Again, this answer depends on the surgery that you have chosen. The gastric sleeve surgery is not reversible. Gastric bypass is reversible but not easily done. The LAP-BAND/REALIZE™, however, is more easily reversed.
It is important to remember, however, that such surgery is considered a lifetime commitment and the reversal of any procedures will likely result in weight gain.
The dietary guidelines provided following surgery are essential for success. First and foremost, they are meant to allow your body to heal from surgery. Going forward, they are meant to help you lose weight appropriately. Any deviation from the dietary guidelines can result in a slow down in weight loss and sickness. “Dumping syndrome” – symptoms experienced when surgery patients eat too much or consume high-fat or high-sugar foods – can include fatigue, sweating, diarrhea, and vomiting.
Losing an excessive amount of weight often means that weight loss surgery patients are left with excess, saggy skin, which can be both uncomfortable and unsightly. Plastic surgery is available to remove this excess skin but, because this is typically considered a cosmetic surgery, it is most often not covered by insurance.
However, there are some cases in which the removal of excess skin is considered medically necessary such as when the skin is causing rashes or ongoing infection. So it’s important to check with your insurance carrier or human resources department to determine if insurance coverage might be available to you.
Weight loss surgery changes your body in many ways and, in the case of alcohol consumption, you will find that alcohol affects you much faster than before your surgery. We suggest to our patients that they avoid drinking alcohol for the first year following their surgery because it is high in calories and can slow weight loss. After the first year, as long as your doctor approves, small amounts of alcohol from time to time may be just fine.
We ask our patients who smoke to quit six to eight weeks prior to their weight loss surgery as smoking can complicate the surgical procedure itself and inhibit recovery.
Of course, we also encourage our patients to continue to avoid cigarettes in the long term as smoking does not fit with a new, healthier lifestyle.
Exercise is not only important; it is essential to your success following weight loss surgery. Of course, exercise burns calories, which is important for weight loss. But exercise also builds and preserves muscle, which is an important component to losing weight. You don’t want to lose muscle mass and strength as you drop pounds. We encourage our patients to follow a regular exercise routine following their surgery and we will work with you to determine what is most appropriate for you.
We recommend that patients refrain from getting pregnant for at least one year following surgery. During this time, you will be losing weight very rapidly and such weight loss can be harmful for a pregnancy. After the first year, when you have returned to a regular diet – and are at a healthier weight – you have a much better chance for a healthy pregnancy.
Sometimes, rapid weight loss – such as occurs following weight loss surgery – results in a lowered intake of protein and zinc. In turn, this can cause some weight loss surgery patients to lose some hair following their procedures. That’s why we recommend that our patients consume adequate amounts of a protein daily and also take a daily zinc supplement. Our weight loss team will work with you to recommend the appropriate supplements and vitamins to take following surgery.
Many people are unsure if they are “overweight enough” to be considered a candidate for weight loss surgery. Weight is, of course, a primary qualification; but there are also other factors. At the Nicholson Clinic, here are our qualifications for a LAP-BAND/REALIZE™ band, gastric bypass surgery, or gastric sleeve:
- A body mass index (BMI) of 40 or more (which translates to about 100 pounds overweight for men and 80 pounds overweight for women). OR
- A BMI between 30 and 39.9 with at least one serious obesity-related health issue such as heart disease, type 2 diabetes, severe sleep apnea, hypertension, etc.)
The patient should also meet these three conditions:
- Have been classified as obese for at least five years.
- Do not have a history of addiction or severe psychiatric problems.
- Have a thorough understanding of the weight loss surgery you have chosen and the lifestyle changes that are necessary for it be successful.
There are many states that have laws that require insurance companies to cover weight loss surgery if it is considered medically necessary and the patient meets the criteria set forth by the National Institutes of Health. Generally speaking, approximately 50% of insurance companies will cover a weight loss surgery including the LAP-BAND/REALIZE™ band, gastric bypass surgery, and gastric sleeve as long as the patient’s doctor provides a Letter of Medical Necessity.
A Letter of Medical Necessity is submitted to your insurance company and allows them to consider your request for surgery. The letter essentially addresses why weight loss surgery is critical for the health of the patient and why surgery is necessary. The Letter of Medical Necessity will include information such as the weight of the patient, including BMI, the number of years that the patient has been overweight, full medical history including conditions related to obesity, and diets and weight loss programs attempted by the patient in the past.
Of course, insurance coverage can be tricky business. Once you schedule an appointment, our insurance verifiers work with our patients step-by-step to provide their insurance company with what they need to help provide coverage.
Some insurance companies that currently provide partial or complete coverage of some weight loss surgeries include Blue Cross (in some states), Humana First Health, United Healthcare, Aetna, and Cigna.
However, be sure to check with your insurance carrier or human resource department to determine your specific insurance coverage for weight loss surgery.
