Dr. Ninh T. Nguyen, MD, is the President-elect of the American Society for Metabolic and Bariatric Surgery. He talked to me about the process of preparing his patients for surgery and important things that patients should know before weight loss surgery.
- Bariatric Surgery is Safe for Most People
Concerns about the safety of weight loss surgery are common among patients during the months before bariatric surgery. As Dr. Nguyen points out, standards set by both the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgeon (ASMBS) have helped reduced morbidity rates for surgery. He adds that 96% of procedures are now performed laproscopically, a procedure that is less invasive and is associated with fewer complications.
But, regardless of the type of surgery you choose, your surgeon should feel comfortable discussing the risks and complications of your surgery and also how many times he/she has performed that particular surgery. You want to make sure that your surgeon is not only board certified by the ACS or ASMBS, but is also very familiar with the type of surgery that you've chosen.
- Preparing for Surgery Takes Several Months
Dr. Nguyen takes about three months to prepare his patients for surgery. During this time, he talks to them about their expectations for life after weight loss surgery, about typical struggles they might encounter after the surgery, and about vitamin and mineral supplementation.
Your doctor might also talk to you about your plans for starting a family. According to updated guidelines released in 2013, the ASMBS along with the American Association of Clinical Endocrinologists (AACE) and The Obesity Society (TOS) now recommend that women should avoid pregnancy before surgery and for 12 to 18 months after surgery.
And lastly, during this preparation time patients also receive counseling from a registered dietitian, undergo clinical tests and attend informational sessions where they can talk to other patients about their experiences. This period also allows the patient plenty of time to get approval through their insurance company
- Don't Binge Before Surgery
You might think that you can eat anything you want before weight loss surgery. After all, everything will change after the procedure, right? Wrong. While you might think that a "last supper approach" is reasonable, Dr. Nguyen disagrees.
He puts his patients on a liquid diet during the two weeks prior to surgery. This is typical for patients who have a BMI of 50 or over. He says that this approach enhances weight loss, shrinks the liver (to provide the surgeon better access to the digestive organs), and reduces the risk of surgical complications.
- The Key to Success is Understanding Life After Surgery
One of the most important discussions you should have with your surgeon is about what will happen after your surgery. Dr. Nguyen says that most of his patients come in with reasonable expectations. Many have friends or family members that have undergone bariatric surgery. But, he still points out that the psychological adjustment is the most difficult part of recovery.
Your surgeon may also discuss how much weight you will lose, the diet and exercise requirements for your life after weight loss surgery and the possibility of weight regain and future surgeries.
- Plan for a Lifetime of Medical Care
It is important for patients to understand that they should plan to see their surgeon for a lifetime of care. Dr. Nguyen follows his patients for the rest of their lives to help them manage issues that arise including excess skin, and the possibility of future surgeries.
Nguyen, Ninh T., MD, President-elect, American Society for Metabolic and Bariatric Surgery. Interview. July 16, 2012