How are bariatric patients treated

BARIATRIC SURGERY Prepare for the operation

Prepare yourself

Surround yourself with a network of professionals, family, friends and fellow patients for support and motivation during your bariatric surgery. This section provides you with a compilation of resources. When it comes to weight loss surgery, never forget that you are not alone.

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Conversation with the family doctor

Conversation with the family doctor

For some people, obesity can be a lifelong struggle that, despite eating healthy and exercising, does not result in significant weight loss. For many people, bariatric surgery can completely change their life and enable a fresh start. You have probably already spoken to your doctor about your weight and other health factors, especially if you are diabetic.

If you have fought against your obesity to no avail, bariatric surgery may be an option for you.

Speaking successfully to your doctor means asking the right questions. Your doctor's answers and experience can help you decide whether or not to have bariatric surgery. Here are a few questions that will help you make this important decision.

Note the selection criteria for bariatric operations:

  • BMI greater than 40
  • BMI greater than 35 for serious health complications
  • Well informed and motivated
  • Lack of weight loss despite non-surgical approaches

Questions for your GP

  1. Can we talk about weight loss surgery and the different approaches?
  2. Do You Think I Am Eligible For Weight Loss Surgery?
  3. Will I Stop Having Weight Problems After Having Weight Loss Surgery?
  4. Which doctor will perform this procedure?
  5. Will my diabetes affect the surgery?
  6. Will the surgery have a positive or negative effect on my diabetes?
  7. Do you see any risks that I should consider with my current state of health?
  8. What weight loss surgery would you recommend me?

 

Conversations with relatives

Conversations with relatives

Facing your obesity also means involving your family and close friends. Talk to them about your weight loss goals, how you want to live, and why you want this change. You are not alone in this. You need your relatives by your side for support and motivation.

Important topics to discuss with your loved ones

Why you are undergoing weight loss surgery.

Explain to your loved ones what this surgery means to you. Tell them about your failed attempts to lose weight and how important it is for you to improve the quality of your life. Allow an open discussion about the project you are now planning.

By explaining the positive aspects of weight loss surgery and behavior therapy, you are helping your loved ones understand how important it is to you to have a better quality of life and that this can also have positive effects on those around you. The quality of life was improved in 95% of the cases. Long-term mortality from obesity-related diseases has been reduced by 30–40%.1 Type 2 diabetes, high blood pressure, dyslipidemia, lack of sleep, asthma, osteoporosis and gastroesophageal reflux diseases are just some of the factors that can be positively influenced by weight loss surgery.

Surround yourself with people who understand you and support you in your goals. Whether it's a phone call, a visit or a letter, your support will be with you every step of the way.

Your relatives may already be concerned about your health and about the operation. Explain to your family that you are not alone but that you have your care team by your side.

Your treatment team

Your treatment team

Your team can include the following professionals:

  • The family doctor / specialist
  • The surgeon for bariatric surgery
  • The nutritionist
  • A multidisciplinary team consisting of
    1. psychologist
    2. Cardiologist
    3. Pulmonologist
    4. Plastic surgery specialist
    5. Trained nurses for bariatric interventions, both in the operating room and on the ward
  • Support groups and
  • Former patients sharing their experiences with you.

 

Prepare for bariatric surgery

Prepare for bariatric surgery

The months leading up to weight loss surgery

Your future doesn't start after the procedure. It starts now. Because your BMI is very important to the procedure, diet and exercise are very important. As part of your weight loss plan, the best time to begin an exercise program is before the procedure. The earlier you start exercising, the easier it will be for you after the operation. Start with more exercise.

  • Daily walks support your circulation and recovery after the procedure. Get a pedometer to measure your progress.
  • If you have joint problems, you should try aqua aerobics. Water aerobics improves your breathing, but doesn't put any strain on your joints.

If you are diabetic, you should check your blood sugar level regularly before, during and after exercise and always have insulin on hand.

Now is the time to work on your eating habits. Discuss with your doctor your current weight loss diet, what foods help you lose weight, and how to make sure you are getting all of the vitamins and minerals you need. Discuss suitable meals for weight loss before and after the procedure.

You should stop smoking at least eight weeks before the procedure. Smoking not only endangers your health, it can also result in complications during surgery. Smoking affects lung function and increases the risk of complications from anesthesia. Smoking increases the risk of other complications, such as deep vein thrombosis (blood clots in the legs). Smokers who undergo anesthesia are at increased risk of cardiopulmonary complications (pulmonary embolism, pneumonia, and the breakdown of the tiny air sacs in the lungs) and infections. In addition to the known risks to the heart and lungs, smoking stimulates gastric acid production, which can lead to ulcer formation. If necessary, talk to your GP about smoking cessation.

The weeks before weight loss surgery

Make sure your surgeon is aware of all the medications and herbal supplements you are taking. Avoid aspirin and all aspirin-containing medications for at least 10 days before weight loss surgery. Even herbal medicines such as ginkgo biloba, garlic and other remedies must be avoided as they have a blood thinning effect. Check the label of your multivitamin as it may contain herbal additives. Over-the-counter medications should also be checked as they often contain aspirin. When in doubt, always contact your pharmacist and / or surgeon.

