+ AM I A CANDIDATE FOR WEIGHT LOSS SURGERY?

Obesity is a spectrum. Some patients need to lose a lot of weight and some patients need to lose just a few pounds. Bariatric surgery is meant for the person who needs to lose a lot of weight, and that depends on the body mass index (BMI). Surgery is generally considered when a patient has a body mass index (BMI) of 35 or higher.

Bariatric surgery is not just for weight loss or cosmetic reasons alone. Surgery may also be an option if the patient has obesity-related medical conditions such as diabetes, high-blood pressure, heart disease, sleep apnea, etc. Obesity can have a direct relationship with those medical conditions and bariatric surgery can help relieve and/or minimize them.

+ DOES BARIATRIC SURGERY WORK?

Most patients at our practice have heard that these operations work. However, because they have failed numerous diet attempts they are concerned that bariatric surgery will fail as well.

The basis of all bariatric operations is to put a mechanism into place that is a constant reminder that eating behaviors have to change. Whether it is immediately after surgery or 10 years after treatment, these operations limit the amount of food a patient can eat and also remind the patient that wise dietary choices should be made.

Laparoscopic weight loss surgery, healthy eating habits, and moderate exercise have led to a successful formula for thousands of patients at our practice. We invite you to read success stories that some of our patients have shared of their results after bariatric surgery.

Not all of the operations work the same, some may yield different results. Have a private consultation with one of our experienced weight loss surgeons and their staff of dietitians and patient advocates. They will help you find a successful operation designed to fit your personal needs and lifestyle.

+ IS IT COMMON TO REGAIN WEIGHT IN THE YEARS FOLLOWING WEIGHT LOSS SURGERY?

Today it is much less common due to improved technologies and patient aftercare. At Dallas Bariatric Center, we ensure every patient receives significant support and education starting from the initial consultation to post-operative care.

+ IS WEIGHT LOSS SURGERY DANGEROUS?

No. In the past several years, major advancements in techniques and equipment have improved the operations, and complication rates have dramatically diminished. Your chance of dying from one of these weight loss procedures is approximately the same as having your gallbladder removed. Dr. Jay has performed over 12,000 weight loss procedures and has a zero percent death rate.

+ WHAT ARE THE RISKS OF BARIATRIC SURGERY?

All surgical procedures, whether bariatric or otherwise, have some level of risk. Each laparoscopic weight loss surgery procedure that we offer has different benefits and risks that are associated with it. Our doctors and staff will make sure that you are fully informed of these benefits and risks. The surgeons at DFW Bariatric Institute are extensively trained and experienced and are committed to minimizing risks to ensure the safest and most effective procedure possible.

The dangers of living with the chronic disease of obesity hold greater risk than surgery. Morbid obesity will shorten one’s life as well as diminish the quality of one’s life. It is calculated that a morbidly obese patient will lose 10 to 20 years of his or her life. It is believed now that up to 20% of all cancers can be caused by obesity. It is the second leading cause of preventable death, just behind tobacco use.

+ WHAT ARE THE ROUTINE TESTS BEFORE BARIATRIC SURGERY?

Patients may need to undergo a psychological evaluation prior to undergoing bariatric surgery with the gastric sleeve resection, laparoscopic gastric bypass surgery, or LAP-BAND® System. In addition, we require a complete blood count, complete metabolic panel, PT, PTT (to check your blood clotting time), urinalysis to include urine nicotine, along with type- and cross-matching your blood. We will perform a chest X-ray and an electrocardiogram (EKG).

In addition to the routine lab work and tests, you may need additional studies such as a sleep study, EGD, echocardiogram, or stress test for cardiac clearance.

+ WILL I EVER REGAIN MY WEIGHT BACK?

The operation is a tool, which helps you control your weight by requiring modification in your dietary intake. If you do not use it correctly, you can regain the weight you have lost. Three common culprits to poor weight loss or weight regain. Not exercising Drinking high-calorie liquids Grazing (eating little bits throughout the day without realizing it)

+ WHAT MEDICATIONS SHOULD I AVOID AFTER SURGERY?

