Weight Loss Surgery
Dr. Naveen Ballem, M.D.
If you have been struggling with your weight and its health-related issues, weight loss surgery may be a safe and effective treatment for you. New minimally invasive procedures make it possible for more people than ever to achieve long-lasting weight loss and better health.
The surgeons at Hunterdon Medical Center are board-certified and skilled at the latest minimally invasive laparoscopic procedures for weight loss. For you, that means smaller incisions, less cutting of muscle and tendons, less post-operative pain, and a faster recovery. Patients are usually able to get back to normal activity within days.
If you have considered weight loss surgery or would like to compare all of your surgical and non-surgical options, you might not know how to get started. That’s why the Center for Healthy Weight offers a program coordinator to help you every step of the way. B.J. Jacobson, RN, BSN, CHPN can answer your questions, guide you through the process, and assist you with all aspects of weight loss.
Is Weight Loss Surgery for You?
Surgery is not for everyone and the decision to have surgery should not be taken lightly. At the Center for Healthy Weight, our team of surgeons, nurses, registered dietitians and licensed clinical social workers will work with you to evaluate your health, relative to the benefits and risks associated with bariatric surgery. Surgery is only an option for considerably obese individuals who have not been able to lose weight in other ways. To be considered you must:
- Be at least 100 pounds overweight or have a body mass index (BMI) of 40 or above, or
- Have a BMI of 35-40 with additional medical problems, such as high blood pressure or diabetes
- Make a strong commitment to maintaining a healthy lifestyle after surgery
- Be committed to long-term follow-up
- Be in proper medical condition to undergo surgery
- Health Risk
- Amount of Weight to Lose
- Eating Behaviors
The decision to have weight loss surgery should be made after careful consideration and discussions with your surgeon, family, and friends.
Many steps are taken to make sure you are a good candidate for weight-loss surgery. Pre-operative screenings and testing must occur prior to someone having surgery. Required testing includes nutrition consultations, a behavioral health evaluation, a sleep study, chest x-ray, electrocardiogram, and blood work. Additional testing may include an upper endoscopy study and cardiac testing. All of your testing can be completed at Hunterdon Medical Center.
Hunterdon Medical Center Offers Many Surgical Options
Once you have determined that you are a candidate for weight loss surgery, you and your surgeon will discuss the many options available to you. At Hunterdon Medical Center we offer the latest laparoscopic methods including gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy. Your surgeon will help you choose the most appropriate procedure for you. View a comparison of the three procedures.
Gastric Banding is a potentially reversible treatment that consists of an adjustable band that wraps around the upper part of the stomach, dividing the stomach into a small upper pouch and a larger lower stomach. This procedure does not generally require hospitalization, and you return to normal activity the following day.
In the Roux-en-Y Gastric Bypass procedure, the surgeon creates a small stomach pouch and then attaches a section of the small intestine directly to the pouch to allow food to bypass a portion of the small intestine, causing your body to absorb fewer calories. With this procedure, patients are normally in the hospital for two days.
During the Sleeve Gastrectomy procedure, a thin vertical sleeve of the stomach, about the size of a banana, is created using a stapling device. The rest of the stomach is removed. Patients are normally hospitalized for two days.
All of these options limit the amount of food you can consume at one time and enable you to feel full sooner and stay full longer. As you eat less food, your body will stop storing excess calories and start using its fat energy supply. All of the options have been shown to offer significant health benefits in clinical trials.
Life After Surgery
Weight loss surgery is the beginning of your journey toward reaching your weight loss goals and living a healthy lifestyle. Your success depends on your commitment to making the necessary changes. But you will not be alone. Our team will stay with you to monitor your progress, provide advice on healthy eating, and support you physically and emotionally. We offer support groups for patients who have had weight loss surgery so that you can share your journey with others while achieving your weight loss goals.
Days after surgery you will be able to resume a light exercise routine. We can offer you a referral to join one of the Hunterdon Health & Wellness Centers at a discounted rate.
Question: Does insurance cover weight loss surgery?
Answer: Having health insurance does not guarantee you will be covered for weight loss surgery. Since the cost of this procedure can be very expensive, most patients would not even consider it an option if it were not for insurance or low-interest financing. Weight loss surgery may be covered by your insurance carrier even though it is still considered an elective procedure.
Before you attempt to get authorization, here are some helpful hints to assist you with the authorization process:
- Read and understand your insurance provider’s “certificate of coverage.”
- Get a referral and copy of medical records from your primary care physician in order to substantiate your claim.
- Keep accurate, detailed records of visits to healthcare providers. Also, save receipts for any exercise equipment, fitness programs, diet centers, weight loss drugs and anything else that can assist in the authorization process.
- With so many different insurance policies and types of plans among insurance providers, it’s important that you understand the authorization requirements for your individual policy.
The insurance company will typically ask for the following information and documentation (be prepared to provide these upon request):
- Current weight, height, and BMI.
- Verification from a physician that the patient is 100 lb or more over their ideal body weight.
- The surgery recommended along with any post-operative follow-up care, including nutritional and psychological support.
- A detailed medical history including co-morbidities (i.e., the presence of one or more diseases in addition to a primary disease).
- Six (6) months of medical records including a patient evaluation, treatments performed to date, and specific types of lab work done.
- Six (6) months of a documented dieting and exercise routine (must include dates and results).
- A psychological/psychiatric evaluation.
