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Hi Friends, New here…I am wondering if anyone has had experience with having any laparoscopic surgeries after getting a tummy tuck. I had an abdominoplasty in 2013 after having a child and losing weight and having a lot of extra skin. Now almost 10 years later I am looking into having a gastric sleeve done. Looking for anyone with experience. Was it harder for the surgeon due to scar tissue or things moved around? Thanks in advance.

I have Kaiser and they refer some of their patients out for bariatric surgery and follow up. They do have a few surgeons but I guess they have a lot of patients so some of us went out of network.

Thank you everyone. I've decided to take the Fusion Bariatric multivitamin chew, they taste way better and are easy to get down. I've also found the Fairlife 30 grams protein shakes that taste way better than Premier. I've been able to drink those down as well. I'm happy now and feel as if I am doing a good job.

My guess is OP's plan has no in-network bariatric surgeons. So she went out-of-network for the surgery and immediate follow-up, but all visits after 6 months must be either approved for continued out-of-network care or with in-network doctors. I think the most important question for you to ask is who your surgeon recommends for your follow-up from this point forward. I am sure they've had other patients in your insurance situation. Who do they recommend you see now? Or is there paperwork they can file to get pre-auth for further follow-up? Congrats on 77 lbs so far! You are going to get so much kudos when they see you for this visit.

I, too, was a low-BMI patient. But, my BMI was just high enough that with my comorbidities, my insurance would cover the surgery. Like me, you are one step away from metabolic syndrome: diabetes, high cholesterol and high blood pressure. I have diabetes and high cholesterol. Only 5% of people who lose weight using "just diet and exercise" will have kept that weight off over a 5 year period. With bariatric surgery, the number jumps to 90%. I would set up the consultation with the surgeon and make your wife come with you to the appointment. The surgeon will explain to her the science of obesity and how it's not as simple as she thinks.

The surgery is a tool, just like using a washing machine or a calculator. It makes it easier, yes but you still have to put in the work. And the tool fades when your hunger comes back so keeping the weight off is just as hard as any maintenance plan I have ever been on with one exception IF you took the time to make real changes to your diet and habits you know what to do to keep it off this time. Having said that, this is a major surgery with real changes to you body. Many of us have chronic constipation to deal with, most of us have to take vitamins forever and I believe all of us are told to avoid NSAIDS forever (which kinda sucks when you get a headache or throw your back out and drs won’t give you pain meds for these things). These are not major things, no but evidence that this does change your body forever. The nutritionist and the bariatric therapists are two huge components to the surgery that make it successful. If you have not tried those two things you may want to consider trying those first before committing to major surgery. I had a low-ish BMI and I had the sleeve (35). I wish I had tried those things first so that I would know I absolutely had to take this extreme option. I may very well be exactly where I am but at least I would know I truly did try everything first. But ask your doctor because you have real medical issues that I did not have and maybe losing it fast is imperative. The surgery will definitely help you to lose it faster that diet alone. Best of luck in whatever you choose. And just keep talking to your wife. My husband is also someone who has always been fit and doesn’t totally get it either. He is at least supportive but he is first to admit he doesn’t understand. I once told him when he was thirsty to try not to drink anything for hours and he will have some clue what it’s like to try to ignore hunger. Not the best analogy I know but it was the best I could think of. I also recommend taking her with you to your doctor visits if/when you do decide to have surgery or while you are trying to decide. They can help explain things to her.

Hello. I am 44y old male and I am seriously considering SG. I am 5’7 and around 195 lb. I know this is not too obese -I am in fact BMI 31- and normally bariatric surgery should not be an option. Yet, after extensive literature reading I believe it is a good option. I have high blood pressure , high cholesterol and early non alcoholic fatty liver disease. Moreover , I have been always struggling with weight issues since I was a teenager, alternating times of physical activity and good diet habits -and a relative healthy weight as a result - with bad periods of overeating and sedentary behavior. All in all, the aggregated tendency is adding up weight on the long run. My wife is highly critical of this decision, blaming me for taking the “easy way” instead of modifying my eating / physical habits. I’ve tried to explain her several times the apparent inconsistency of deeply wanting to get rid of my weight problem with the fact that it is nevertheless not easy at all. She’s naturally skinny and cannot grasp how fat/obese people relate with food. I’d love to hear from those on a similar situation. I believe it is the right step to do, but I want to hear open, sincere opinion -so not just for reaffirming my choice but rather to have well grounded , unbiased, facts for a well informed decision.