Medications that irritate the stomach should be avoided. This includes aspirin, ibuprofen, and NSAIDS (non-steroidal anti-inflammatory drugs). Any physicians who treat you in the future should be made aware of your surgery, and aware of avoiding these drugs. However, there may be situations where there drugs are necessary for a short time. If you have any questions, please call Dr. Jay’s office for guidance.

+ WHAT DIET WILL I FOLLOW AFTER SURGERY?

You will be on a progressive diet starting with full liquids, then soft proteins, and finally regular foods around week 8. Your diet will always need to be low in fat and sugar. Remember, when you begin to think about solid foods, you will want to avoid breads, pasta, potatoes, and rice, at least initially. Most patients are able to tolerate a bite or two of these items by 6 months or so post-op. When you eat any meals, think PROTEIN FIRST. You will always have access to a nurse and a dietitian to answer any questions you have concerning food choices and good nutrition.

+ HOW SOON AFTER SURGERY CAN I GET PREGNANT?

The minimum recommended time is 12 months after you reach your goal weight. Ideally, patients should wait 18 to 24 months after surgery before conceiving.

+ WHEN CAN I GO BACK TO WORK?

When you return to work will depend on the type of work you do, your personal energy level and any restrictions your employer places on you. Patients have returned to work as soon as the next 4-7 days but the majority of patients take off 2-3 weeks. During the first few months after surgery, you will find that your body uses a great deal of energy for the healing process. This means that there is not a lot of energy “left over” for other activities. You will have days when you seem to have more energy, and others when you seem to tire easily. When you feel tired, take time to rest. However, the more you can do the better. Be sure to listen to your body and use common sense.

+ WHAT ARE SOME OF THE CO-MORBIDITIES OF MORBID OBESITY?

Diseases or conditions associated with obesity such as: Type 2 diabetes, High blood pressure/Heart disease, Osteoarthritis of weight bearing joints, Sleep apnea/Respiratory problems, Gastroesophageal Reflux Disease (GERD), Gallbladder disease, Depression, Infertility and/or menstrual irregularities, Skin breakdown, Swollen legs/Skin ulcers, Urinary stress incontinence & Pancreatitis.

+ HOW DO I CALCULATE MY BMI (BODY MASS INDEX)?

The manual formula is: BMI = (Weight in lbs X 703) / (Height in inches X Height in inches)

+ HOW DOES THE PRE-OPERATION PROCESS WORK? ?

The pre-operation process is the same for every procedure. Patients will meet with Dr. Jay for an initial consultation to discuss their health. This includes family history of obesity, past weight loss attempts (including surgeries), lifestyle habits, and what initiated the weight gain.

The first consultation helps our team understand the patient as best as possible. Following the consultayion, the surgeon will go over the expectations for before, during, and after the procedure.

After that first conversation, patients will meet with a dietitian to discuss diets before and after the procedure. Prescribed by the surgeon, patients will begin changing the amount of food they take in and what kinds of food they eat.

At Dallas Bariatric Center, we believe the key to success for any patient is a complete lifestyle change and proper support. We provide all of our patients with a comprehensive pre-op and post-op guide to ensure optimal weight loss success.

+ HOW ARE LAP BAND ADJUSTMENTS PERFORMED?

The adjustments take only a few minutes and are performed in our office.

+ HOW DO I KNOW IF I NEED A BAND ADJUSTMENT ?

Are you losing weight? We expect you to lose weight at the rate of one to two pounds per week. Do you have hunger between meals? You may need a fill. Do you experience reflux or vomiting? Your band maybe too tight, and you should see your doctor. Band adjustments are usually done on a monthly basis.

+ DO I HAVE TO QUIT SMOKING?

Yes. Smoking increases the risk of lung problems after surgery, can reduce healing, increases the rates of infection, and interferes with blood supply to the healing tissues. This can result in immediate (life threatening) complications as well as long term (ulcers and strictures) complications.

+ IS THERE A SUPPORT GROUP I CAN JOIN?

Yes, to join the Dallas Bariatric Center Support Group, click here: https://www.facebook.com/groups/dbcsupport

+ DOES MY INSURANCE COVER BARIATRIC SURGERY?

The best way to determine if you’re covered is to contact Member Services. The number is always listed on your insurance card. If you require assistance at any time, please contact our office and ask for our Insurance Coordinator.

