What Are Your Red Flags when Choosing a Weight Loss Surgeon?

[Alex Brecher 10,512]

I was talking to a friend who was trying to choose a bariatric surgeon. She was telling me about this surgeon who had great reviews and who seemed like a super nice and organized doctor who made her feel comfortable. I asked her about the nutritional support she’d get after surgery, and she said if she had a problem, she could call a nutritionist. I asked if the nutritionist was affiliated with the surgeon, and she said no, the surgeon told her she could go online and look for an outside nutritionist.

To me, that was a red flag. Nutrition is so critical to WLS success, yet this surgeon doesn’t even work closely with a nutritionist that he regularly sends patients to?

So, I was wondering, when you were (or as you are) looking for a bariatric surgeon, what did (or would) you see as a red flag, that might something to be concerned about and follow up on? What would be (or were) your deal-breakers when choosing a surgeon?

[byebyebmi 100]

I went to two consultations to compare/contrast. Both were recommended by people who actually had the sleeve done by them. The one had an online or in person seminar you needed to watch before scheduling a consult which included each procedure he performed, how it was done, potential complications and a chart of his personal complication rates, as well as how many of each surgeries he had performed.

I had already watched the webinar when I had my consult with the other doctor, so I asked him if he could produce a chart or report of his complication rates, which I felt was an important disclosure made by the other guy. He replied that he was so busy performing successful surgeries that he didn't have anything like that put together. I'm sure he's a well qualified surgeon, and I personally know people who have had great results with him, but that was a red flag for me. I think that we should be entitled to those facts and figures to help us make the right decision.

The doctor I chose ended up having a very overall organized operation. They had the webinar with a quiz at the end to make sure it was understood, mailed me my registration papers before the consult so I could take my time, and scheduled my dietitian and psych eval appointments for me (those people are directly affiliated with them).

I'm glad I went to multiple appointments and listened to my gut when I felt like a red flag was raised. Now I can go through the process with confidence and excitement!

[gowalking 10,790]

A fat surgeon...

Sorry...just couldn't resist..lol.

[CowgirlJane 14,259]

I would not have known this except for choosing surgeons that had this perspective... I would never go to a surgeon for bariatric surgery unless they have an in depth understanding of the metabolic disease of obesity AND they are capable of articulating it to patients (and their support staff is on the same page)

This probably sounds a little crazy, but the support from the actual surgeons about how I got into the mess I was in removed so much guilt and unnecessary angst from my emotional state. I had never in my life had a medical professional explain to me how it was that no matter what I tried, I just gained more weight than I started with from dieting. It also put a context for me of how seriously I needed to take the nutritional and behavioral changes when I decided to get the sleeve.

So, i would never go to a surgeon that didn't have an affiliation with a top notch, educated on metabolic disease/obesity. I will take it a step further, i wouldn't go unless they had a carefully orchestrated plan for the preop, post op, weight loss and maintenance phases. I don't care if the plan is from the surgeon or the NUT, but it needs to be based on the latest research, kept modern and up to date, and delivered in a clear, compassionate way to the patient who is going through very emotional times (Weight loss surgery!)

I would also hope the surgeon had a larger support structure around his/her practice - access to support groups, access to people in the office to answer all the little questions that come up (surgeon's assistants and nurses etc).

I think so highly of the practice I picked, that I go to them now for any medical thing that they happen to do in that practice. Example, they do colonoscopies and I feel confident going to them. They also have a small "cosmetic" practice and I have gone to them for laser hair removal. Everything i have done with them is top notch.

[Inner Surfer Girl 12,015]

I agree with the above:

a comprehensive bariatric practice and understanding of bariatric patients with a multifaceted program with required education components is crucial.

Another red flag would be a surgeon who will schedule a surgery right away (within days or weeks) without requiring time for the patient to consider, adjust, and prepare. I know it's rare in the U.S. for this to happen but I have seen it happen with folks on this site.

