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Knowing the physical requirements for patients of gastric bypass surgery is the first step for those considering this medical procedure.
Gastric bypass surgery, also known as Roux-en-Y (roo-en-wy) Gastric Bypass, is a tier 1 elective surgical procedure for patients who wish to lose weight. Tier 1 puts it in the same category as cosmetic surgery
Gastric bypass is commonly an arthroscopic surgery that involves creating a small pouch from the stomach and then attaching it directly to the small intestine.
This allows the food that you have eaten to bypass most of your stomach and the upper portion of your small intestine.
According to the Mayo clinic, gastric bypass is done when conventional methods such as exercise and diet prohibit a person from losing weight and their weight is creating serious health issues.
Knowing the physical requirement of gastric bypass surgery may save you a lot of time and money before you consider the procedure. Although this is elective surgery, not everyone will qualify for it.
How Do I Get Approved For Weight Loss Surgery?
Getting approved for weight loss surgery is simple as long as you meet all of the requirements set forth by the ABMS (American Board of Medical Specialties).
If you meet the following criteria, you may be a candidate for gastric bypass.
- You have a BMI, Body Mass Index, of at least 40 or higher.
A healthy BMI range is from 18.5 to 24.9. Once your BMI has
reached 30 or higher, you are considered obese.
- Your BMI is between 35 and 39.9 and you are subject to a serious weight-related health issue.
Some of the health-related issues may include sleep apnea, Type 2 diabetes, or high blood pressure.
- Your BMI is 30 to 34 and you have some serious weight-related health issues, you may qualify for other types of weight loss surgery.
After the surgery has been completed, you must be willing and ready to make permanent changes to your lifestyle and dietary habits.
Be prepared for a series of follow-up visits with your doctor to ensure you are on a successful road to recovery.
You should also expect to be involved in a long-term follow-up that involves monitoring your diet, nutrition, psychological welfare as well as any other medical conditions.
Not everyone will get approved for gastric bypass surgery. Your physician will guide you through a thorough screening process. This will ensure you are a good candidate for the surgery.
In addition to your physician’s physical and mental evaluation process, you must get approval from your insurance company, unless you are a self-pay patient.
Who Is Not A Candidate For Weight Loss Surgery?
Not everyone who may have the BMI requirements will not automatically qualify for weight loss surgery.
If your physician feels it is in your best interest for an alternative weight loss procedure or program for gastric bypass, then you may be denied.
Your psychological health also plays a big role in whether or not your physician qualifies you.
A mini-mental psychological examination, known as a Folstein test, will be completed to screen patients for the procedure.
Patients are screened for the following conditions: depression, anxiety, suicidal tendencies, psychosis, substance abuse, mania, as well a family history of mental health issues.
According to the Journal of Clinical Psychology, 18 of 500 candidates for gastric bypass failed the psychological evaluation and were denied the surgery.
Your insurance company may not agree to cover your gastric bypass. If this happens, talk with your physician about setting up a consultation with your medical insurance liaison to discuss why it is necessary for you.
Why Was My Bariatric Surgery Denied?
Being denied bariatric surgery can be very discouraging for patients. They may see this as their only alternative to losing weight for personal or health reasons.
If you are denied the surgery, there may be things you can do to improve your eligibility.
Here are 5 reasons patients are typically denied bariatric surgery:
A persons’ body mass index must be a minimum of 40 without mobilities. If there are certain underlying health issues, a person with a BMI of 35 may qualify for the procedure.
There are currently no age limits for adults to have the procedure. As long as their physician feels they are physically and mentally qualified for the procedure and the recovery.
However, children under the age of 13 or if the child’s body is still developing, do not qualify. It should be pointed out that your insurance will likely deny coverage for children under the age of 18.
- Poor Health
There are certain health issues a person may have that will disqualify them from the surgery. Some of those conditions may be an active stomach infection, active cancer, progressing liver or lung disease. Any other medical condition that may jeopardize the patient during or after surgery.
It is worth mentioning, if and when those health issues resolve, the person may be re-evaluated for approval.
If you’re a smoker, your physician will require you to stop smoking for up to 2 weeks prior to surgery. Nicotine restricts your blood vessels and that would be a risk during your surgery as well as your recovery.
- Poor Diet
You will be given a pre and post-surgery diet plan. Your ability to strictly follow that diet is critical to the success of the surgery as well as your recovery. Failure to follow the diet prior to your surgery will likely cause the procedure to be delayed or possibly denied.
Most of the reasons for bariatric denial can be overcome for future re-evaluation.
If you have been denied surgery by your physician or your insurance company, talk with your doctor for possible solutions that you are capable of overcoming.
Is There A Weight Limit For Bariatric Surgery?
In order to qualify for gastric bypass, all patients must pass a screening process. That process is designed to protect the patient from adverse reactions to the surgery.
As a result of the screening process, 5.4% of patients are rejected from elective bariatric surgery.
One of the reasons for rejection we have not discussed is that some patients are actually too overweight to qualify. It has nothing to do with their health as much as their mass. I know it seems strange to say you can’t have a weight loss surgery because you weigh too much but bear with me.
Patients who are over 450 pounds are typically rejected from the gastric bypass procedure. Hospital radiology equipment can only accommodate people under that weight and a certain size.
The inability to have proper internal images is too great a risk for the doctor and the hospital.
What Are Some Physiological Effects of Gastric Bypass Surgery?
