Bariatric surgery, also known as weight loss surgery, has been available in the United States since the 1950s and, over the years, a variety of surgical procedures have been evaluated. Today, in the United States, the two most common procedures are the gastric bypass and the adjustable lap-band. Both have been found to be good tools for long-term weight management. Most patients who utilize the procedures lose a significant amount of their excess weight and keep most of it off indefinitely. (Click on Helpful Links to search the Professional Organizations and Information links for websites that provide details about the surgical procedures.)
The most commonly performed gastric bypass procedure in the US is the Roux-en-Y. It facilitates weight loss by restricting the amount of food that can comfortably be eaten at one time, while preventing the body from absorbing all of the food that is eaten. Percentage of excess weight lost three to six years after surgery ranges from 53% to 77%, and seven to 10 years after surgery ranges from 25% to 68%.
The adjustable lap-band procedure assists weight loss by restricting the amount of food that can be comfortably eaten at one time. Percentage of excess weight loss three to six years after surgery ranges from 45% to 72%, and seven to 10 years after surgery ranges from 14% to 60%.
Despite the excellent weight loss that most patients enjoy with bariatric surgery, it is important that prospective patients understand that the surgery does not guarantee good weight management. Surgery helps you remember to make healthy choices but it does not make the choices for you. Thus, even with surgery, you must make the lifestyle changes that are required for weight control in general.
Reference: Medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. (2009). Obesity, Vol. 17, Supplement 1.
Pre-Surgical Psychological Assessment and Evaluation
Most bariatric surgeons and insurance companies require a Psychological Assessment before scheduling surgery. Although these requirements typically cause apprehension in patients about “passing the eval,” this fear is unnecessary. The three-hour Assessment is not designed to “test” you. Rather, the protocol is designed to help you identify what strengths you have that will optimize your post-operative outcome, and what might be going on in your life that may interfere with a good outcome. We help you figure out how you can address the problem areas to best prepare for surgery. The goal of the Assessment is that by its end, you are prepared to make better use of this surgery than when you first came in. Bariatric surgery is not a cure or fix for obesity. It is a tool that the well-prepared patient can use to improve his or her health.
When you attend your Assessment, plan to spend approximately two hours with the Psychologist. Before you leave, she will explain her recommendations to you. In most cases, the report will be written and faxed on the same day. A signed report will also be mailed to you. Please retain your copy of the report.
Bring to your Appointment
- A completed Clinical Intake Questionnaire and Treatment Agreement (see Intake Paperwork on the New Patients page.)
- A working fax number for each provider to whom you want the report sent.
- Your insurance card(s)
- Your copay which must be either cash or check.
Every patient who does her or his Assessment with us is encouraged to schedule at least one follow-up visit after the operation. In most cases, one visit to trouble-shoot is all you need. Sometimes, however, there are unexpected psychological or social results of the surgery or of weight loss and more sessions are needed. When this is the case, you and we can work together to make the post-operative adjustment as smooth as possible.