Proper hygiene is a must before any operation. The skin should be intact at the incision site. Keep the skin clean and dry, especially in the days leading up to surgery. Damage to the skin could potentially delay your bariatric procedure.

The day before weight loss surgery

Your surgeon will give you final instructions at your preoperative appointment. You may only drink clear liquids such as water, coffee, tea, apple juice, grape juice, cranberry juice, bouillon, broth, clear water ice, soda water and gelatin drinks. After midnight on the day before the operation, you are not allowed to consume anything, except medication approved by the anesthetist and surgeon. Your stomach must be completely empty at the beginning of the procedure to minimize the risk of aspiration.

If you have a cold, persistent cough, fever, skin problems, or notice any changes in your condition prior to surgery, please notify the surgeon immediately. Your suitability for surgery must then be reassessed. Your bariatric surgeon wants you to be in the best possible shape for anesthesia.

The day of the weight loss surgery

It is advisable to shower on the day of the operation. Do not use moisturizers, creams, lotions, or cosmetics. Take off all jewelry and do not wear nail polish. You are allowed to wear a denture until the operation, but it will then be removed.

When you go to the hospital, only bring what you need with you.

After the operation

It usually takes 2 to 4 weeks for bariatric patients to fully recover from the procedure. This period of time can be different for each person and depends, for example, on your general state of health or on which bariatric intervention is chosen by the doctor. Talk to him about this during the preparatory talks.

Self-help groups play a central role in the recovery process, both physically and mentally. It is recommended that all patients participate in a monthly support group.

Alcohol can cause stomach upset and liver damage. With extreme weight loss, the liver is particularly sensitive to toxic substances such as alcohol. You will find that just a few sips of wine will have the quick and powerful effects of alcohol intolerance. In addition, alcoholic beverages are high in empty calories and can lead to “dumping syndrome”. It is recommended that you abstain from alcohol for a year and then only drink it gently after the operation.

reimbursement

reimbursement

For some patients, the operation is covered by the health insurance company after an application is submitted. However, health insurances are very different and so you should research in detail what is covered according to your type of insurance. Some health insurances do not recognize the positive long-term effects of operations on severe obesity. Call your insurance officer and ask how much weight loss surgery your insurance will cover.

There are currently no standard procedures for weight loss surgery in insurance companies. Each insurance company has its own criteria for coverage. Some of the common health insurance requirements are:2

  • Body mass index of 40 or 35 with health restrictions.
  • Recommendation of the surgical intervention by the family doctor.
  • Psychological assessment by a recognized psychologist or psychiatrist.
  • Assessment of the nutritional behavior and the nutritional therapy carried out by a recognized nutritionist or scientist.
  • Medical supervision by a doctor for a period of 3 to 6 months prior to the operation, including diet, exercise and nutritional advice.
  • Access to the medical record for all previous and current illnesses related to obesity.
  • Access to data on previous attempted diet programs, food diaries, or doctor's clinical notes on the diet. Some insurance companies require medically documented attempts at weight loss to be submitted before consenting to the reimbursement of costs for an operation.
  • Your insurance company may request additional medical records and / or examinations before approving the operation.

Information for carers

Information for relatives

If you are living with someone who is obese, your support is crucial. There are many challenges in everyday life for obese people. While most like to go to the movies, play games with the kids, or go shopping, obese people often find these everyday things very difficult. In obtaining a holistic view of obesity, the attending physician has the opportunity to explain all options for treating obesity to the patient, including surgeries for weight loss.

It is important that loved ones fully understand the situation of obese people. Obesity has a medical, but also social, physical, psychological and financial impact. The psychological consequences of obesity include depression, low self-esteem, social isolation, discomfort in public and with intimacy, and decreased libido. A combination of behavior therapy and bariatric surgery can help patients lose weight and thus live healthier lives.

The physical limitations of obesity can affect:

  • Visits to the cinema
  • When traveling by bus, in the theater or on a plane
  • Applying seat belts
  • Passage through a turnstile
  • Playing with children, carrying children
  • personal hygiene
  • Buying clothes

Behavioral therapy for obesity dates back to a time when it was thought that obesity was caused by poor diet and exercise habits. Scientists today understand that there are other factors besides behavior that affect body weight. The causes of obesity can be genetic, environmental, and behavioral. Patients request surgery as their disease progresses. It's not just about how they look.

Medical consequences of obesity:

  • diabetes
  • hypertension
  • Lipid disorders
  • Heart disease
  • asthma
  • Sleep apnea
  • Gallstones
  • Urinary incontinence
  • Reflux disease
  • Osteoarthritis and gout
  • Cancer (breast, colorectal, prostate, endometrium, etc.)
  • Infertility and menstrual cramps

If you live with an obese person, knowing the complexities of obesity will enable you to assist your loved one with therapy.

 


The information on this page is not intended to be a substitute for a discussion with your doctor. Talk to your doctor about diagnosis and treatment.