Once you have submitted your claim, it’s a simple matter of waiting for your insurance provider to respond. At times it can be a frustrating and discouraging process, but don’t give up. If your claim is denied you have the right to appeal the decision. Being denied coverage for surgery happens to many patients and this initial set back does not mean that you’ve reached the end of the road. Some insurance providers may initially deny bariatric surgery claims automatically the first time they’re submitted and can be more receptive to follow-up appeal letters.
If you have questions about the insurance process, please don’t hesitate to contact our office. Let our experienced bariatric team help you with the authorization process.
Question: Is bariatric surgery safe?
Answer: A surgical procedure of any kind will always involve a certain degree of risk, and bariatric surgery is no exception. In the past, weight loss surgery was viewed as extremely risky. However, with the development of new procedures and advancements in technology, bariatric surgery is a relatively safe solution to morbid obesity. Today, the overall risk of weight loss surgery is fairly low with most patients experiencing few, if any, complications. This is not to minimize the fact that this is still a serious operation, which should only be considered after all other weight loss options have been exhausted.
Once a surgeon has determined that you are a candidate for weight loss surgery, it’s very important that as a patient you reveal all pertinent medical information to your surgical team. The bariatric surgeon will assess the risks involved with your particular surgery and take every precaution necessary to ensure your safety and to reduce the risk of complications.
Regardless of the type of weight loss surgery, it’s important that the decision to undergo surgery is carefully thought out. It’s imperative to weigh the risks of surgery with the long-term risks of remaining obese. Discuss any concerns you might have with your surgical team and your outside support system (family and/or friends).
Question: What kind of lifestyle changes will I have to make following surgery?
Answer: Aside from the most obvious change that takes place with respect to diet, there are a number of other lifestyle changes that have to occur in order to experience success on your weight loss journey.
- Avoid alcoholic beverages.
- Avoid high fat, high fiber foods.
- Chew slowly during meals.
- Don’t drink with meals (it makes you feel full too fast).
- Keep snacking between meals to a minimum.
- Omit desserts and sugary foods.
- Home/Work Life
Most patients can return to work within 1-3 weeks following laparoscopic surgery, while open surgical procedures may be slightly longer. Exercise can typically resume within six weeks or fewer after surgery.
Long-term follow-up care will be required annually and sometimes more frequently depending on post-surgical body functions. There will be frequent testing to determine:
- Nutritional levels (vitamin B-12, iron, and folate levels, etc.)
- Is the patient anemic (i.e., low red blood cell count)?
Having the support of family and friends is important; however, equally important is for a person to surround themselves with other weight loss surgery patients who understand the intricacies of weight loss surgery. Weight loss surgery is not a quick fix to repair the years of emotional pain caused by being morbidly obese. The support groups are merely a way for patients to share their challenges and/or success with others who have been through similar experiences. In fact, there is typically a big difference between the patients who are involved in a support group on a regular basis and those who attempt their weight loss journey alone. Our surgical team will provide you with a list of support groups to fit your needs.
For the first 18-24 months after weight loss surgery, it’s important that women of childbearing age do not conceive. Pregnancy can be taxing on the body and the potential for fetal damage increases. During this waiting period, it’s important to give the body time to heal and recuperate. For this reason, a surgeon will typically advise you to take every precaution necessary to reduce the chances of becoming pregnant.
Question: Am I a candidate for weight loss surgery?
Answer: With more than 90 million Americans suffering from morbid obesity, the need for weight loss surgery has become more apparent. Morbid obesity brings with it a plethora of health issues that if left untreated will substantially shorten life expectancy. In fact, morbidly obese adults are twice as likely to have an early death as compared to a non-obese adult.
To determine if you are a candidate for surgery, it’s important to know what medically classifies an individual as morbidly obese. The following criteria are characteristic of a morbidly obese individual and could qualify you for weight loss surgery:
- 100 pounds or more over their ideal body weight.
- BMI (Body Mass Index) of over 40.
- A BMI of 35-40 accompanied by significant life-threatening medical conditions such as Type II diabetes, high blood pressure, heart disease, and severe sleep apnea.
- Inability to maintain healthy body weight for a sustained period of time after numerous attempts to achieve weight loss with diet, exercise, medication, hypnosis, therapy, or a combination of methods.
- Overweight for at least 5 years with many failed attempts at losing the excess weight.
- Weight loss surgery is often the only option for obese individuals to improve their health. In fact, for many patients, the risk of death from not having weight loss surgery is much greater than the potential risks associated with the procedure itself. It’s important that you discuss all of your concerns with our bariatric team. Remember, we’re in this with you, every step of the way.
Please Note: It’s important to remember that weight loss surgery is not the answer for everyone who suffers from obesity. The operation is an elective procedure so it’s imperative that you are well informed on the potential risks and benefits involved. Also, the surgery is not a guarantee to produce and maintain long-term weight loss. It’s only the beginning of a lifelong commitment to healthy living that is required if you are to succeed. Following the operation, you will begin the process of making important lifestyle and behavior changes in order to increase your chances of experiencing lasting weight loss and continued good health.
Dr. Ballem has been named a “Top Doctor” by Jersey’s Best magazine and Castle Connelly as a leader in bariatric surgery.
Naveen Ballem, MDSurgeon
Vivek Bansal, MDEndocrinologist (Clinton/Washington)
Harvey C. Rainville, MDSurgeon
Additional Staff & Specialists
B.J. Jacobson, BSN, RN, CHPNProgram Coordinator
Rosemary Logue, MS, RD, CSOWMClinical Dietitian
Diana L. Scanlan ANP-BC, CDEAdvanced Practice Nurse
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