Your Surgical Weight Loss Journey

You did it! You made the decision to change your life. You are about to join the many patients who call their procedure a “life-changing experience,” as they now have renewed confidence, health and energy.

Numerous patients have experienced great success in losing inches and pounds through gastric sleeve and Roux-en-Y gastric bypass procedures. We understand that choosing to have weight-loss surgery is an important decision, and we hope that we, at the Avera Bariatric Institute, can be a valuable resource for you.

The Surgery Process

The Avera Bariatric Institute surgery process includes the following:

• Surgeon consult. One month after you have attended a seminar and know that you have benefits for bariatric surgery at the Avera Bariatric Institute, you will have a consultation with a bariatric surgeon. The surgeon will talk with you about your options and what surgery may best meet your needs.
• Nutrition consult. You will meet with a registered dietitian the same day that you meet with the surgeon. The dietitian will complete a thorough assessment of your nutrition status to determine nutrient deficiency risk pre-surgery and help promote optimal status prior to surgery. The dietitian will also assess for special medical and mechanical dietary needs.
• Psychological consult. Surgery is often the easy part, but it is the lifestyle changes that can be very difficult. The psychological assessment is required and will occur following your initial consult with the surgeon. It will provide you and your surgeon with a valuable objective determination as to whether you are ready to make lifestyle changes. Some people will need additional supportive services, and these services will help you with decreasing your risks post-surgery.
• Optimize your health before surgery. We have a team of medical providers who will help you get physically healthier before surgery. Decreasing your health risks prior to surgery promotes the best outcomes possible. You will have blood work completed, recommendations will be made regarding vitamins and mineral supplementation, work on pre-surgery weight loss, and work on improving any chronic health conditions that you might have. Many bariatric pre-surgery patients have undiagnosed obstructive sleep apnea and are referred for a sleep study.

The amount of time that you will work with this team varies greatly but you can anticipate this process taking several weeks to months prior to surgery. You are a key player on this team.

Bariatric weight loss surgery does require evidence-based preparation, along with your dedication and our team effort to achieve success. Studies support these efforts for successful weight loss, and improved physical and nutritional health. Long-term maintenance of a healthy weight, optimal physical and emotional health is our ultimate goal for you!

Insurance

Typically, insurance will consider coverage for weight-loss surgery for patients who have:

• A body mass index (BMI) of 35 to 40 along with one or more comorbidities, such as sleep apnea, type 2 diabetes, acid reflux or high blood pressure
• A BMI of 40 or over for any surgery with no additional comorbidities

Out-of-pocket Costs

• Vitamins and Minerals: $41-$57/month + tax.
• Probiotics: $58.95 + tax for 30-day supply
• Meal Replacement Products: $23.52/box, most need 6 boxes for 2 weeks. ($141.12 total)

Types of Surgery

Gastric Bypass

During this procedure, the stomach is stapled to make a smaller pouch. Then, most of the stomach and intestines are bypassed as the small stomach pouch is attached to part of the small intestine. This aids weight loss by limiting the amount of food you can eat and reducing the amount of fat and calories you absorb.

Sleeve Gastrectomy

This surgery is a minimally invasive resection of the stomach by separating the greater stomach from the smaller part of the stomach. The opening between the stomach and the small intestine, known as the pylorus, remains intact, leaving behind a stomach in the shape of a tube or sleeve. By keeping the stomach and pylorus intact, the stomach works normally, but the volume is drastically reduced.

Effectiveness

• Patients may lose as much as 60% of excess weight six months after surgery, and 77% of excess weight as early as 12 months after surgery.
• On average, 5 years after surgery, patients maintain 50% of their excess weight loss.

The bypass and sleeve gastrectomy procedures have a 1% risk of mortality. This risk is low compared to the risk presented by morbid obesity. Complications after surgery, while rare, may include bleeding, infection, a blockage or tear in the bowel, or the need for further surgery. Pregnancy is not recommended for at least 12 to 18 months after a gastric sleeve or bypass surgery. Patients who lose weight and maintain weight loss experience a greater quality of life emotionally and socially. The health benefits are many. Research indicates the following health benefits accompany weight loss:

• Improved survival of obesity-related diseases, especially type 2 diabetes
• Decreased blood pressure
• Among diabetics, lower blood sugar levels and less need for medication or insulin
• Prevention of a new diagnosis of type 2 diabetes
• Improvement of obstructive sleep apnea
• Improvement in mobility
• Improvement in mood and self-confidence
• Lowered risk of heart disease
• Lowered risk of many cancers, including breast, colon, kidney, pancreas and esophageal

Lifestyle Changes After Surgery

• No eating and drinking at the same time
  • May resume drinking 1 hour after meal
  • No Carbonated beverages
• WATER: Consume at least 64 ounces of water each day or more
• Daily exercise is a MUST to maintain weight loss
• Food choices should have NUTRITIONAL VALUE
  • NO EMPTY CALORIES like sweets, chips, crackers, soda, coffee WITH cream/sugar or other sugary beverages
  • Don’t drink your calories!
• Must take vitamin & mineral supplements daily
  • A bariatric dietitian provides recommendations based upon individual assessment

Support

Support is needed! Studies show that when you have positive support and accountability, you will be more likely to maintain your weight loss. Attending a bariatric support group once a month will help to keep you on track.