Supposed to go for a scope. Rather figure this out with some help. Went to Mexico years ago. Come back to the states to find out that the spleen was lacerated. The Bariatric dr here acted like a spoiled child that I went to Mexico. Very uncomfortable seeing a dr. Thanks guys for mentioning restriction not normal. I didn’t think it was either but then again. It’s all still very new 2 years later. Peanut butter and a spoon!

Sure, nothing wrong with pasta, especially if it's whole grain. The restriction returning is not normal and somewhat concerning? What does your bariatric surgeon say about that?

Because intonation is hard to tell, I'm going to say what I'm going to say and it's out of concern for your wellbeing. If you suspect at all that you are dealing with potential cardiac issues, you need to seek emergency help right away. I don't know if you're asking on a reversal of a gastric bypass thread, if a reversal could help you with that, if it is unfortunately no one except a bariatric surgeon could help with that. And that should be one you see in person. I didn't give you the exact answers you wanted because unfortunately in the questions you brought up brought up different kind of questions that I think might take precedence. If you feel secure in your health status and just want vitamin input from a 10 year plus grad, you might be better served starting a new thread on this forum site to best suit your needs.

rThanks everyone, I know that I will be doing cardiology, pulmonology, nutrition, and psych at the bariatric center prior to surgery consult. I also have been doing medically supervised diet not through the bariatric center but through another dietician group for at least 6 months now with minimal results. I wonder if that time will help me shave some time off the wait time, either way I am just happy to be getting started.

Most insurance plans require your participation in a "physician supervised weight loss program". These tend to range from 3 to 6 months. For example, my insurance only required 3 months, but like @kcuster83, my bariatric team required 6 months. The main reason for this is that surgery alone isn't all that effective long term. To truly lose weight and maintain, we have to learn to change our relationship with food. In addition to that requirement, you'll likely also have to complete a psych eval and may, depending on your program, have to have any number of other tests done like blood & urine tests, CT scans, swallow studies, an endoscopy, etc. Depending on if you have other health issues, you may also have to get other specialist doctors to give their okay, which means even more appointments. It took me almost 3 years to make it through everything, though obviously I'm the exception. You can read all about my journey here: https://www.bariatricpal.com/topic/441618-spartanmakers-long-and-winding-road/ Best of luck.

Every insurance company and surgeons requirements differ so much. My insurance requires a 4 month process (Cigna), but my Bariatric office requires a minimum of 6 month process.

Hello! I have attended my seminar and scheduled my initial consultation at Bailey Bariatric in Owasso, OK and the insurance verification called to say that the insurance will pay but mentioned something about 4 months, but said something about that being the average time it takes to get through the pre-op appointments. Does anyone know if this is a required 4 month waiting period through HealthChoice or if this was just an estimate. I also have a secondary insurance that will cover the expenses but I won't have it for much longer so I was kind of hoping to get the surgery done before the end of the year, but I am guessing that won't happen. any insight would help, thanks!

I think you will be okay if you have lost weight you are probably shrinking your liver. It just depends on how big it was to begin with I imagine. The smaller it is the safer your surgery will be though so definitely don’t do it again. The more important thing I would be asking myself is if you can do the post op diet without cheating. No judgement here if you can’t but you really need to be certain you are prepared for it because one little cheat post op and you can seriously hurt yourself. If you aren’t ready there is no shame in that. Only you know if you are really ready for the post ip changes. If not, Perhaps a bariatric therapist can help you explore why you are “cheating”.

I have to do IV iron infusions because I can't take iron pills. I found that it did help with my energy and at the time my hair was actually falling out a bit, so the infusions help (this was before bariatric surgery). I can't imagine you should be taking a multivitamin with iron if you are getting iron infusions, but that's something to ask your doctor.

Sounds yummy. If you can make it with spray pam instead of oil or butter it would be even better for you. Maybe a little cinnamon and sweetener. i like to make s’mores in banana boats. I use sugar free choc chips and almonds or pecans instead of graham crackers so the only bad thing really is the marshmallows. It’s still higher calories and not necessarily for weight loss phase but for maintenance for me it’s a healthy-ish alternative to s’mores Have you considered a bariatric therapist to try to get to the root of the head hunger. A lot of people swear that this has helped them tremendously.