Once a person has undergone gastric bypass surgery, the real work to make a permanent and healthy change begins.
The process of recovery is ongoing and requires a stringent and dedicated routine to ensure success.
During the recovery immediately following surgery, there are some physiological challenges the patient may experience.
Many of these conditions can be cured by following a strict post-op diet prescribed by the patients’ medical team.
Some physiological effects of post-op gastric bypass include but are not limited to the following:
- Dumping syndrome
This is a condition when food, especially high sugar foods, move from the stomach into the small intestine too quickly.
The effects of dumping syndrome are nausea, malnutrition, vomiting, and low blood sugar
- Acid reflux
- Anesthesia-related risks
- Inability to eat certain foods or types of foods
- Chronic nausea and vomiting
- Dilation of the esophagus
There may be other physiological effects of gastric bypass surgery on patients, but the ones mentioned above are the most common.
There are psychological effects that have just as serious an impact on the patients’ life and recovery potential as physiological ones.
What Are Some Psychological Effects Of Gastric Bypass Surgery?
It is worth mentioning the psychological requirements and effects of gastric bypass surgery. Our mental health has a direct impact on our physical health and vice versa.
Some of the psychological effects of the procedure according to the National Library of Medicine and National Institutes of Health include, but may not be limited to:
- Mood disorders
- Eating behavior disorders such as binge eating and bulimia
The psychological evaluation prior to surgery approval is a vital aspect of the pre-op screening process. It is vital for a healthy and successful recovery and continued success for the patient.
How Long Is Recovery For Gastric Bypass Surgery?
Recovery from gastric bypass surgery is a fairly simple recovery. Provided the patient follows the medical teams’ advice and recovery plan diligently.
The best route for a successful recovery after the procedure is rest, diet, and exercise.
Immediately following the surgery expect to spend 2 to 5 days in the hospital for observation from your medical team.
In the hospital, you will be monitored for the following:
1. Vital signs
2. Using a breathing tool to help expand your lungs after the surgery
3. Compression socks to avoid blood clots
4. Getting out of bed to exercise your legs and core by walking.
Once released from the hospital, expect to rest at home with minimal activity for another 3 to 5 weeks.
For your home recovery, you can expect to do the following:
- Drink 1.5 to 2 liters of water per day
- Transition from a liquid diet to a soft diet and then eventually a full diet over a six-week period.
- Take nutritional supplements daily to compensate for your limited diet. Supplements may include but are not limited to, B12, Vitamins C & D, Calcium, Magnesium, Iron, and a complex multi-vitamin.
- Avoid strenuous activity.
- Walking daily. Have a goal of walking 2 miles per day by the sixth week of recovery.
- Avoid any heavy lifting for the first six weeks of recovery.
- No driving or operating heavy or dangerous equipment until you are completely off any pain medications.
Recovery for some may be much easier and quicker than for others. The above is a general guideline of recovery meant for the average patient.
Always follow the advice of your physician and medical team. Your recovery is detrimental to the ongoing success of your surgery.
How Do You Sleep After Gastric Bypass Surgery?
Sleep and good rest are some of the most important aspects of your post-surgery recovery.
While you may feel some discomfort immediately after surgery, there are ways to get some sound sleep.
It is recommended that you sleep either on your non-surgical side or on your back. Do this for the first couple of weeks post-surgery.
Sleeping with a pillow between your legs while side sleeping is better for your spinal alignment. Sleeping with a pillow under your knees while sleeping on your back is good for circulation.
It is worth mentioning for comfort to avoid crossing your surgical side leg over the middle of your body. Keep your legs parallel to one another whether on your back or your side.
If you are a stomach sleeper, try avoiding sleeping on your stomach for at least two weeks post-surgery. The weight and pressure on your incision and stomach may delay and hinder your recovery.
Do You Get A Catheter During Bariatric Surgery?
This really depends on your surgical team and what they prefer. I didn’t have to deal with this but understand that more than 50% of the time people do.
One of the procedures for any bariatric surgery where the patient is under anesthesia is having a catheter. For some people, this is a mentally challenging procedure, but there is a very good reason for it.
After or sometimes during, surgery your bladder may not work properly. This is one of the reasons you are not released from the hospital after surgery until you have urinated.
The catheter will ensure that when you urinate, your urine will go into a bag. This will prevent you from soiling yourself and your bed involuntarily. The catheter should be removed within 2 to 3 days post-surgery but most patients go home within 24 hours of surgery.
Wrap Up To Physical Requirements For Patients of Gastric Bypass
Gastric bypass surgery is a life-changing procedure for the majority of the people who elect it. Without the procedure, the risk of ongoing and potentially life-threatening conditions will persist.
According to the Beth Israel Deaconess Medical Center, there is a 40% mortality rate for those who are denied bariatric surgery and need it for health reasons.
Although it is still considered and categorized as a Tier 1 elective surgery, it has immediate and lifelong health benefits for those who qualify and need the procedure to maintain an ongoing healthy life.
Whether or not you choose to go through with gastric bypass surgery is a decision best left up to you, your loved ones, and your medical team. Bariatric surgery should be approached with cautious optimism.
While it may have lifelong positive results for you, there are both physical as well as psychological side effects that may or not improve your overall happiness and health.
Do your research and consult with your doctors. For most people who have elected to go through with the surgery, it is a positive and beneficial procedure.