If you're considering bariatric surgery at Penn, you must meet specific criteria before you can be considered for a screening evaluation. This criteria is based on universal standards established by the National Institutes of Health and includes:
- Body weight greater than 100 pounds or 45 kg above ideal weight.
- Body Mass Index (BMI) greater than 40 or BMI greater than 35 with medical complications related to obesity, including high blood pressure, type 2 diabetes, sleep apnea and gallbladder disease.
- A documented history of weight management and weight loss attempts with supervised diets and exercise programs.
- No indication of active alcoholism, active drug addiction or a major psychiatric disorder.
- Our surgeons will evaluate other criteria, such as your age and general health, to determine if bariatric surgery is appropriate for you.
Bariatric Surgery Screening Process
Once it has been determined that there are no medical issues that would preclude you from surgery, a nutritional evaluation is conducted. In some cases, you'll also be evaluated by physical therapy and social service professionals to ensure that you have all the necessary support structures in place at the conclusion of surgery and upon discharge.
After the screenings, our Bariatric and Weight Loss Surgery team will meet to decide whether you are an appropriate candidate for surgery. This decision is based upon your physical and emotional state, as well as eating habits, food preferences, activity levels and other health problems.
In some cases, the type of surgery you desire will not offer optimal outcomes, and a different type of bariatric surgery or an alternative treatment may be recommended.
You also may be required to meet certain criteria — such as losing weight, attending counseling or undergoing physical therapy — before your surgery is scheduled. This helps to ensure that you will have the best possible chance of recovering from the surgery and succeeding at weight loss.
Once you successfully complete the screening process and obtain insurance approval, your surgery will be scheduled and pre-operative preparation will begin.
Pre-operative Psychology Screening for Bariatric Surgery
Surgical treatment for obesity changes a person's relationship with food. Therefore, it is essential as part of the pre-operative assessment process that you undergo a psychological evaluation. 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'll be assessed for your:
- Psychiatric history
- Current psychological function
- Weight and dieting history
- Current eating behaviors
- Level of physical activity
During the evaluation, you'll also be educated on the behavioral changes necessary to ensure good post-operative results, as well as any psychological changes that can be anticipated after surgery.
Pre-operative Medical and Surgical Screening for Bariatric Surgery
The pre-operative medical and surgical screening determines whether you are healthy enough for bariatric surgery. The screening involves a series of tests to rule out a medical issue as the cause of obesity.
Tests are also performed to determine if you have any obesity-related diseases (such as diabetes, heart disease, hypertension, pulmonary disease, sleep apnea, vascular disease or depression) and how these disorders affect you health. It's important to note that patients with advanced heart or lung disease may not be appropriate surgical candidates.
Some of the pre-operative tests that may be required include:
- Abdominal ultrasound
- Blood studies including a complete blood count (CBC), blood urea nitrogen (BUN), cortisol, creatinine, electrolytes, prolactin and thyroid-stimulating hormone (TSH)
- Cardiac clearance
- Chest x-ray
- Echocardiogram (ECG)
- Electrocardiogram (EKG)
- Liver function tests
- Medical clearance
- Pulmonary function tests
- Sleep study
- Upper gastrointestinal (GI) evaluation
Pre-operative Nutrition Screening and Diet Counseling for Bariatric Surgery
Our pre-operative nutrition screening is focused on changing your eating behaviors and food selection practices. This helps you more easily adjust to your post-operative diet and achieve the best results possible from bariatric surgery.
During nutrition screening, a dietitian from our team will evaluate your weight loss history and current eating behaviors using a weight and diet history questionnaire. You'll also keep a food diary to record your daily intake and learn the principles of dietary progression, protein and fluid requirements, and lifelong vitamin and mineral supplementation.
Obesity and Weight Loss Facts
Learn more about obesity and weight loss in America, including bariatric surgery options from Penn Medicine