Bariatric Surgery

Preparation for Weight-Reduction Surgery

Qualification

Mayo Clinic surgeons will not perform weight-reduction surgery merely because someone is overweight or for cosmetic reasons. The person must have a high risk for developing health problems or have a weight-related health problem that could likely improve by losing significant amounts of weight.

Health problems that can result from obesity include:

• Degenerative joint disease
• High blood pressure
• Heart disease
• Hyperlipidemia
• Diabetes
• Obstructive sleep apnea

The evaluation

Bariatrics is the study of obesity — its causes, prevention and treatment. The Mayo Clinic bariatric health care team consists of:

• Specialist in bariatrics or endocrinology who conducts a thorough initial examination,
• Nurse practitioner or physician's assistant who may participate in follow-up care,
• Dietitian who will discuss necessary diet changes,
• Psychologist who will help identify behaviors that may interfere with long-term success of the surgery, and
• Surgeon who specializes in weight-reduction techniques.

Cardiologists and sleep disorders experts also frequently participate in the care of a person who is obese.

Not all people who meet the criteria for weight-reduction surgery are psychologically or medically ready for the surgery. A thorough medical exam is necessary prior to a decision to perform surgery.

For some, psychological or psychiatric problems may need to be addressed before surgery. Mayo Clinic has learned that people with untreated anxiety or depression may have a longer and more difficult recovery from surgery. People are also more likely to maintain weight loss if they have behavioral therapy before and after surgery. Each candidate for bariatric surgery meets with a psychologist to identify factors that might complicate the surgery and long-term weight loss. After an evaluation that typically includes an interview and some questionnaires, the psychologist shares findings with the person considering surgery and with his or her doctor. The best path to success for some may be to postpone surgery until complicating psychological factors are managed and controlled. All candidates for weight-reduction surgery are expected to participate in behavioral therapy both before and after surgery.

Mayo Clinic believes that a thorough evaluation and behavior modification program will ultimately ensure that patients are successful after the surgical procedure. The initial evaluation process usually takes from one to three months, but the overall evaluation takes about three to six months. The time until surgery can be longer than six months because of insurance processing and scheduling.