Ask Our Bariatric Surgeon

Based on the recommendations from the National Institute of Health Consensus panel, bariatric surgery candidates must be morbidly obese, which usually means 100 pounds overweight for men or 80 pounds overweight for women, with a body mass index (BMI) of 40 or higher. Alternatively, the procedure may be appropriate if a patient is 80 pounds overweight with a BMI greater than 35 and a serious obesity-related condition. Before becoming eligible for surgery, patients meet with the team for a full evaluation. Your insurance company may also have additional criteria that you may have to fulfill.

The Miriam team is delighted to take care of our weight loss patients with respect, dignity and great insight into the daily difficulties our patients encounter. We are proud to offer a state-of-the-art, multi-disciplinary surgical weight management program for our patients. Not only do we utilize the most up-to-date surgical technology, but we also have expert physicians taking care of our patients’ medical and surgical needs. Our strong nutrition program and compassionate and caring nursing staff work together with the surgical team to offer long-term (at least five years), close follow-up care to our patients.

All major surgery comes with risks, which differ for each patient and from one type of procedure to another. Opting to have bariatric surgery is a very personal decision, and only a discussion with a physician can clarify the individual risks and benefits each patient can expect.

The average patient loses between 50 to 80 percent of excess body weight. This occurs over 18 to 36 months, depending on the type of procedure.

Women should avoid pregnancy for at least 18 to 24 months after surgery. It is important to discuss pregnancy plans with your surgeon during your first appointment.

Insurance coverage varies with each patient's insurance plan. Check with your insurance provider before coming in for an appointment.

Prospective patients should contact their insurance provider to determine if bariatric surgery is covered. Then patients should call 401-793-3922 for more information.

Gastric bypass and gastric sleeve patients usually stay in the hospital for one to two days; the adjustable gastric lap band patients usually leave one day after surgery.

It varies depending on the surgery and the type of work you do. On average, gastric band surgery patients may return to work within two to four weeks. Gastric bypass and sleeve patients may take 4-8 weeks to return to work after surgery.

Exercise is vital to your short- and long-term success. At The Miriam, patients are able to walk approximately two hours after completion of the surgery; walking one to two blocks within a week is generally encouraged. You should seriously consider joining a gym or physical therapy program (if you have physical limitations) after surgery when your surgeon gives you approval to do so. An exercise program is crucial for optimal weight loss and maintenance of weight loss. We often enroll some of our patients in our cardiac rehabilitation program, which can make their transition to an exercise program safer.

There are many terminologies that are being used to describe the Roux-en-Y gastric bypass surgery. Almost all our bariatric procedures use minimally invasive techniques (laparoscopic). The following four procedures are performed at The Miriam Hospital:

• Roux-en-Y gastric bypass
• Adjustable gastric band
• Vertical sleeve gastrectomy
• Biliopancreatic diversion

Generally you need to be 65 or under to meet the qualifications and requirements that your insurance company may have. However, this is a case-by-case basis.

We agree with your doctor; it is the best option for diabetics who are obese. Please call 401-793-3922 to register for an in-person orientation or complete the online orientation.

There are reasons why there are some weight limitations. Many CAT scanners and barium study machines cannot accommodate patients over 350 lbs. Also, the heavier the patient-especially men over 400 pounds-the more likelihood of severe complications from surgery and the more likely the operation must be "open" rather than laparoscopic. At The Miriam Hospital, we prefer you to be less than, or close to, 400 pounds to ensure the best results of surgery with limited complications, by a planned pre-op weight loss program.

Our surgeons are experienced in revisional surgeries. There are options such as sleeve gastrectomy and gastric bypass. Revisional operations are always higher risk than first-time procedures and may need to be performed "open" rather than laparoscopically.

Most insurance companies cover the majority or all costs, if you qualify. We get preapprovals from insurance companies before surgery to ensure that the patient does not have to pay a huge bill after surgery. The cost of surgery is variable and there are financing programs that will assist patients without insurance coverage.

We are working with the hospital for a flat fee structure for patients seeking surgery. The band companies have also made arrangements with certain banks for financing so that patients can utilize an additional mode of payment. The surgeon's fee is usually less than 8% of your total cost. We could also work out a monthly payment plan for the surgeon's fee.

It sounds like you might be a good candidate. We will have to evaluate you further to determine the risks and your benefits. Please call 401-793-3922 to find out about our orientations that are held free of charge monthly, or complete the online orientation, for patients considering surgery.