Steps Leading Up to Weight-Loss Surgery

In a previous post, we outlined the basics of determining whether or not you are a candidate for weight-loss (bariatric) surgery. If you met the minimum qualifications, such as body mass index and the presence of comorbidities, you can proceed—with the careful guidance of your physician—with several more steps to further ensure that weight-loss surgery is an appropriate course of action for you.


The most important element of the process is consultation with a team of health professionals. In addition to your primary care physician, you will likely need to be evaluated by a surgeon, a dietitian, a psychologist, and possibly other specialists to ensure that you are fully prepared for the procedure.  Weight-loss surgery is the most successful method for achieving significant and sustained weight loss as well resolving associated medical diseases.  It has been very successful in helping many patients change their lives and improve their health, however, like all surgeries, also carries some risk. 

Nutrition and Medical Condition

For starters, determining your readiness for weight-loss surgery will involve a number of factors related to your overall nutrition and medical history. This will include weight trends, past diet programs, overall eating habits, alcohol intake, exercise activity, and other lifestyle factors. In addition, your health care team will also take a close look at any health problems that could lead to increased surgical risk such as heart problems, kidney stones, liver disease, blood clots, etc. 

Psychological Readiness

Another important aspect of your evaluation will include an assessment of your psychological and emotional status, and overall motivation for the procedure. Some mental health conditions may complicate the ongoing maintenance of benefits of weight-loss surgery. These could include substance abuse, depression, anxiety disorders, and other conditions. Although these conditions may not ultimately prevent you from having weight-loss surgery, your physician and care team may recommend postponing surgery until they are treated and managed appropriately.

Types of Surgical Procedures

There are several different types of procedures that have been proven to be safe and effective with many patients. The type of procedure that works best for each individual depends on many of the factors previously described and involves varying degrees of invasiveness and permanence.

Sleeve Gastrectomy
This type of procedure involves reducing the size of the stomach, resulting in a more streamlined, sleeve-like form. As a result, patients have portion control, decreased cravings, eat less and have a decreased appetite. This procedure is generally irreversible.

Adjustable Gastric Band
In this approach, a band is placed around the top area of the stomach, leaving a smaller pouch available for food. Patients feel full after eating only a small amount of food. This requires frequent adjustments of the band and is infrequently performed.

Roux en-y Gastric Bypass
This technique involves creating a stomach pouch out of a small section of the stomach and attaching it directly to the small intestine, thus bypassing a part of the stomach and small intestine. As in other procedures, this results in a significantly reduced pouch to hold much food, leading to feelings of fullness after eating a small amount. This procedure is rarely reversed.

Intragastric Balloon
This is a non-surgical procedure in which a special balloon filled with saline solution is placed in the stomach. A deflated balloon is inserted into the stomach through the mouth and esophagus and is then filled with sterile saline solution. The filled balloon, roughly the size of a small grapefruit, slows the passage of food through the stomach, resulting in feeling full more quickly while eating and longer afterward. The balloon is usually removed after 6 months and can be replaced.

Procedure Prep

In the months before your surgery, your physician and care team will guide you to change your eating and lifestyle habits to begin losing some weight. Why do this before surgery? Studies have shown that the more weight patients lost while preparing for weight-loss surgery, the more likely they were to be successful after surgery.  Also, it’s important to have momentum in following new and healthy habits so that after the surgery, you won’t have to make drastic changes in your lifestyle to maintain your weight loss. If you don’t condition yourself to follow healthier eating and exercise regimens, you’ll likely fall back to unhealthy practices and may gain weight back after the surgery.

Making the Right Decision

While weight-loss surgery is a powerful tool for causing sustained, significant weight loss and also reversing many health problems it requires significant commitment. Unless you are committed to making long-term changes to your diet and exercise habits, you will not maximize the strong benefits weight -loss surgery has to offer. If you think weight-loss surgery is right for you, talk to your physician. With the proper preparation and outlook on your health, it could be a decision that will reap major benefits for many years to come.