Before Bariatric Surgery

Bariatric surgery is a type of surgery to help you lose weight. It's a choice for some people who are very obese. And for people who are obese and have obesity-related health problems such as diabetes, heart disease, high blood pressure, arthritis, or sleep apnea and haven't been able to lose weight by other methods. Diabetes and some other health problems can get better with weight loss.

Being approved for bariatric surgery

Before having surgery, you’ll meet with a team of healthcare providers. They'll make sure the surgery is the right choice for you. They'll look at your general health, your emotional health, and other factors. If they approve you for the surgery, you’ll need to get ready for it. You may need to meet with members of your healthcare team several times in the months leading up to your surgery.

Lifestyle changes before bariatric surgery

You’ll need to make some healthy lifestyle changes in the months before your surgery. You’ll also need to plan for changes in diet, exercise, and lifestyle after the surgery. This will lower your chance of complications after surgery. You'll likely need to:

• Go on a special diet. About 2 or 3 months before your surgery, your surgeon or dietitian will put you on a diet. This will help you lose some weight before your surgery. Losing some weight before the surgery will reduce your risk for surgery complications. This diet will be high in protein and low in carbohydrates and fat. This diet will help keep you from losing too much muscle mass. Your healthcare provider may also have you keep a food diary during this time. Your surgeon or dietitian can give you details about what diet you should follow. This diet may be similar to the one that you will need to follow after your surgery. In some cases, you may be told to follow a low-calorie liquid diet for a couple of weeks before your surgery.

• Start exercising. Your healthcare team might also have you start an exercise program. This may also help you lose weight before your surgery. It can also help start positive habits you will need to keep up after your procedure.

• Stop smoking. If you smoke, you’ll need to stop smoking before your surgery. Smoking raises the risk for complications after surgery. Talk with your healthcare provider about ways to help you quit. Many bariatric surgeons will not do surgery on people who are still smoking.

• Get counseling. Some people may benefit from counseling as they get ready for surgery. Many people who are obese have disordered eating habits. These often have an emotional link. Working on any emotional concerns with a therapist may help you have a better result after surgery. Counseling also helps you set realistic expectations for life after surgery.

Your healthcare provider may have more instructions about how to get ready for your surgery. Make sure to follow all of their advice.

Getting ready for your surgery

Talk with your healthcare provider how to prepare for your surgery. Tell them about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. You may need to stop taking some medicines before the surgery, such as blood thinners and aspirin. Follow the advice on how far in advance they should be stopped.

Follow any directions you're given for not eating or drinking before surgery.

Before your surgery, you may need tests such as:

• Electrocardiogram (ECG), to check your heart rhythm

• Blood tests, to test for infection or other conditions

• Nutritional tests, to see if you're lacking certain nutrients

Tell your healthcare provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, foods, or anesthetic medicines (local and general)

• Are pregnant or think you could be

Also make sure to:

• Ask a family member or friend to take you home from the hospital. You can't drive yourself.

• Follow any directions you're given for taking medicines and for not eating or drinking before surgery.

• Tell your provider in advance all of the medicines that you take. Find out which ones should be taken the morning of the surgery with a sip of water. 

• Follow all other instructions from your provider.

You'll be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully. Ask questions if something isn't clear.

Reasons a surgery may be postponed or canceled

Even after you’ve been approved for surgery, it may need to be delayed if:

• You have a new health issue like a fever, cough, cold, or a new heart problem right before your surgery

• You didn’t make new lifestyle changes before surgery, and you gained weight during this time

• You continued to smoke

• A mental health provider thinks you're not psychologically ready for the surgery

• You missed preoperative appointments

• You changed your mind about having the surgery

Your medical team will only do the surgery if they know it will give you health benefits. For the surgery to be a success, you'll need to make lifelong changes to your diet and lifestyle. Your medical team will want to know that you're ready for the life changes that go with surgery.

Even if your surgery gets postponed, you might be able to have it at a later date. Talk with your healthcare provider about why your surgery was postponed. Ask what you can do to increase your chances of having the surgery at a later date.