Bariatric surgery is not a quick process. Yes, the surgery only lasts a few hours. But it often takes 6 months to get approved for surgery. It takes a year to reach your weight loss goal. And it takes a lifetime to keep it off. Remember that bariatric surgery is a tool to get your weight down. After a year, the surgery has done its job and you’ve lost the weight. Now it’s up to you to keep it off.
Choosing a surgeon is a big decision. You are going to see your surgeon for at least that first year after surgery and multiple times before surgery. If you’re going to be successful you should plan on going to support groups every month for a minimum of one year after surgery but possibly longer.
If you choose to have Lap Band surgery then you’ll likely see your surgeon 2 or 3 times a year for the rest of your life to have your band fill-levels checked. Again, choosing a surgeon is important. And its not just the surgeon that you’re choosing. You’re choosing their Bariatric Coordinator, their Dietitian and the resources that they offer to help you reach their goal.
We’ve come up with 6 questions that are important to ask your surgeon. Remember you are interviewing him or her and they want your business. Do not be shy to ask some difficult questions.
1.) What is your experience?
When it comes to surgery, experience is important. However, don’t confuse having performed a lot of surgeries with being the most skilled. Often, young surgeons coming from quality training programs don’t have as many cases under their belt as a surgeon that has been doing bariatrics for 10 or more years.
Don’t write off a young surgeon. Experience can come from a quality bariatric fellowship program. What’s a fellowship program? A fellowship is typically a two year program where a surgeon trains under another surgeon specializing in that surgical specialty. In the case of bariatric surgery, the surgeon spends two years after their standard surgical training to gain further skills in bariatric surgery (typically the trainer is a very well regarded bariatric surgeon).
But experience does count. If everything else is equal, a surgeon with more cases under his/her belt will often be more able to handle difficult cases. They’ve honed their technique, built-out quality resources, and will continue to be around for years to support you after surgery.
2.) What resources do you offer before and after surgery?
This is an important and often overlooked part of bariatric surgery. As I mentioned, weight loss surgery is a journey. It’s not an act. Successful weight loss surgery patients change habits, they dedicate the time to learn how to keep the weight off, and they’ve developed a close group of family or friends to support them.
Your bariatric surgeon should know that success is not just a result of his skills on the operating table. The staff dietitian should be truly concerned with your health. You should feel comfortable telling the dietitian what you eat and drink. The dietitian should be a good listener and able to offer advice catered to you and your situation.
Your surgeon should offer quality support group meetings. I’d ask if you can attend one of these. Typically, support groups are held once per month. Some practices offer online support groups, weekly support groups and even Facebook support groups. Support group topics range from, ‘Eating healthy during the Holidays,’ to ‘Sex after weight loss surgery.’
Some bariatric practices offer smartphone apps to help you stay connected. All of these things are important factors that lead to your success.
3.) Which procedures do you perform?
Don’t assume every surgeon performs every bariatric procedure. They don’t. But there could be a good reason for not offering every procedure.
Some surgeons offer gastric bypass surgery, gastric sleeve surgery, duodenal switch surgery and revision surgeries, but they don’t offer Lap Band. Ask why? The reason could be that they have found, through experience, that too many patients did not meet their weight loss expectations with that procedure. That is an acceptable reason for not offering the procedure. In fact, it may indicate that the surgeon is more concerned with your success than he is with making money from offering another procedure that you may want.
If, on the other hand, the surgeon only offers Lap Band surgery, ask why. It could be that he or she was never trained in the other procedures. If Lap Band is the procedure that fits you best, then this surgeon may be a good option. However, a surgeon that only offers one procedure has a direct interest in making that one procedure sound like your best option. At a minimum, I’d recommend sitting through a weight loss surgery seminar with another surgeon that offers more than just one option.
4.) What procedure would you recommend for me?
A good bariatric surgeon knows that there isn’t one procedure that fits everyone. This question is good to ask because to answer the question properly the surgeon needs to know about you. The surgeon should ask you about lifestyle, your risk tolerances, your exercise habits, and your dietary habits. Gastric bypass, gastric sleeve or gastric balloons may be appropriate.
The surgeon shouldn’t choose a procedure for you. Instead, they should present you with the benefits and risks associated with each procedure. This shouldn’t be a rushed process. Bariatric surgeons are busy but a good bariatric surgeon is going to take the time to explain each procedure to your satisfaction. If a surgeon rushes through your consultation then you can probably expect the same in future interactions.
5.) What are your complication rates?
Complication rates vary from procedure to procedure. According to a study in July 2010 issue of JAMA (Bariatric Complication Rates 2010), serious perioperative (during surgery) complication rates for gastric bypass were 3.6%. Serious complication rates for gastric sleeve surgery (sleeve gastrectomy) were 2.2% and serious complications for Lap Band surgery were 0.9%.
Keep these rates in mind when speaking with your bariatric surgeon. His or her rates should be around or lower than the national average.
The complication rates mentioned are serious perioperative complication rates. They do not include minor complications after surgery.
6.) Why should I choose you?
This question may throw the bariatric surgeon for a loop. It’s not every day a potential surgery candidate will ask this. But I think you’ll get some interesting responses. What’s the right response? That’s up to you.
Personally, I like a response that tells me why the bariatric surgeon loves his job and why he’s going to be with me to support me in this journey. A surgeon that touts his skill probably wouldn’t be the answer I’d want from this question.
Ultimately, your level of comfort in the surgeon’s skill and the knowledge that he’s truly there to help you get healthy will make your decision. The questions above will have you walking out of your initial consultation with confidence that yes this surgeon is the right one for you. Or, you’ll know that you still have some more surgeons to interview. And that’s ok. Weight loss surgery is the first step towards your new life. Start off on the right foot. Take your time and ask the right questions.