- You must have a Body Mass Index (BMI) of 40, or
- BMI of 35-39 with at least one obesity-related medical condition (co-morbidity). Use the calculator in the left column to check your body mass index.
These constitute the minimum criteria for insurance approval prior to weight loss surgery. Roller Weight Loss & Advanced Surgery will consider many other factors before determining whether or not surgery is right for you.
Things to Consider
Can you make the lifestyle changes required to achieve positive results from the surgery? Weight loss surgery will help you control how much you can eat before you feel full. Surgery should be considered a tool that will allow you to lose weight and successfully keep it off if the tool is used correctly. It is not cosmetic surgery. It is life-saving surgery that can allow you to live a longer, healthier, happier life. In order to achieve optimal results after surgery, you must also make the necessary nutritional, psychological, and behavioral changes. Staying active and carefully monitoring the amount and types of food you eat are essential. You will be making these changes for the rest of your life, and you must be willing to commit yourself to living in a new way. Certain changes, such as quitting smoking and becoming more active, will begin before surgery. Can you comply with the follow-up required after surgery? Before and after surgery, you will have instructions from Dr. Roller and his staff that are very important to follow. Making the right dietary choices and establishing an exercise regimen is essential to achieving optimal weight loss results. Continued follow-up with our program, including lab tests and office appointments with our physicians and dietitians, is necessary to minimize and/or prevent potential complications as well as achieve and optimize weight loss results. We strongly recommend attending support group sessions both before and after your procedure. Again, this is a life-long commitment, and you will never have a break from following the guidelines provided to you by our office. In the year following surgery, you must attend follow-up office visits two weeks, six weeks, three months, six months, nine months and 12 months after your date of surgery. You will complete annual follow-up visits for life. Lap Band patients will need more frequent follow-up for adjustments. We want to follow our patients for life, and know this will help our patients be successful in the long-term. Depending on the procedure you have, your stomach will be greatly reduced in size and will only hold two to four ounces of food at a time. Your post-operative diet will begin with a strict liquid diet for two weeks to allow your stomach to heal after surgery. We also require our patients to avoid carbonated beverages, caffeine and alcohol after surgery, as they can cause discomfort and promote dehydration. Straying from this diet could impede healing and lead to medical consequences that could require more surgery or hospitalization. How will you pay the out-of-pocket costs? Insurance companies offer widely varied coverage for weight loss surgery, and some do not cover it at all. Every patient must undergo several pre-operative consultations and evaluations. Any of these appointments not covered by insurance must be paid for out-of-pocket by the patient. For example, some insurance plans will not pay for the psychological testing required by the insurance company. Other out-of-pocket costs could include the required nutritional supplements after surgery. Even if your insurance company covers weight loss surgery, you will likely have co-pays and deductible costs for pre-op clinic visits, hospital stays and follow-up visits. It’s best to know these costs beforehand. If your insurance policy includes a specific exclusion for the surgical treatment of obesity, you will not be covered for surgery, regardless of your current health issues. If this is your case, we have a range of self-pay and financing options available. We will work with you to help this process go as smoothly as possible. You do need to be aware that the cost quoted to you for surgery is only an estimate and does not cover extended hospital stays, complications or re-admissions. We have several financing options available and will be happy to discuss these with you. Are you looking into surgery for the right reasons? Weight loss surgery is NOT cosmetic surgery. Its purpose is to improve failing health for individuals with clinically severe obesity. If you meet the medical criteria, you are doing it for health reasons. Feeling better is the goal, while looking better is a side effect. Giving you your life back is our goal. Do you have the emotional support you need? A strong support network of family and friends who will be there to help you through the decision-making process and post-surgery recovery period is crucial to helping make surgery successful. Strong support will help you make the needed adjustments that accompany surgery and stay mentally strong through the changes that will occur after surgery. Opting to investigate this surgery is a major decision, and we applaud you for having the courage to do so. As you learn more about weight loss surgery, it’s best if your close friends and family members also learn as much as possible about it. We encourage you to bring a support person with you to our seminar, “Surgical Weight Loss, Is it right for me?” and encourage you to bring your support person with you to all of your appointments. Going through the process with you will help this person understand what you are going through and allow them to offer better support. We offer monthly weight loss surgery support groups, and we encourage you and someone close to you to attend these both before and after your surgery. Surgery is a stressful experience. This is a major life change. Should you currently have any other significant stressors, such as a pending divorce or the death of a loved one, you may want to wait until you feel you are on more solid ground. It is also important to have realistic expectations before and after surgery, and realize that surgery and the resulting weight loss will help you to live a longer, healthier, happier life, but will not solve all of your problems. Click here for a seminar schedule.