Ask Your Doctor Discussion Guide:
Questions for Your Weight Loss Surgeon

Ask Your Doctor Discussion Guide

Best for: first office appointment with a weight loss surgeon

Weight loss surgery overview

Weight loss, or “bariatric,” surgery is a common term used to describe a variety of operations for treating obesity. The operations vary in the type of physical changes made to the stomach and/or the small intestine, but all are designed to help you reduce your food intake. It is a proven method for long-term weight reduction and portion control for people who are exceedingly obese, but it should not be confused with cosmetic surgery.

The type of surgery you select should depend on several factors, such as your level of obesity, your overall health status, your ability and willingness to adopt lifestyle changes after surgery and your health insurance coverage. Your surgeon will recommend the surgery that is most suitable for you.

Most people who undergo bariatric surgery experience the following benefits: What types of weight loss surgeries are available, and how do they differ?

There are several types of weight loss surgeries, and they fall into two main categories: restrictive procedures and restrictive/malabsorptive procedures. Successful results depend on your willingness to adopt a long-term healthy eating and exercise plan.

Restrictive procedures

These surgeries significantly reduce the size of the stomach, making you feel satisfied after eating less food and you stay full longer. Adjustable gastric banding is a widely used restrictive procedure. There is also a new experimental procedure called sleeve gastrectomy, which involves stapling the stomach to create a small pouch and removing the rest of the stomach. However, it is only an experimental procedure not readily performed, and there are currently no long-term outcome data on weight loss effectiveness.

Adjustable gastric (stomach) banding in which an adjustable band is placed around the top of the stomach and then filled with saline. This forms a small stomach pouch that is able to hold only a very small amount for food and a narrow passage to the rest of the stomach. This also slows down the digestive process and helps you feel fuller. The adjustable gastric band is reversible and can be removed if it becomes medically necessary. In comparison, other surgical procedures change the anatomy of the stomach and small intestine and are permanent.

Advantages of restrictive procedures:

Disadvantages include:

Risks commonly associated with restrictive bariatric surgery include:

What other risks are associated with weight loss surgery?

Before your operation, your surgeon will carefully explain the risks that are unique to you and specific to the type of procedure you decide upon. Problems associated with bariatric surgery can range from minor to life-threatening. Complications may occur during, immediately after, or within weeks or several months after surgery. Additional surgery, re-admission to the hospital, medication or nutritional supplements may be required. Health insurance may not cover some or any of the costs related to these unanticipated circumstances.

Be sure to use this as a general guide to ask your surgeon any questions you may have about risks and benefits of weight loss surgery before undergoing your procedure.

What types of tests will my surgeon conduct prior to my surgery?

Before your operation, you will be scheduled to have the following types of tests:

The presurgery medical and psychological evaluation may uncover concerns that may cause the surgeon to deem bariatric surgery too risky for you. If this occurs, you may be advised to postpone your surgery until these concerns are resolved. If the problem doesn’t improve, you will be strongly discouraged from having the surgery.

How much will the weight loss surgery cost?

The cost of your surgery will depend on many factors: the type of procedure you have, where you have your surgery, your health status and whether any complications occur during or after surgery. In addition, your health insurance may or may not cover the costs of weight loss surgery, and your employer may or may not have weight loss surgery as a covered benefit. In general, the cost of surgery ranges from about $12,000 to $25,000 for an adjustable gastric band and up to $35,000 for gastric bypass.

Will my health insurance provider cover the costs of the surgery?

Many health insurance providers cover the cost of bariatric surgery. However, before committing to any surgery, you should review the “Exclusions of Coverage” section of your insurance policy contract.

Insurance regulations vary from state to state, and what one health insurance provider covers may not be covered by another. Over the course of your lifetime, however, there may be other unforeseen costs, especially if you experience complications related to your surgery. Your health insurance provider may not cover or reimburse you for some of these costs.

If you need special approval from your health insurance company, your weight loss surgeon’s office can assist you. It is important to keep in mind that this approval may take several months. You will be responsible for completing a considerable amount of paperwork and investing time in communicating with your insurance company.

Here are some things to keep in mind:

What if I am thinking about getting pregnant?

Getting pregnant is often easier after significant weight loss. However, pregnancy should be postponed for at least one year after surgery because you will experience significant physical and behavioral changes in the initial months—changes that could make pregnancy risky during the first year.

If you are a woman thinking about pregnancy or attempting to become pregnant, consult with your surgeon first to discuss certain adjustments that can be made. For example, the adjustable gastric band can be loosened during pregnancy for increased nutrition and then tightened again after childbirth.

What specific questions should I ask my weight loss surgeon?

During your appointment with the weight loss surgeon, be prepared to ask questions about his or her practice and experience. It is very important for you to feel comfortable with and confident in your surgeon. A few sample questions are listed here:

If you would like a second opinion from another surgeon prior to committing to weight loss surgery, ask your PCP to make another recommendation. The American Society for Metabolic and Bariatric Surgery (ASMBS) can assist you and your PCP in locating another surgeon. The ASMBS promotes the practice and improvement of bariatric surgery through research and education. A member of the ASMBS is board certified in weight loss surgery and has been the lead surgeon in at least 25 bariatric operations in the previous two years.