Preparing for Bariatric Surgery

You'll undergo some medical tests to assess your surgical risk and to check your gastrointestinal anatomy. This may include:

• Pulmonary testing to make sure your lungs are healthy
• An EKG, stress test or echocardiogram
• Upper GI and/or endoscopy to look at the inside of your esophagus, stomach and small intestine
• Sleep study

Your dietitian is an important member of your weight-loss team. You'll learn to incorporate dietary changes into your life, how to read labels, regulate your appetite by developing a structured meal pattern, and how to control your portions – even when dining out.

Your pre-surgery diet is an important part of preparing your body for surgery and recovery, and getting on a path to a new healthier eating lifestyle. This diet will:

• Decrease fat
• Limit sugary foods and drinks
• Limit high-carb foods

It may also include protein supplements such as powders or shakes.

In addition, you should also:

• Avoid alcohol and stop smoking
• Avoid binge-eating
• Stop certain over-the-counter medications and prescription medications with guidance from your physician

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You'll begin losing weight even before the surgery as you begin to incorporate the strategies you'll need for success. Patients who receive counseling from a dietitian before and after weight loss surgery have been shown to achieve more clinically significant weight reduction and are less likely to regain body weight.

Your multidisciplinary team will help you understand how to make proper food choices and put together an exercise program to increase your activity level. You must weigh less than 400 pounds to qualify for any of our surgical procedures.

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All bariatric surgery candidates must have an evaluation to determine whether their expectations for weight loss are realistic. Success is based on your level of commitment to a healthier future, and a surgical procedure is just one step in your lifestyle change.

The psychological evaluation can help identify your strengths, but also determine where you might need support after surgery (i.e., depression or mood swings, lack of family support or triggers for past emotional eating).

You will be required to attend pre-operative education classes. These are free and conveniently located at Torrance Memorial.

Torrance Memorial also offers a variety of free support groups where you will have the opportunity to speak with our surgeons, our bariatric staff, and patients who have successfully navigated the bariatric surgery process. This will help you know what to expect along the way.

There are support groups for each specific surgical option, but you can also attend general groups. In addition, you'll be expected to bring a "coach" with you. Your coach can be a friend, significant other or family member who will support you emotionally, so you stay on track.

• Follow instructions regarding eating food and drinking liquids
• Do not drink alcohol the day or night before
• Review your pre-surgery checklist
• Get a good night’s sleep

If you are sick anytime within the 10 days leading up to your surgery, report any of the following:

• Cold, flu, fever, or chills
• Any type of infection, even a tooth abscess
• Any non-healing ulcer or skin wound (i.e., insect bites, etc)
• Herpes outbreak
• Skin rash or any kind of "flare-up"

If you think you might be pregnant, let your doctor know immediately. Your surgery may have to be postponed or cancelled.

• Do not drink any liquids or eat any food, including gum, mints, or candy
• If you must take medication, swallow it with only a small sip of water
• Avoid swallowing water when you brush your teeth

Recovery time can vary, but the typical bariatric surgery patient stays 1-2 days for the laparoscopic gastric bypass and sleeve gastrectomy, and 4-6 days for revisional surgery or the open gastric bypass. The band patients are usually home the same day and do not need to stay overnight.

An exercise regimen is key to maintaining weight loss, and your team at Torrance Memorial will help you develop a plan. You'll start by walking soon as soon as you can after surgery, and continuing to walk more once you go home. Patients with knee or ankle problems are encouraged to swim or bicycle, once cleared by their surgeon.

Patients must stop smoking before any weight loss surgery. Smokers risk having lung problems or infections after surgery. It also slows the healing process. Smoking after surgery can also lead to complications such as ulcers after the bypass or sleeve, or erosion of the band in those patients.

Your doctor and dietitian will help you with your specific eating plan, but you can expect to be on a liquid diet right after surgery. After two weeks you can then begin eating pureed or semi-solid food. Most patients resume eating solid food after about four weeks. Again, your doctor and care team will outline your specific diet plan.

National guidelines suggest that bariatric surgery should only be performed on patients 18 years of age or older. Patients should be mature enough to handle the commitment and hard work needed to maintain a healthy lifestyle after surgery.

Each policy is different, though many insurance providers understand that this is a medically necessary and lifesaving procedure. Your team at Torrance Memorial will help you to work with your insurance company to determine your bariatric surgery coverage.

If you're planning to become pregnant, your surgeon will advise you on how long you should wait. Patients are typically told to wait about 18 months, or when your weight loss and nutritional status has stabilized.