My ex's uncle had this. Usually it's stumbled upon accidentally during an emergent surgery situation. Which is what happened with his uncle. He had emergency appendectomy probably about 50 years ago and the surgeons were just dumbfounded when they opened his abdomen. So of course this has nothing to do with weight loss surgery, but my advice would be if you live close to a university that teaches medicine, and has a bariatric center, reach out to them. They would LOVE to get their scalpels on you, lol. Sorry, bad joke. But yeah, they love hard cases, and atypical cases. They publish papers on these cases. You're in North Carolina. How close are you to Wake Forest, they have a bariatric center https://www.wakehealth.edu/treatment/b/bariatric-surgery I wish you the best! Keep us updated!

A chose bypass due to GERD, but I also had some reservations around dumping and medications. Medication-wise, the reality is over time, a lot of the medications you take may end up going away. Especially if they are for conditions like high blood pressure or diabetes that are often reversed with weight loss. Personally, I was really worried about NSAIDS, because I have a number of physical issues that have had me on prescription NSAIDS for over 35 years now. My surgeon agreed that even with bypass, I could keep taking them as long as I continued to take a PPI to limit the risk of ulcers. I'm also hopeful that as I get closer to goal, I may be able to give them up entirely. For the rest of my meds (if you include supplements, I take over 30 different pills a day), no mention has ever been made about me needing to adjust the dosage in any way. Honestly, I think the whole "malabsorption" thing for bypass may be a bit overblown? As far as I'm aware, the only ones where you might run into a problem are extended release versions of medications. For most of those, there are non extended release alternatives. If you have specific medication concerns, my suggestion would be to talk with your bariatric team. They can best advise you if bypass would be an issue for you with that medication. As far as dumping is concerned, dumping is far from guaranteed with bypass. I have not experienced it and many others here have not either. Plus, we've had first hand reports that even some sleevers have end up with dumping syndrome. Certainly it's much more likely with bypass, but I'm not sure I'd worry about this too much. If you do end up with that issue, it can certainly help you stay on plan and may help you do better in the long run by controlling your intake of things you probably shouldn't be eating anyway.

I went down to 200lbs the day of surgery, I'm 3 weeks out & have lost 15lbs. I read a passage in my bariatric handbook that basically said, 'Your metabolic rate is higher when you weigh more, meaning you lose more doing less. Weighing less will slow that down. Essentially, the surgery will help you when losing weight is at its hardest.' Aka, this will help us lose those stubborn last pounds! Its very encouraging for me

