Weight loss Wellness & Mental Health

Weight Loss Surgery: Approval Process

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The weight loss journey began the day I decided to get surgery in February of 2019.  I considered all my options and decided to get the gastric sleeve. The weight loss surgery approval process is the same for the bypass.

Weight Loss Surgery is very personal and people tend to say rude stuff to you like, You Cheated, It must be nice, etc. Even though it is extremely difficult.

So, I opted to tell my husband, best friend, aunt and cousin, that’s it.  After the surgery, I ended up telling 2 more friends because they were getting the surgery too. 

I’m a slow loser to begin with so I don’t have to tell people if I don’t want to.  Apparently, everyone just thinks its due to keto anyway.  I’m not ashamed, I just don’t want to harsh my mellow with other people’s BS.  I’m writing this to share my journey, unedited and maybe even give a little insight into the process.  Here is how I began the process.

Does my insurance cover weight loss surgeries?

  • More and more insurance companies cover this procedure because, in the long run, it will save them money by having a healthier client.  But not all insurance companies do
  • It’s important to see if your insurance company covers the procedure, how much they cover and what requirements they have (more about that later)

Am I a candidate for bariatric weight loss surgery?

  • You can’t gain a little weight and then go see a doctor and expect surgery, it’s not that simple.  You have to show a history of being overweight, your surgeon will make you fill out a lengthy questionnaire about your weight and past weight loss efforts.  They may reach out to your primary physician to see your weight over the past 5-10 years
  • Obviously, you must be overweight to even be considered.  Generally speaking, you qualify for the surgery if you are over 40% BMI; exceptions are made if you have co-morbidities and your BMI is between 35-39%.  For example, if you are diabetic or have diagnosed sleep apnea, you may be eligible if your BMI is 35%

How to pick the right surgeon:

  • You’ll want to meet with a few surgeons in order to give you options
  • Ask questions at your consultation:  How many surgeries have you performed, what is the mortality rate, ask about recovery time and pre and post-op requirements
  • Ask a friend or family for a referral if they have had weight loss surgery
  • If at the consultation you feel rushed, or if the doctor isn’t answering questions, this may not be the doctor for you.  You will have a lot of questions through this process and you will pay a lot of money so you want to make sure you feel confident with your doctor
  • You’ll also want to determine which weight loss surgery is for you.  There are several options but the 2 most popular are Gastric Bypass and Gastric Sleeve.  I chose the sleeve

The weight loss surgery approval process is lengthy so make sure you pick a surgeon with great reviews and is thorough during his or her consultation.

What other requirements are there?

  • Each surgeon and insurance company is different.  With my experience, I had to have 4 dietician appointments in 3 months.  You weigh in on day 1 and you must weigh less than that amount by the 4th appointment.  Depending on your start weight your surgeon may require significant weight loss, check with your doctor for your individual goal
  • You may have to do bloodwork, upper GI study, get clearance from a cardiologist and pulmonologist.  I had to have an endoscopy and get clearance from a GI doctor as well
  • You will have Psych Appointment-they will determine if you are in a good headspace to have the surgery and a good support system post-op.  I suffer from depression and anxiety but through medication and talk therapy, I was thriving.  Mental Illness is not necessarily seen as a detractor.  Just be honest and you’ll be fine.

Once I picked a surgeon and completed my clearances I scheduled my surgery.  I started a 2-week liquid diet before the surgery, also known as, the liver shrinking diet.  Some doctors don’t do this, others do shorter timeframes each person is different.  I won’t lie here; this is the hardest thing I’ve ever done to body. 

My diet consisted of 5 protein shakes a day, sugar-free Jell-O, sugar-free ice pops, G2 or Zero Gatorade and soup broth. This was the hardest part of the weight loss approval process for me. The first 2 days are horrible, I was a super bitch.  My husband couldn’t even eat near me because he didn’t know if I was going to cry or cuss him out.  Luckily, he loves me and understood all that, he went with the flow. 

I should point out that you will not be hungry on this pre-op diet, the protein shakes to keep you feeling full.  It was rough because we were invited to parties and barbeques and I couldn’t eat anything.  The liquid diet is eye-opening because I realized that my marriage and my friendships all revolved around food.  It really helped change my relationship with food.  So, in 14 days I lost 14 more pounds.  On the day of my surgery, I weighed 244lbs. 

Surgery Day

I’m not going to lie I was very nervous; I threw on my Captain America tee, my big girl panties and headed out.  New Jersey had a tornado the night before and when we left for the hospital at 4am, roads were flooded, trees and debris was everywhere and things were on fire. It looked like the apocalypse had hit.  Of course, me, always the second guesser, thought this was a bad omen.  My husband reassured me that everything would be okay and we soldiered on barely making it to the hospital at 5am.