[NikkiDoc 312]

I went to one informational session and asked the surgeon how many VSG he personally performed. I got a 5 minute song and dance about how long the sleeve had been being performed and it was a very safe surgery. He never answered me. so how experienced was HE at the surgery and follow-up care? Who knows.

It may have been a language barrier thing as I think Chinese was his primary language. I didn't want a language barrier either.

This was a progam that was being started a few months after the informational session at my local hospital. He and another surgeon doing baratric surgeries at a hospital about an hour away. But the support staff at the local hospital would be new. Neither surgeon were exclusively bariatric.

[VSGAnn2014 12,992]

I took great comfort that the bariatric surgeon I chose:

* Answered every specific question I asked with specific answers -- re complication rates, his surgery experience and record, his predictions / prognosis about my own long-term success, etc.

* His entire team's performance -- nurses, nutritionist, PAs, psychologists available for counseling, etc.

* His age (he was neither too young nor too old)

* My gut-level response to him (I trusted he was candid and honest in all his responses)

* What his staff, prior patients, and online reviews said about him

* The fact that his operation / hospital was an ASMBS "Center of Excellence."

* Our conversations took us to a "sweet spot" of what I wanted / thought vs. what he recommended. He listened / I listened.

I'm happy to report that he turned out to be a great choice for me. Easy surgery, easy recovery, great results (all weight lost and maintenance going well now).

[Mountaingal 322]

Thanks for bringing up the important discussion Alex.

[JustWatchMe 7,117]

Although my surgeon asked me why I wouldn't consider the sleeve over the band, he did not push me into the sleeve. He performs many lapbands. I would shy away from a surgeon that wasn't 100 percent in agreement with your choice of surgery.

[byebyebmi 100]

@@JustWatchMe I agree. My surgeon asked me first what I was considering based on the research I had done and the webinar I saw and then confirmed that he agreed and would have suggested the same thing. I would not have been okay with someone who argued with me or tried to pressure me into something I was uncomfortable with.

[CowgirlJane 14,259]

THAT I agree with too!

I was a failed lapband patient and the first surgeon I went to regarding a revision essentially "poo poo'd" the sleeve for me since he claimed it was only restrictive like the band and would only discuss the gastric bypass with me. I went along at first... but I didn't like his NUT and a few other things made me seek a different surgeon. The practice I went to ultimately presented both options - sleeve and bypass as "good options" for me, but clearly their practice is heavily focused on sleeve so I felt confident about that. Seems like it is really ideal if the surgeon "believes" in your choice of procedures!

Although my surgeon asked me why I wouldn't consider the sleeve over the band, he did not push me into the sleeve. He performs many lapbands. I would shy away from a surgeon that wasn't 100 percent in agreement with your choice of surgery.

[Sajijoma 1,324]

There were several things I looked for. First was a TEAM to help and not just a surgeon. I need a whole team of people from NUT to psych to surgeon. I also need them to be friendly. Even in bariatrics you find some surgeons and doctors who are very condescending and look down upon overweight people, like they think they are your super man saving you from your bad choices and you should be grateful to them for your existence. UH UH that doesn't work! I also need a surgeon who is honest and open about the not good sides. Like for instance, and this is probably why a lot of people don't like me, at my seminar, I asked the surgeon what was his death rate. I think I phrased it something like "how many patients under your care have you lost as a result of complication after surgery" and he was open and honest and told us about the numbers. That kind of openess is very much needed if you want the pleasure of rooting around inside my body one day making new express lanes and tole bridges. LOL They obviously also have to be able to handle my odd personality that only gets weirder the more they know me.

[Alex Brecher 10,512]

Thanks for all of these great replies! I hope these will help future bariatric surgery patients find a surgeon that is right for them. You have all come up with some good ideas for what to look for and what to run from.

[Beachsprite 118]

I'm the opposite to some of you I don't like specialists that are "yes" people I wanted mine to question my ideas and preconceptions and not just another payday for them. I am paying them thousends out of my own pocket for their expertise so it would raise a red flag for me if I wasn't questioned significantly about my options, motivation and understanding. Obviously all done with a good bedside polite manner