Medical Groups Replace Outdated Consensus Statement that Overly Restricts Access to Modern-Day Weight-Loss Surgery NEWBERRY, FL – Oct. 21, 2022 – Two of the world’s leading authorities on bariatric and metabolic surgery have issued new evidence-based clinical guidelines that among a slew of recommendations expand patient eligibility for weight-loss surgery and endorse metabolic surgery for patients with type 2 diabetes beginning at a body mass index (BMI) of 30, a measure of body fat based on a person’s height and weight and one of several important screening criteria for surgery. The ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery – 2022, published online today in the journals, Surgery for Obesity and Related Diseases (SOARD) and Obesity Surgery, are meant to replace a consensus statement developed by National Institutes of Health (NIH) more than 30 years ago that set standards most insurers and doctors still rely upon to make decisions about who should get weight-loss surgery, what kind they should get, and when they should get it. The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest group of bariatric surgeons and integrated health professionals in the United States and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) represents 72 national associations and societies throughout the world. "The 1991 NIH Consensus Statement on Bariatric Surgery served a valuable purpose for a time, but after more than three decades and hundreds of high-quality studies, including randomized clinical trials, it no longer reflects best practices and lacks relevance to today’s modern-day procedures and population of patients," said Teresa LaMasters, MD, President, ASMBS. “It’s time for a change in thinking and in practice for the sake of patients. It is long overdue.” In the 1991 consensus statement, bariatric surgery was confined to patients with a BMI of at least 40 or a BMI of 35 or more and at least one obesity-related condition such as hypertension or heart disease. There were no references to metabolic surgery for diabetes or references to the emerging laparoscopic techniques and procedures that would become mainstay and make weight-loss surgery as safe or safer than common operations including gallbladder surgery, appendectomy, and knee replacement. The statement also recommended against surgery in children and adolescents even with BMIs over 40 because it had not been sufficiently studied. New Patient Selection Standards — Times Have Changed The ASMBS/IFSO Guidelines now recommend metabolic and bariatric surgery for individuals with a BMI of 35 or more “regardless of presence, absence, or severity of obesity-related conditions” and that it be considered for people with a BMI 30-34.9 and metabolic disease and in “appropriately selected children and adolescents.” But even without metabolic disease, the guidelines say weight-loss surgery should be considered starting at BMI 30 for people who do not achieve substantial or durable weight loss or obesity disease-related improvement using nonsurgical methods. It was also recommended that obesity definitions using standard BMI thresholds be adjusted by population and that Asian individuals consider weight-loss surgery beginning at BMI 27.5. Higher Levels of Safety and Effectiveness for Modern-Day Weight-Loss Surgery The new guidelines further state “metabolic and bariatric surgery is currently the most effective evidence-based treatment for obesity across all BMI classes” and that “studies with long-term follow up, published in the decades following the 1991 NIH Consensus Statement, have consistently demonstrated that metabolic and bariatric surgery produces superior weight loss outcomes compared with non-operative treatments.” It is also noted that multiple studies have shown significant improvement of metabolic disease and a decrease in overall mortality after surgery and that “older surgical operations have been replaced with safer and more effective operations.” Two laparoscopic procedures, sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB), now account for about 90% of all operations performed worldwide. Roughly 1 to 2% of the world’s eligible patient population get weight-loss surgery in any given year. Experts say the overly restrictive consensus statement from 1991 has contributed to the limited use of such a proven safe and effective treatment. Globally, more than 650 million adults had obesity in 2016, which is about 13% of the world’s adult population. CDC reports over 42% of Americans have obesity, the highest rate ever in the U.S. “The ASMBS/IFSO Guidelines provide an important reset when it comes to the treatment of obesity,” said Scott Shikora, MD, President, IFSO. “Insurers, policy makers, healthcare providers, and patients should pay close attention and work to remove the barriers and outdated thinking that prevent access to one of the safest, effective and most studied operations in medicine.” The ASMBS/IFSO Guidelines are just the latest in a series of new recommendations from medical groups calling for expanded use of metabolic surgery. In 2016, 45 professional societies, including the American Diabetes Association (ADA), issued a joint statement that metabolic surgery should be considered for patients with type 2 diabetes and a BMI 30.0–34.9 if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. This recommendation is also included in the ADA’s “Standards of Medical Care in Diabetes – 2022.” About IFSO The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) is a Federation composed of national associations of bariatric surgeons and Integrated Health professionals. Currently, there are 72 official member societies of IFSO, as well as individual members from countries that thus far have not formed a national association. IFSO is a scientific organization that brings together surgeons and integrated health professionals, such as nurse, practitioners, dieticians, nutritionists, psychologists, internists and anesthesiologists, involved in the treatment of patients with obesity. About ASMBS The ASMBS is the largest organization for bariatric surgeons in the United States. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org.

I listened to this female-centric podcast during my walk today, which somewhat addresses this temporary cognitive dissonance following bariatric procedures: https://drmariza.com/435-most-effective-way-to-transform-your-self-image/. It's on Apple Podcasts. The guest speaker has lost a lot of weight, in addition to making other significant changes in her life. She suggests you change your environment (e.g., the contents of your bookcase), your personal style, etc., to allow the external match the internal. Kinda interesting, but OP is male so his mileage may vary.

Wow, that's got to be so disappointing, but you seem to have the right mindset about it! Kudos also to that doctor. For him to decide not to move forward meant he cared more about your health and safety than his ego. While not really the same, my unusual anatomy did cause my surgeon some extra work. Simply put, my intestines are routed differently than most people, so she had to put in a lot of extra work to locate some on the anatomical markers they use to properly measure the roux limb for the bypass. Apparently it made my surgery take about an hour and a half more than usual. Thankfully she is one of the most experienced bariatric surgeons around.

I had VSG at HospitalBC and they also do plastic surgery, specializing in post-weight loss stuff. I'm not familiar with that side of their work, I just know that many patients return for plastics. I did have a wonderful experience there for my bariatric surgery though,

HI all, My sister is planning on having the gastric sleeve procedure done in Mexico in a few months. I am going to go with her and I am considering liposuction. Basically, surgery buddies, but different procedures. I know a lot of bariatric patients end up needing some surgery for loose skin, etc. But I'm not sure which practices provide both. Does anybody have any experience with a bariatric place in Mexico that also provides plastic surgery? Thanks, Kelly