Obesity Management

Pre & Post Op Care

When considering bariatric surgery, it is important that a patient begins their new lifestyle preoperatively. Weight loss surgery is one of the tools available to help re-establish a healthy weight.

All patients should have undergone a comprehensive medical evaluation and history, including evaluation of the causes and complications of their obesity, with special attention directed to those factors that could affect a recommendation for bariatric surgery. Physical, psychological and nutritional evaluations, as well as appropriate preoperative diagnostics, will need to be performed.

All patients should have optimal preoperative control of their obesity – related conditions such as diabetes, hypertension, hypercholesterolemia, sleep disorders and liver abnormalities.

Patients are strongly urged to attend support group sessions and change dietary and exercise habits. Some insurers may require preoperative weight loss prior to surgery.

For those patients considering a gastric band, a local bariatric surgery specialist should be considered, as the close proximity may facilitate post-surgery adjustments.

Expectations

  • The amount of weight loss and rate of weight loss is dependent on the type of surgery. Weight loss expected from the gastric bypass and sleeve gastrectomy is faster than the gastric band expectation of about 1 to 2 pounds per week.309
  • Assessment of inadequate weight loss may require radiological studies as well as an evaluation of plan compliance.
  • Follow-up laboratory tests should be regularly performed, including a complete blood count and measurement of iron and B12 levels.
  • Pregnancy is not recommended for at least 12 months.
  • Support group attendance is strongly encouraged.
  • Medication dosages for obesity-related conditions should be closely monitored. Extended-release medications may need to be changed to regular release formulations.
  • Oral contraceptives may not be fully absorbed after bariatric and metabolic surgery, potentially decreasing their effect.
  • ASA and NSAID products (eg., ibuprofen, naproxen sodium) should be avoided due to increased risk of ulcers and strictures.
  • Patients may need lifelong vitamin and mineral supplements.
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