Weight loss surgery

Weight loss surgery is a life-changing decision that can dramatically improve your quality of life. It can also reduce several life-threatening diseases, such as Type 2 diabetes, heart disease, high cholesterol and many types of cancer.

While the benefits of weight loss surgery sound very appealing, you will also need to discuss risk factors with your doctor.

Aside from talking about your medical history and current physical condition with your primary care provider and surgeon, we encourage you to be prepared with several important questions to learn more about your health.

• How would I benefit from weight loss surgery?
• In my current health condition, what are my best options?
• Am I a candidate for a particular surgical procedure?
• What other health considerations should I have regarding weight loss surgery?
• What other steps I should take to prepare for the operation?

Choosing weight loss surgery isn’t an easy decision. That's why Sentara Comprehensive Weight Loss Solutions requires everyone to attend our informational seminar, "About Bariatric Surgery," before their first appointment.

Led by our bariatric surgeons, the seminar can help you answer these basic questions about bariatric surgery:

• Is weight loss surgery the best option for me?
• What specific type of bariatric surgery will help me meet my weight loss goals?
• What other services does Sentara Comprehensive Weight Loss Solutions offer to support my needs?
• What is the next step?

Many insurance companies provide coverage for bariatric surgery. They have specific requirements that patients must meet to qualify for the surgery. Our team will help you to determine if you are a candidate for bariatric surgery and you navigate through the insurance process.

To do so, we will review insurance requirements with you when you have your first appointment with your surgeon. Our office will also submit a request for authorization once you complete the preoperative requirements. If you don't have benefits for bariatric surgery on your policy, our office can reach out to you to discuss self-pay options.

If you are not able to pay for weight loss surgery out of pocket and your insurance doesn’t cover it, we suggest that you contact your employee benefits manager to discuss the possibility of your employer adding coverage for bariatric surgery.

Sentara does not offer any payment plans or discounts for this surgery.

Sleeve gastrectomy involves laparoscopically removing approximately 75-85% of the stomach. The remaining stomach takes the shape of a tube or "sleeve" and is about the size of a banana. This procedure limits the amount of food you can eat and helps you feel full sooner. It allows for normal digestion and absorption.

With a gastric byass, surgeons partition the stomach so that food quickly fills a very small stomach "pouch" after it’s swallowed. This pouch is designed to initially hold less than an ounce. A segment of the small intestine is then connected to this pouch. These surgical changes physically restrict food intake and limit the sensation of hunger.

Single anastomosis duodenal-ileal switch (SADI) is a combination of the sleeve gastrectomy and gastric bypass procedures. The surgeon connects the small intestine to the stomach in a way that allows enough absorption of vitamins and minerals to maintain healthy levels of nutrition.

Patients experience successful weight loss along with less hunger, more fullness, blood sugar control and diabetes improvement This surgery is an excellent option for a patient who already had a sleeve gastrectomy and is seeking further weight loss.

During this procedure, the surgeon removes the lap band and performs a gastric sleeve or gastric bypass.

Sometimes patients need revisions from previous bariatric surgeries. This may be done if patients are not losing sufficient weight or if they would like to reverse a procedure that can be reversed.

Lifestyle management and weight loss medications for established bariatric surgery patients

Before surgery, you will spend several months working with us to prepare for your surgery. That includes meetings with our surgeon, dietitian and psychologist.

You will learn how to eat before and after your procedure. Often, patients lose weight before surgery because of what they learn from our dietitians. They will teach you about portions, nutrients, what to eat and what not to eat. You will need to modify your diet so that it is compatible with a smaller stomach. That also includes eating more slowly to give your smaller stomach more time to digest. These sessions are not intended to weed people out, but rather to help ensure their success.

Many insurance companies require that you meet with a psychologist so that you can be sure you are ready for the long-term dietary requirements after weight loss surgery. You will also discuss the future changes in your weight. Although you will most likely welcome seeing a lower number on the scale and feeling healthier, you will also experience psychological side effects as you adjust to your new shape and size.

We will order presurgical blood work and need a supporting letter from your primary care provider. We schedule patients for an upper endoscopy (EGD) to look for any abnormalities in their stomach that would affect their future surgery. Many people will also need to undergo a sleep study to assess for obstructive sleep apnea.

We will ask some patients to gather supporting letters from their other long-term providers (cardiology, pulmonology, psychiatry, etc.) as well as updated preventative healthcare screenings. We will create your personalized preoperative checklist during your initial consultation with us.

After you receive authorization from your physician and insurance company, we will schedule surgery. We will also schedule you for a preop visit with the surgeon and another visit with the dietician.

After you check into the hospital, we will take you back to prepare you for surgery. After surgery, you will go to the recovery room for observation then to a private room.

Many patients are surprised that they are expected to get up off the stretcher and walk to the bed with assistance, but they typically can do so without much difficulty.

After surgery, you will rest but we will also require you to get up and walk around frequently. Your surgical pain with be managed with a regiment that aims to keep you comfortable as well as minimize your need for narcotics. You will start sipping on liquids to see how your altered stomach is handling the change.

The morning after surgery, your surgeon will check on your progress and determine whether you are ready for discharge later in the day. You must be able to consistently sip on water and other liquids so that you can keep yourself well hydrated at home. Some patients will need to stay on daily injectable blood thinners to help prevent postoperative blood clots.

Immediately after surgery, you will be on a liquid diet at home. This will progress from clear liquids to mashed/blended foods. Then you can introduce soft foods before progressing to solid foods. You will receive a helpful handbook with guidance on what you can eat from week to week after surgery.

We will also book follow-up visits. You will meet with our team at two weeks, four weeks, three months, six months and one year after surgery then yearly after that. At each annual visit, you will have lab work to check your nutritional status.

With any procedure, it is important to understand the implications for your health and your life. The Sentara Comprehensive Weight Loss Solutions team firmly believes in the importance of education, which is why we make sure our patients are informed about weight loss surgery and what each operation entails. We offer a variety of classes and support groups to help you achieve and maintain your weight loss goals.

Classes

Before surgery, our patients must attend our free seminar, "About Bariatric Surgery," or watch it online. They will learn more about whether weight loss surgery is right for them, what it entails and how to get started. The class is available in person every other month or online any time.

Support Groups

Bariatric support group

Following bariatric surgery, we recommend that you participate in activities that provide continued support, encouragement and education. Sentara Martha Jefferson Hospital offers a free support group that provides just that. Our registered dietitians facilitate the group, which are offered in person or virtually. Topics include nutrition, exercise and overall wellness.

Sentara Martha Jefferson Bariatric Support Group - Facebook

We encourage our postoperative patients to join our private Sentara Martha Jefferson Bariatric Support Group Facebook page, which provides additional encouragement, education and support for our postop patients.