Frequently Asked Questions

To qualify for weight loss surgery, you must meet the following criteria established by the National Institutes of Health and the American Society for Metabolic and Bariatric Surgery. The criteria includes:

• You are more than 100 pounds over your ideal weight or you have a Body Mass Index (BMI) of 40 or greater, or a BMI of 35-39.9, along with two or more medical conditions such as diabetes and/or hypertension which would improve significantly with weight loss. 
  
  • Surgery may be considered with a BMI as low as 35 if your doctor determines that there's a medical need for weight reduction and surgery appears to be the only way to accomplish the targeted weight loss.
  • Body Mass Index (BMI) is a measure of the degree of your excess weight, based on weight and height. BMI is calculated by dividing body weight in pounds by height in inches squared and multiplying that amount by 704.5. This provides a metric calculation for BMI. 
• You have tried and been unable to lose weight through diet and exercise
• You are prepared to make a lifelong commitment to dietary, exercise and behavioral changes necessary for long-term success
• You have no mental or behavioral disorders that may interfere with long-term weight loss success

If you are interested in weight loss surgery, your primary care doctor must provide us with a letter supporting your request for weight loss surgery. 
 

Many insurance providers will require documentation that you have made prior attempts at medically supervised weight loss. Your primary care doctor can provide this in their letter.
 

To qualify for surgical weight loss, you must complete a medical and psychological pre-evaluation process showing that you are committed to adhering to long-term, follow-up care after surgery and that you have a clear understanding of the extensive dietary, exercise and medical guidelines that must be followed for the rest of your life. The requirements for weight loss surgery are listed below and we will review them with you as well. 
 

Requirements to be considered for weight loss surgery are:
 

• All patients over age 50 must have had a colonoscopy in the last ten years.
• All women over age 40 must have had a mammogram in the prior year.
• All women of child-bearing age must be on active birth control, and have had a pap/pelvic exam in the prior year.
• All patients with active severe reflux disease must have had an EGD in the past year.
• All patients will undergo standard lab screening including CBC, Chemistry panel, LFTs, Thyroid function Patients with diagnosed sleep apnea will need to have a functioning and adjusted CPAP machine prior to surgery.
• All patients will undergo psychiatric evaluation and counseling with one of our programs providers.
• All patients will be provided intensive dietary counseling preoperatively.
• Selected patients will be scheduled to see a cardiologist for preoperative testing and a pulmonologist for overnight polysomnogram and sleep apnea treatment. This can be arranged in our clinic or by your primary care physician.  

Many health insurances cover weight loss surgery but each plan is different and may have different guidelines.

Laparoscopic surgery is less invasive, heals faster and leaves fewer scars. We perform the majority of procedures laparoscopically, to help our patients get back on their feet quicker, with reduced risk of infection and complications.

At Dignity Health, we believe that your state of mind is a catalyst for healing. We want you to be fully prepared before having surgery. We will enroll you in a bariatric surgery education program that prepares you, not just for surgery, but also for life afterwards. During the program, you will receive nutrition counseling, undergo physical exams, and be given a psychological evaluation. From a lifestyle perspective, there are many things you can do to prepare your body for bariatric surgery:

• Start a preoperative diet: Your care team may suggest that you start eating several small meals a day to prepare for the changes ahead. Your doctors may also recommend that you gradually stop consuming high calorie/high carbohydrate foods and drinks, such as soda, ice cream, or milkshakes.
• Quit smoking: If you are a smoker, you may already know that to quit smoking is a healthy choice. Your care team will highly recommend that you quit prior to surgery as the termination will optimize the healing process.
• Exercise regularly: As with diet, exercise will be a key part of recovery and long-term weight loss. Light exercise before surgery will help you increase your lung capacity and prepare you for an active post-surgery life.

You could be back home as quickly as the day after your surgery.

Immediately after bariatric surgery, there will be some pain and discomfort. Our highly-skilled and sensitive care team will offer you the right medications to help you feel better. You will stay in the hospital for one to two days after surgery, and then return to normal activity within two to three weeks.
 

During the first two weeks of your recovery, we will recommend that you only ingest liquids. We will then guide you as you gradually progress to pureed foods, soft foods, and then to regular foods about two to three months after surgery. You will need to chew your food slowly and fully. You may experience a very fast weight loss initially, so it is important to get all of the nutrition, vitamins, and hydration you need. Your doctor will also likely recommend supplements.
 

If you undergo the Lap Band procedure, you may return during the first six months to have your Lap Band adjusted. This adjustment will help to enhance your weight and appetite loss. It involves injecting saline into the port just under the skin connected to the Lap Band. You will be happy to find out that the adjustment is painless. Also, the adjustment is typically done by the surgeon who performed your procedure successfully.
 

During weight loss, you may experience fatigue, chills, body aches, dry skin, mood changes, and temporary hair thinning. However, as your weight stabilizes, you may find out that these problems fade out.
 

Weight loss typically continues for about a year and then abates. You should use the first year to develop good eating and exercise habits that will keep you from regaining weight.
 

Many weight-related health problems improve or even disappear after bariatric weight loss surgery, including diabetes, high blood pressure, asthma, and obstructive sleep apnea.

Adjusting to life after bariatric surgery can be challenging physically, socially, and emotionally. The support from a caregiver can make a world of difference. While people who undergo bariatric surgery usually do not need intensive help, having support on-hand is key. If you are considering getting a caregiver, try to make the appropriate arrangements ahead of time.
 

Immediate post-surgery care — people typically take one or two weeks off from work. You may need help with food preparation, dressing, or self-care. In the early weeks, you may have low energy. You may need assistance with house activities and shopping until you can lift and drive, usually in about six weeks.
 

Dietary support — your diet will be restricted as you will progress gradually from liquid to low-volume meals. You should educate your caregiver on the guidelines and restrictions to help with your adherence. Your caregiver should be firm and not give in to food requests that may make you stray. Look up recipes to make healthy choices fun and interesting. Ensure that you take all vitamins and supplements according to your doctor’s prescriptions.
 

Physical activity support — regular exercise is necessary for maintaining a healthy metabolism throughout the weight loss process. Your caregiver can support your active schedule by getting involved. Do gentle stretches together that are within the guidelines provided by your medical team. Go for evening walks together. Go to an attraction that requires walking (such as the zoo), which will not only improve your physical health, but also lift your spirits.

To learn more about our bariatric program, please call our program coordinator, Brenna Calabrese, MSN, at (805) 940-2765. To find a Dignity Health weight loss specialist that’s right for you, please use our online search tool: