Question:
Can anyone tell me why I must loose 10% of my weight before surgery?

I have been told that I must loose 10% of my weight before surgery. I am confused, If I could loose on my own I would not need the surgery. I am terrified that if I don't loose the 10% I will not qualify for the surgery. It is bad enough my Insurance makes us weight six months to get the surgery. PLEASE RESPOND I NEED SUPPORT:)    — Maritza S. (posted on November 28, 2003)


November 28, 2003
You need to ask the surgeon why he has this requirement. It's not an insurance requirement or anything like that. Personally, if I was still a pre-op and had a choice of surgeons to do this surgery on me, I would pick one that had no such requirement...JR
   — John Rushton

November 28, 2003
a lot of the docs require you to lose some weight before surgery. The primary reason is to shrink your liver to make your surgery go better. Some docs don't. Mine didn't require it of me but they did want me on a high protein, low carb for about two weeks pre-op. i didn't lose any but maintained. As John said, if you don't feel you can do this, ask around and find another surgeon.
   — Delores S.

November 28, 2003
While I'd suggest a high protein, zero to very low carb diet to get off the 10%, I must agree with John that I'd never take a doc on who had the requirement as a standard for his patients. Now if you are planning a lap surgery, he/she may require it to reduce your liver - but even in that scenario rarely do you need to lose THAT much in order to shrink it. Even a 5 pound loss can reduce it sufficiently. Have you considered checking out other surgeons?
   — [Deactivated Member]

November 28, 2003
I have heard of this, the University of Iowa does this too. I chose a surgeon who didn't require this pre-op. I agree with you and felt if I could do that I could continue to lose on my own and not need surgery....they would be asking too much if I had to lose that before hand. BUT, I think one reason some ask this is that they want to see your dedication and IF YOU CAN FOLLOW NEW DIRECTIONS AND EATING REGIMENS. Just my opinion! Hang in there and give it a shot, if it doesn't work out try a different surgeon. I do think high protein-low sugar can get you results...but not sure about 10% without WLS?
   — Carol V.

November 28, 2003
a lot of the ins. co. gods require a "supervised diet". it's basically a "catch 22". the surgeon may feel, like the others have said, any weight loss can help shrink the liver making surgery easier. i expierenced the same thing. i worried that if i lost too much weight,(i've lost and gained hundreds of pounds in the past), that they would say "just keep on doing what your doing". ins, co's. hope to discourage you from surgery so they dont have to pay out and thus keep their profits up. keep trying, and try to meet their demands. harvey simon
   — harvey S.

November 28, 2003
There are several good reasons for losing weight before the surgery. First, you will most likely have to eat smaller meals, thus lower calorie intake - this is to prepare you and your body for the smaller physical intake and fewer calories you will be "forced" into post op. Both physically and mentally, this is worthwhile preparation. Second, you will most likely include exercise in your weight loss plan. This will make you more physically fit for the surgery - it's of big benefit to your respiration which translates into fewer problems post op. Third, the less you weigh, the lower (in general) your risk from ANY surgery. Fourth - you have a definite goal that is reachable - this is good for self esteem. Fifth - why put weight loss off? The surgery is not a cure-all, just a tool... why not give your body a head start by losing weight before surgery? If you maintain your weight before the surgery, the risks remain the same. If you GAIN weight before the surgery, your risk increases (some people do this by "pigging out" prior to surgery as if they'll never be able to eat again!) And, remember, you have succeeded at weight loss before - it's the keeping it off that's a problem, and while you've failed in the past at weight loss long term, you most probably will not fail at keeping this pre-op weight off because it will be followed rather quickly by surgery and post-op losses. Personally, I'd go ahead and lose the weight up front and I would stick with the Dr. that requires you to lose the weight beforehand - he/she has your best interest in mind and wants the patient (YOU) to be in the best physical condition going into surgery as possible. Good luck and God bless. Judy (7mos post, 112lb loss, 10% loss up front by using 1000 calories/1 hour brisk walking per day pre-op)
   — Judy N.