+ DO I HAVE BENEFITS FOR SURGICAL TREATMENT OF MORBID OBESITY?

The Insurance Coordinator verifies benefits after your initial consultation to obtain information on your benefits, deductibles and how much is met. It usually takes two to three weeks for this process due to the large number of patients.

+ WHAT DO I HAVE TO DO TO GET APPROVED?

Insurance companies are required to review medical records prior to making the decision to approve your surgery. They use these records to determine medical necessity, to review your health for surgery, and to see if you can stick to a diet plan. Ask your Member Services representative for a copy of these requirements, or you can find them on their website. These records will come from your prior visits with any and all of your doctors, or new visits with a nutritionist and a psychiatrist.

+ WHY DOES IT TAKE SO LONG TO GET INSURANCE APPROVED?

Bariatric surgery, unlike any other medical care, undergoes intense scrutiny at each level of the whole approval process. Each major insurance company may have many different plans. Each employer may choose a different plan – some of those plans may have a bariatric benefit, some may not. If the plan has a bariatric surgery benefit, each insurance company may have a different criteria requirement to approve the operation. Some of these criteria may be historical (5 years of documented morbid obesity, for instance) and some may be proactive (must complete a 6 month program of diet, exercise and behavior modification, for instance). Because of the complex intricacies of each plans’ criteria, we employ “patient advocates” – they help you navigate the tortuous voyage through the approval process.

+ HOW IS THE INFORMATION GATHERED AND SUBMITTED?

After your initial consultation, you will be given a list of what your insurance company requires. It is your responsibility to get this information to the Insurance Coordinator. A list of requirements will be placed in your chart, and as each item comes in, it will be checked off. When all items are checked off, a letter of predetermination will be written and the entire package of records will be sent to your insurance company either by fax or by certified mail.

+ HOW LONG DOES IT TAKE TO GET APPROVED?

Most insurance companies take 30 to 60 days to go through the approval process. Typically they will send a letter to the office and to the patient informing them of their decision. We contact you as soon as we hear from your insurance company. To check the status of your request, we suggest that you start calling your insurance company approximately three weeks after we submit everything. Due to the number of patients we have waiting to get approved, this office cannot call to check the status. Insurance companies typically respond to their members much better than they do to the providers.

+ WHAT DO I ASK THE INSURANCE COMPANY WHEN I CALL ABOUT APPROVAL?

Inform the Member Services representative that you are asking about the letter of predetermination sent from Dallas Bariatric Center, and that you wish to know how long the predetermination process takes. Don’t hesitate to call frequently. Our history shows that persistence on your behalf pays off faster.

+ HOW WILL I KNOW IF I AM APPROVED OR DENIED?

You will receive a letter from your insurance company, usually before our office receives a duplicate letter. Once we receive notice, we will call you to schedule your surgery.

+ HOW DO I QUALIFY FOR THIS SURGERY?

The general rule of insurance companies is that your BMI must be 35 or greater with additional co-morbidities such as Hypertension, Sleep Apnea, Coronary Heart Disease, Type II Diabetes, and Dyslipidemia; or your BMI must be 40 or greater without any co-morbidity.

MedicalFinancing.com works with patients to get the help they need by offering loans up to $30,000, low interest rates, and affordable monthly payments. Payment schedules range from 12 months to 7 years, making your weight loss dreams a reality. Visit us at MedicalFinancing.com or click the logo above to see if you qualify.

+ CARECREDIT FOR TREATMENT AND CARE

We offer CareCredit to make it easier for you to get the treatment and care you want and need. CareCredit, a part of GE Capital, and the nation’s leader in patient financing has a variety of payment plans for you. Depending on your procedure, you can conveniently pay over time with a Low Monthly Payment Plan that fits comfortably into your lifestyle and budget. Learn more by visiting CareCredit.com or contacting our office. Ready to apply? Apply online for your CareCredit card today.

We are in network with all policies of Aetna, UnitedHealthcare and Cigna.

We accept all plans with out of network benefits also known as PPO plans, i.e., Medicare, Texas True Choice, and Blue Cross Blue Shield.