Five Hurdles to Jump Over Before Bariatric Surgery
You’ve heard of weight loss surgery and decided it's right for you to finally lose the extra weight you’ve been carrying for years. You may even know someone who has had bariatric surgery and has successfully maintained their weight loss. You’ve researched bariatric surgery and have a general idea of what it is and how it can help you improve your health and overall lifestyle.
Are you ready to get the ball rolling and start your pre-op journey? The hardest part of a weight loss surgery journey is making that first step and learning what you don’t know.
You’ve already taken an important step by researching and finding us.
We’re here to help you get all your questions answered and support you along the way. We’ve been where you are. It can feel like a daunting task to figure all of this out on your own, in addition to the heavy emotional decision you made to change your life.
Where do you begin?
How much will it cost?
Are there tests needed?
You have so many questions about how to start the process, and we’re here to get you on the right path to surgery. We’ve put together a short list of steps to complete before you can be approved for bariatric surgery.
1. Insurance or Self-Pay
The best place to start is with your insurance company if you have one.
Unfortunately, not all insurance companies cover bariatric surgery. This doesn't mean you’re out of luck. You’re faced with the decision of paying out of pocket with a surgeon in the US or medical tourism. We know many bariatric patients that have gone to Mexico and have had successful outcomes.
Don’t count yourself out if you don’t have insurance or it's not covered. There are options.
If your insurance does cover bariatric surgery, they may have requirements you need to meet before being approved. The most common requirements may include:
Accredited Bariatric Programs or a Center of Excellence
Nutrition Counseling
Psychiatric Evaluation
3 - 6 months of weight management counseling
BMI of 35 with at least comorbidity or a BMI of 40 or higher
Once you know what your insurance requires, you can start looking for a program in your area. Your insurance company can even give you a list to get you started.
2. Find a Surgeon
When we got our surgeries, we didn’t know we could interview and shop around for a surgeon or bariatric program we liked. We went with programs we were familiar with and are happy with who we chose. Having the option to choose who to go to offers awesome freedom of choice!
Read surgeons’ websites fully, join their patient Facebook group if they have one, read reviews, and call their office to ask questions. Schedule a consultation with a few programs if possible and pick the best fit for you.
Remember, if you’re going through insurance for your bariatric surgery, they’ll likely require a referral from your primary care physician. Make sure you get this before you start booking appointments with surgeons.
Most bariatric surgery programs have a questionnaire for you to complete prior to your first appointment. They may also require you to sit through an information session to learn more about the different types of bariatric surgery and their specific program. Post-pandemic, most of these information sessions are now offered online, so you can do this easily in the comfort of your home.
We know of surgeons who do all their pre and post-op follow-ups virtually. You can travel to them to have your surgery, experience a few days of recovery, and then travel home.
The relationship with your surgeon is essential. You’ll have several pre-op and post-op follow-up appointments with them over the next few years. You want to make sure you’re comfortable and feel like they’re ready to care for you.
3. Nutrition Counseling
If you’re going the insurance route, most insurance companies require some sort of pre-op nutrition counseling before bariatric surgery approval. The length of the program depends on your insurance but generally ranges from three to six months.
Your bariatric surgery program should have a nutritionist or dietitian on staff or under contract with their office so you can meet with them in person or virtually.
You’ll meet with your dietitian once a month to review your progress and talk about any changes to your meal plan that may be necessary.
Most programs have at least one nutritional education program or class for you to attend, including several programs in Mexico. In this class, in person or virtually, you’ll learn about the various food stages after bariatric surgery and your program's specific requirements for post-op eating and recovery.
4. Medical Testing
Depending on your medical history or the bariatric surgery you plan to have, there are several pre-op procedures your surgeon may require before surgery. Some of these procedures may include the following:
Sleep Apnea Test (at home or sleep center)
Upper GI X-Ray
Endoscopy
EKG
Pre-op Blood Tests
These tests are usually spread out over the three to six months you’re waiting for your surgery, so don’t be alarmed if it seems like a lot. Take small steps toward your surgery date.
5. Psych Evaluation
The last hurdle to get over before bariatric surgery is the psychological evaluation. It sounds scary, and many patients get anxious about the evaluation. The psych eval is a way for doctors and insurance companies to understand and evaluate your mindset towards surgery. Some questions they may ask include:
How long have you struggled with weight loss?
What are your sources of stress?
What’s your personal history? (Including where you’ve lived, marital status, and education.)
What’s your mental health history?
Do you have forms of support available?
What is the likelihood you’ll follow post-operative instructions?
There are several ways to get the evaluation completed.
Many bariatric surgery programs have a psychologist or psychiatrist you can see. Here are some different ways patients completed the evaluation.
In person – You may be required to see them only once or every month prior to surgery, as Kellie did.
Virtual appointments – From the convenience of your home via video conference or over the phone, as Mel did.
Your current therapist – We also know of some patients who were able to get an evaluation to submit from their current therapist.
Check out our episode Dissecting the Bariatric Psych Evaluation with Bariatric Therapist Timisha Malone for a more in-depth look at the psych eval.
You’ve Checked All the Boxes, Now You Wait
Once you’ve completed all the requirements for surgery, your program’s surgery coordinator will gather all your test results, forms, and evaluations to submit to your insurance for approval.
Yes, you’ve done months of tests and hard work, and you’re still not guaranteed your surgery will be paid through insurance. It can be nerve-racking to wait. This process can take a few days up to a month.
Do your best to stay positive knowing you have done everything you can to get your desired outcome. You put in the effort. Be proud of that.
In most cases, once the surgery is approved, the surgeon's office will work with you to schedule a date for your bariatric surgery – hooray!
If you haven’t already, be sure to join our email list and receive our awesome OSLP Guide to Bariatric Surgery with lots of pre-op and post-op information. It also has a few checklists to help keep you on track. Once you sign up, you’ll see us in your inbox right away!