November 28, 2003
My doctor did not require any specific weight loss before surgery, but I lost 60 pounds on my own anyway. I couldn't see any point in wasting another 4 months of my life waiting for surgery to "rescue" me. I wanted to do what I could do for myself. I know the lost weight and walking I did before surgery made for a much easier recovery time, and adaptation to life after surgery. Unlike some I never had really bad "head hunger" after surgery, since I didn't have a drastic reduction in food intake compared to my pre-op diet. I too wish some doctors didn't require this, but you can take it as a personal challenge, and make something good out of this opportunity if you want to.
   — Jim F

November 28, 2003
It is totally going to depend on your surgeon/facility that you have the surgery at. I'm pre-op, but my surgeon required a 46 lbs weight loss for me which put me at 259 prior to surgery (open RNY). It is becoming more common to be required to lose weight prior to surgery and is done to "defat" the liver which is more rigid when fatty and gets in the way during surgery. With less fat in the liver, it is easier to move over. What has helped me is to remind myself that with each pound I lose and each minute I exercise I am making it so there will be less chance of complications during my surgery or right after. Yes, it has been difficult. I hit my goal weight for surgery at my pre-op appt at the end of October. Then unexpectedly had to cancell my surgery because of a family crisis. So now I am in limbo. What helped me with the weight loss in the beginning was doing Weight Watchers, then in July switched to a high protein (watched portion control tho) and gave up bread, pasta, rice, potatoes, and desserts. Some days I did a protein shake in stead of lunch and/or dinner. I started riding an exercise bike too. Any movement is better than no movement at all. Don't go into this with the attitude that I "can't" lose the weight, take the attitude that I "will try my best" and then do it a step at a time. Mary
   — [Deactivated Member]

November 29, 2003
You need to address this question to your surgeon's office. My surgeon did not require a pre-surgery weight loss, but I have heard many that have. Many insurance companies require a pre-surgery diet attempt before they will approve you. Mine required 3 12-week physician supervised diets, one of which must be in the last calendar year. I've heard many pros and cons on this. Most surgeons that require it do so to determine if you have the discipline to follow the regiment that will be imposed upon your post-op. Some people view WLS as a 'get of of fat free' procedure and many surgeons just want to weed out those folks who can't follow a program, because it will be a program for life if you're successful. Start now and lose what you can and get healthy before your surgery and you'll have a much easier recovery and the eating restrictions won't be so traumatic for you after your surgery.
   — Cathy S.

November 29, 2003
I do believe that it has some validity to the shrinking liver as well, but if it helps them get the patient in slightly better health prior to surgery then less chance of problems happening in the OR or complications that can be associated to them.<P> This is just my opinion, but I think some Docs give out the 10% requirement before hand to weed out perfect patients and to reduce the wait time for others seeking surgery. Perfect patients meaning they look to him for all the answers, do everything exactly as he says and are basically bobble head dolls without any questioning of his ability or the procedure. And since some surgeons out there are so highly regarded or in such demand, telling patients that they must lose weight prior to surgery sends some people elsewhere right away or if they dont meet the requirement causes some to get cancelled therefore easing up the long wait.<P> Me, Personally - I would go to a surgeon who suggested that I try and lose weight before surgery as long as I was making an effort to lose that would be ok. If he had a iron-clad requirement that said I had to achieve a certain weight or would cancel me even if a few pounds over, then I would be looking elsewhere. Because for me 10% would be close to 50 pounds...never gonna happen on my own. Good Luck!
   — ImANewDee

November 29, 2003
Maritz, I'm not sure about the 10% figure but... my surgeon said your kidney, bladder and all those other body parts shrink when you diet. So when he goes in they won't be in the way. [my comment: Which in turn greatly cuts down on the possibility of any of those getting knicked or some other complication.] Some times it means the difference between open and lap also.
   — Emily H.

November 29, 2003
My doctor didn't require any weight loss before surgery, if she had I would be in trouble, since I turned to surgey after trying to lose weight for 2 years on my own and not ever being able to lose more than 10 lbs (and at 300 that isn't much at all) I could comply to diets just fine, for 3 or 4 months at a time, yet still no loss. If you have a choice you may want to seek another doctor. Ask your surgeon's office what happens if you can't lose the 10% will they cancel? will they perform the surgery anyway?
   — Patricia T.




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