What if I gain Weight Before Bariatric Surgery?

Should I lose weight before surgery? How many pounds should I lose? What if I cannot control my stress and end up having curb cravings? And finally, what if I gain weight before bariatric surgery?

If you’re reading this article, you must have thought about one of these questions at least once. Don’t think you’re crazy or are overthinking surgery. Out of 10 bariatric surgery patients, at least 7 of them share these mutual concerns.

There are different theories about the necessity of losing weight for weight loss surgery patients before the actual procedure. Therefore, sometimes you might be asked by your bariatric surgeon to lose some pounds with the help of your dietitian.

On the other hand, in some cases, some insurance companies, require patients at least to try to lose weight.

I will first explain the two sides of losing weight before weight loss surgery, why insurance companies ask patients to do so, in what cases losing weight does not cancel your surgery, and last but not least, what happens if you gain weight.

Is Losing Weight Before Surgery Advantageous?

Some surgeons believe weight loss before bariatric surgery is beneficial. This is why it’s been more than 30 years that bariatric surgeons ask their patients to lose a specific amount of their excess weight in order for them to be eligible for the surgery. Even though nowadays, all doctors do not ask for any efforts regarding weight loss, there are still some who involve their patients in a weight loss program before surgery.

There are two main reasons for this:

  • Shorter Surgery Time
  • Fewer Complications

Many surgeons believe even 10 minutes fewer increases the long-term success of surgery while decreasing the complication rates.

On the other hand, some studies show weight loss prior to bariatric surgery may not be necessary for all patients. This is not a definite claim for everyone, but in some cases, losing weight before surgery is dangerous because it compromises the patient’s necessary nutrition status.

It also depends on the complexity of your surgery. For instance, patients who demand a gastric balloon procedure are mainly not asked to lose weight before the operation.

Up to this point, what we conclude is that there is no general answer for everyone, and it differs from case to case. In my bariatric surgery mortality rate article, I have mentioned that too much excess weight is known as one of the main reasons for major complications after a weight-loss operation.

The final decision is up to your surgeon and their bariatric team. If there’s even the slightest chance that your extra weight might threaten your health, you’ll be asked to lose weight.

But in other cases, such a process is not necessary. Also, some people assume if you lose some pounds before surgery, you will decrease the chance of weight regain in your post-op life. Frankly, there is no strong proof to support this claim.

Weight Gain Tendencies

Have you heard of “last supper syndrome“? The majority of patients know they must change their lifestyle, eating habits in particular, after any type of weight loss surgery. But what most of them don’t know is that is it really necessary to start this change prior to surgery?

Certainty of weight loss after surgery tempts some patients to eat whatever they want before the operation day because they think they will never get a chance to eat unhealthy food again.

Such behavior is not only frowned upon in bariatric surgeons’ society but is not healthy at all. If you want to leave all the lifestyle changes for your post-operative life, it’s like leaving a 300-page book for the exam night.

I’m not saying you have to be so strict about what you eat and your exercise plan before the operation, but you should start faking it so that you’ll for sure make it later.

Moreover, there is a suggested pre-surgery diet that most dietitians ask their patients to follow about 2-3 weeks before the surgery date.

But if you seem like you’re gaining weight, your risk of complications will be more. Of course, it differs from case to case. But if you have a very high BMI, something more than 45, you must consult with your doctor. Find out the reason for gaining weight. Is it stress? Is it hormonal changes? Is it nervous eating? Talk to your psychiatrist about it. Otherwise, your surgery may be postponed to the time when you can finally solve this problem.

Will My Insurance Company Ask Me to Lose Weight?

Let’s face the truth: the cost of surgery is not low. Moreover, the difficulty with insurance coverage for bariatric surgery is that most of the time, you should go through a lot of hassle to prove that you’re not able to lose weight without surgery and your health is really in danger because of obesity comorbidities.

Even after providing them with documents that reveal your failure at your previous attempts to lose weight, they will still want you to ask your dietitian to provide you with a healthy diet, and then, if no noticeable loss of weight is achieved, your surgery cost might be covered, or they will offer you partial coverage.

Two of the most popular conditions insurance companies have is to have a minimum BMI (Body Mass Index) of 35 alongside obesity-caused difficulties, like sleep apnea and high blood pressure, or a BMI of 40 or more in the absence of any significant comorbidities.

You have another solution that helps you ditch all these health insurance plans hitches, yet undergo bariatric surgery with expert teams alongside savings in the majority of costs.

Final Notes

Some surgeons recommend losing weight before surgery regarding your health conditions and the severity of the surgery you will undergo. If pre-op diet is required, you will get help from a dietitian. Some insurance companies might want documents from your dietitian and doctor. If they don’t ask you to lose weight, you don’t need to worry but inform your doctor about the situation.

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