial Meeting and Medical History
Most bariatric consultations start before you’ve even met your surgeon. Get ready to be early for check-in so you can fill out paperwork about your weight history, dieting attempts, medications and health concerns (if any). The facility needs a massive medical report about you for insurance purposes and assessment.
What does that mean? You should expect to answer questions about how long you’ve been overweight, what means you’ve sought (thus far) as efforts to lose weight that have failed so far, and if you have comorbid conditions related (or exacerbated) by obesity. For example, many surgeons evaluate patients differently if they have Type 2 diabetes, sleep apnea, hypertension, joint pain or fatty liver versus no comorbidities. The more honest you can be about such information, the more clear a picture your surgeon can get.
Some facilities will send you this paperwork home so you can fill it out privately. If that’s the case, do it. You’ll spend more time in the waiting room getting accurate answers pertinent to your medical needs.
Meeting With Your Surgeon
This is the crux of your meeting. Expect the surgeon to gauge your goals for weight loss and to gain some surgical options that make sense (but she might still need to assess further before a definitive answer).
For example, expect her to ask what you typically eat in a day. She’ll probe deeper than just blind attempts to understand if you have any emotional connection with food or what your support system is at home. She’ll want to know what you’ve done so far naturally, too, to meet a successful weight loss goal. These are not trick questions; they’re for your surgeon’s benefit to know how much mentally, psychologically and emotionally ready you are for such a life-change.
You will also undergo a physical assessment, expect her to check your abdomen for hernias (which complicate surgery) and gauge your overall health. There may also be BMI-related assessments; for example, many surgeons work under strict guidelines that a 40+ BMI (or 35+ BMI with severe obesity-related comorbidity) threshold is necessary for surgery-related intervention in Australia.
Getting To Know Your Options
Expect the surgeon to guide you through all potential procedures and which ones make sense based on your consult assessment. This typically comes down to gastric sleeve or gastric bypass (and rarely gastric banding).
Each has different means of operating. For example, gastric sleeve surgery removes approximately 80% of your stomach, effectively creating a pouch the size of a banana, thus preventing gastrointestinal accommodation for such enormous eating habits. The bypass creates a pouch on top of the stomach and reroutes the small intestine so patients eat less but don’t absorb as many nutrients (which is why those hoops are jumped through in some situations where insurance provides specialized parameters).
Those who are interested in more advanced options should go through facilities that offer heidelberg weight loss surgery to better assess what’s best for their needs and goals at hand.
This is your time to ask medically anticipated outcomes. For example, what should I expect in weight loss post-op? What’s the anticipated recovery? What’s the anticipated success/failure? What’s life like post-op?
The Reality Check
Surgeons who don’t sugarcoat what’s to come are often the better-optioned surgeons. Surgery is a tool; it’s not a magic bullet. You must also be prepared for excess eating habits, consistent exercise, psychological assessments, consistent meetings years down the line.
They’ll talk about the complications, during surgery and post-op as well, as will nutritional deficiencies, postoperative complications (if bypass), strictures and weight regain post-op (if lifestyle changes are not made).
Some people even require revisions down the line.
While this may be overwhelming at first, it’s eye-opening. Surgery has serious success rates especially if patients know what’s coming down the line; those who acknowledge pitfalls – and have complications down the line, tend to fare better overall.
Pre-Surgery Assessment
If you’re deemed an acceptable candidate, then expect the surgeon to discuss what’s next leading up to surgery.
More often than not, this means other appointments with specialists and testing.
Most candidates will need at least one Bariatric Dietitian meeting, one psychological evaluation (mental assessments are critical) and possible further tests as needed (bloodwork; imaging studies; cardiac assessments; evaluations for other concerns which may complicate beforehand/during surgery/after).
In addition, most surgeons require their patients to lose weight pre-op, not as a test of willpower, but because science suggests that those who lose 5-10% of their body weight before surgery have fewer complications during their operations and can show compliance with post-op dietary concerns.
The Financial Talk
At one point, either with the surgeon or with an independent patient coordinator, financial information will be assessed.
This is important because not all Bariatric appointments are covered by insurance.
Whether you’re using Medicare options in Australia or private health insurance networks there should be thousands worth of out-of-pocket expenses regardless.
Your facility should empower you with an explanation of costs, what’s covered and not – and how much you’ll owe out of pocket whether it’s surgeon fees; anesthetist fees; hospital tickets; preoperative costs not associated with insurance.
If it’s an amount that surprises you, ask about payment options. Most facilities work with medical financing companies who provide patients options over extended periods.
Questions You Should Ask
At the very end of your meeting do not leave without asking pertinent questions relative to your experience thus far.
How many times has this surgeon performed these surgeries? What is her complication rate? Where will my surgery take place? How long do patients typically stay overnight? What does post-op care look like?
Especially get answers regarding revision surgeries if your results tank or if something unexpected happens. Is there an avenue for support down the line, support group; additional meetings with dietitians; clinic for psychological adjustment?
After The Meeting
Realize you’re probably not going to leave with a final decision, and that’s okay.
The best surgeons recognize that they need the information gathered during this first visit time to mull over, and you may want a second opinion down the line.
Thus, they should provide printed materials relative to what was discussed during this consult with applicable avenues for next steps should you want to move forward.
Take some time afterward to digest what you’ve learned and talk about it with loved ones who will also become part of your support system if you choose to proceed.
This meeting is as much about gathering information as it is about figuring out patient candidacy; likewise, if something doesn’t feel right or if your questions go unanswered by your surgeon it’s totally fine for you to take your business elsewhere.