To us, patient safety is paramount. The first step in the bariatric surgery process is to attend a free online weight loss surgery information session. During the session, a member of the Penn Bariatric and Weight Loss Surgery team will explain the process at Penn Medicine in detail, including medical weight management, surgical preparation, available procedures, and long-term follow up care.
After attending an information session, you'll schedule a meeting with a surgeon and the rest of the bariatrics team. During this appointment, you will be evaluated to determine whether you meet the specific criteria required for bariatric surgery.
If you are a candidate for weight loss surgery, you'll undergo a series of medical screenings and attend a pre–operative nutrition class where you'll receive extensive diet education.
At this time, a letter will be sent to your insurance company to obtain approval for the operation. The approval process can take from a few weeks to a few months, depending on your insurance company.
The Bariatric Surgery Process
The Information Session
The information session is an important part of the process before surgery. A bariatric clinician (surgeon, nurse or dietitian) gives a presentation explaining all of the surgeries performed, who is a candidate for surgery and the surgery process in detail. This free, online session gives you the opportunity to learn more about our program and bariatric surgery without having to commit to an appointment.
Sign up for a free online information session.
The First Visit
At the first visit, you will meet with multiple clinicians, including a dietitian, nurse/nurse practitioner and a surgeon. During this visit, the nurse/nurse practitioner will complete a full physical and record your medical and surgical history. He/she will also review all of the tests required before surgery. Some of the tests include:
- Abdominal ultrasound
- Blood studies
- Cardiac clearance
- Chest x-ray
- Echocardiogram (ECG)
- Electrocardiogram (EKG)
- Liver function tests
- Medical clearance
- Pulmonary function tests
- Sleep study
- Upper gastrointestinal evaluation
During your visit with the dietitian, he/she will complete a full nutrition assessment including your dieting history, any dietary restrictions, and food availability. The visit will also include briefly reviewing the Medical Weight Management process and after surgery diet.
At your first visit, your will meet with the surgeon to discuss the actual surgery and which might be the best choice for you. You may sign consents as well.
Medical Weight Management
Most insurance companies require three to six months of supervised weight loss, called Medical Weight Management. At each of these monthly visits, you will meet with a nurse practitioner and a dietitian to work towards completing all the testing required before surgery and preparing for all the dietary and behavior changes that come with surgery.
Surgical treatment for morbid obesity changes a person's relationship with food. Therefore, it is essential that all patients undergo a psychological evaluation before surgery. This evaluation is conducted by the mental health professionals at the University of Pennsylvania Center for Weight and Eating Disorders to determine whether surgery is an appropriate treatment for you.
You are assessed for your:
- Psychiatric history
- Current psychological function
- Weight and dieting history
- Current eating behaviors
- Level of physical activity
During the evaluation, you are also educated on the behavioral changes necessary to ensure good post-operative results, as well as any psychological changes that can be anticipated after surgery.
All patients are required to attend at least one support group before surgery. See the support group calendar.
Last Steps before Surgery
All of the testing you completed is sent to your insurance company for pre-authorization. You will work with your coordinator to then determine a surgery date and schedule nutrition/nursing class and final steps.
Additionally, a dietitian reviews the diet for after surgery one last time. A nurse also reviews what you can expect while you are in the hospital.
All bariatric surgeries require general anesthesia. Most surgeries are performed laparoscopically, and some may also use robotic assistance. The hospital stay is usually one to three nights. Most patients start walking the day of surgery and begin sipping fluids while still in the hospital.
Patients should avoid lifting more than 10 pounds for four to six weeks after surgery and avoid abdominal exercises for six to eight weeks after surgery. Typical surgical follow up visits are at 10 to 14 days, six weeks and three months after surgery.
Lifelong follow up is required. Usual follow up visits are at six months, one year, and annually after surgery. At these visits, you will meet with a nurse practitioner or a surgeon and a dietitian. The goal of these visits is to help you stay on track with your weight loss and prevent weight regain, nutrition deficiencies or late complications from surgery.