If you have sleep apnea, like I do, bring your CPAP to the hospital.  The pulmonologist checked to make sure it was functioning properly.  Then I got the standard blood pressure check and a weigh-in.  The anesthesiologist and surgeon came to introduce themselves, I found this very calming.  Oh, and for all the females out there they do a pregnancy test just before surgery.  I kissed my husband and honestly that’s the last thing I remember clearly. 

Some people will tell you anesthesia is the best nap you will ever get.  I fall into the other category where I wake up completely freaking out, knowing time has passed but super confused.  I should point out I was in absolutely no pain, I did throw up though, but I think that’s normal.  What made me laugh is everyone kept coming by to tell me how good I did in surgery.  Um…all I had to do was be unconscious and lay there, I want to hear that the surgeon did well, but anywho.

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Typically, you only stay over one night in the hospital, I had a little trouble keeping fluids down so I stayed a couple extra nights.  My husband was even allowed to stay over in my private room which was comforting.  It felt like I had done a thousand sit-ups, but other than that no pain.  I mean it was round the clock nurses giving me Dilaudid for pain and Zofran for nausea but it was fine. 

I got up and walked every hour to avoid blood clots and I was peeing constantly from the IV fluids.  Also, you’ll get a blood thinner injected every day too to prevent clots.  You have to do a minimum (sometimes more) of a week’s worth of injections yourself but it”s not as bad as it sounds.  The needle is really small and you barely feel it. If you are scared of needles, have a helper do it.

Once I got discharged, I headed home and sobered up.  You are given pain meds, but I only took them at night to fall asleep for the first few days. Each day I felt a little bit better than the last. 

You will be fatigued, it is important to stick to your vitamin regiment for the rest of your life.  To be honest the worst part of the whole thing for me, and this is TMI, is I couldn’t go number 2 for 11 days after surgery.  I tried it all Milk of Magnesia, laxatives tea, a stool softener, and even an enema.  (I warned you about the TMI, it’s going to get worse).  But nothing happened.

  Finally, on day 11 I went a little.  Your poops are going to be weird for a while.  Remember all those medicines I took to try and make me go…well, I guess they all kicked in at once a few days later when I thought I had gas.  It was not gas; I straight up shit my pants.  Definitely not my finest moments, but if you are taking anything to make you go, beware that’s a possibility.  It only happened once, and I was so thankful I was home alone.

This paragraph is for the ladies…. Ladies, your period maybe a little crazy after surgery.  Some women get there periods right after surgery while in the hospital.  I got mine 2 weeks later, and it was the worst I ever had.  You can’t take Ibuprofen anymore and that was my period go to.  I spotted and cramped for 5 days, which was proceeded by 7 days of lucifer’s waterfall, very heavy.  Make sure you are getting in your iron because that period took it out of me. I think it’s from the blood thinner, but by the next period, everything was just normal period pain.

Post Op

Every surgeon has their own protocol, but here’s my experience.  Liquid diet for two weeks.  You won’t feel hungry so you’ll have to remind yourself to eat/drink, it’s weird but very cool.  I can’t stress this enough it is very important to get your protein goal every day.  I still add protein powder to everything.  My goal was 60-80 grams of protein a day. 

After 2 weeks of liquids, I moved to pureed foods, basically baby food and strained soup, then after another 2 weeks, I advanced to soft foods, basically anything you can cut with a fork.  Then you’ll move back to slowly eating a normal diet.  I didn’t have any issues with food, I’m lucky, a lot of people can’t tolerate certain things right away. 

My tip is to always eat protein first.  You’ll barely be able to get down 2 ounces, it’s so bizarre. The biggest adjustment for me is you can no longer drink anything with your meals.  In fact, you can’t eat until 30 minutes after your last sip.  And you need to wait 45 minutes after eating to have a drink again.  If you drink with your new tummy you will feel like shit, or get an upset stomach. 

Today is the 70th day since my surgery and I feel amazing.  I’ve lost 44lbs, and I’ve lost 40 inches.  Yes, my boobs shrank, but now my back doesn’t hurt so I’ll say that’s a tie.  I’ll keep everyone updated on my journey, maybe when I’m feeling confident all I’ll show a progress pic too.

If you are considering this surgery, I wish you nothing but luck!  Comment below with someone of your weight loss tips.

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All articles are strictly the opinions of the writer based on his or her experiences in life. If you have questions or are unsure of anything regarding your health we strongly advise you to contact a professional for all medical advice.

2 comments on “Weight Loss Surgery: Approval Process

  1. Pingback: Road to Skinny: Why I got Weight Loss Surgery – Geek Girl's Guide to Life

  2. Pingback: After Weight Loss Surgery: Protein, Water and Vitamins – Geek Girl's Guide to Life

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