Southern Surgical Associates

For many people, gastric bypass surgery is affordable because it is included in their health insurance coverage. For other people, gastric bypass surgery is a medical treatment they pay for themselves, called self-pay or cash pay.
Whether your insurance company will cover the cost of gastric bypass surgery or you are paying for it yourself, you will need to prepare detailed written documentation to support the medical necessity of your surgery. Thorough documentation of previous unsuccessful dieting attempts, including medically supervised attempts, co-morbid conditions, and other factors, such as the medications you’re currently taking, can help document that gastric bypass surgery is necessary for the treatment of your morbid obesity.

A typical comprehensive bariatric program will consist of a combination of the following healthcare professionals: a program coordinator, psychologist, dietician, exercise physiologist, and other healthcare professionals to help with your case. Each expert is dedicated to providing support for gastric bypass patients both before and after surgery.
Many patients report that during the first 12 to 18 months following surgery, they feel highly motivated and energized. During this time, they are making substantial lifestyle changes such as eating new foods and smaller portions, taking vitamins daily, and exercising regularly. Many of these changes will be discussed before surgery and should come as no surprise following surgery.
While these changes are healthy, they may be overwhelming for some patients. This is where your bariatric program support team can guide you. Each expert can provide advice and insight that will educate you and help you make healthy choices.

Many successful gastric bypass surgery patients say that their support network helped them immensely in maintaining their new healthy lifestyle changes. From family and friends to bariatric program support groups, there is a wealth of options available for people interested in gastric bypass surgery.
The first step in getting support is talking to your family and friends about gastric bypass surgery and your interest in it. You might find that they are completely supportive. While this is always ideal, you might find that some family members and friends are against your decision. Often, this is because your loved ones are concerned about you or have preconceived notions about gastric bypass surgery. Explaining the advantages, benefits, and risks of gastric bypass surgery may open their minds to its importance.
If you find that they are unsupportive, it doesn’t mean you are alone. Many people have had gastric bypass surgery and have been very successful with the care they received from the healthcare professionals on their bariatric program team. Bariatric programs usually include a support group for gastric bypass surgery patients both pre- and postsurgery.
Support groups are an excellent resource. You’ll find people who share your goals of health and wellness. A support group is a forum for celebrating successes, such as the improvement or resolution of co-morbidities. The support group is devoted to people who have common experiences, who can share their feelings in a safe environment, and develop relationships that can contribute to improved physical and emotional health.
If you are thinking about gastric bypass surgery, and you want to learn more about the patient’s perspective or help reluctant family and friends understand, attending a support group meeting can be invaluable.
Getting Family and Friends to Support My Decision
It’s important to realize that for many people, not just patients, surgery can be frightening. For gastric bypass surgery patients, family and friends may not be supportive in the beginning because, as with all surgical procedures, they are concerned about possible risks and complications.
If you find that your family and friends are not supportive, providing information and education may calm many of their fears. In addition to support groups, many bariatric surgery programs provide information sessions and encourage the attendance of prospective patients, their family, and their friends. Seeing and hearing the successes of others can help people understand the importance of gastric bypass surgery.

What If My Family and Friends Don’t Support Me?
Unfortunately, some gastric bypass patients find that their family and friends do not support their decision. It can be very disappointing, but it doesn’t have to alter the patient’s decision to have gastric bypass surgery.
Bariatric surgery programs often include two components that can help a patient: a psychologist and support groups. A psychologist can provide tips and techniques for dealing with unsupportive people and listens to your frustrations without judgment.
Support groups are a wonderful place to meet people and get perspective on bariatric surgery. You’ll hear about successes, frustrations, plateaus, and special moments, and have a chance to share your own experiences.

Gastric bypass surgery is a major procedure, and recovery doesn’t happen overnight. Therefore, it’s important to follow your surgeon’s postoperative recovery instructions.

Postoperative Pain and Discomfort
Many people think that bariatric surgery will be followed by a long and painful recovery period. However, postsurgery patients usually do not have that experience. In fact, many patients who were interviewed spoke of discomfort and soreness rather than pain. Recovery does, however, vary from patient to patient. You may want to speak with your surgeon if you are very concerned about postoperative pain.

Being out of Commission
As with any major surgery, there will be a recovery period when you’ll have to take it easy. Remember that this is a necessary step, and the better care you take during recovery, the more likely and quickly you’ll return to normal activity. Recovery time varies from patient to patient and also is based on the type of surgery you have.
You can expect to be up and moving within hours of your gastric bypass surgery. While you may move slowly at first, many patients have found that each day often brings improvements. Many patients return to normal activities, such as driving, cooking, and caring for children, three to six weeks after surgery.
Whether it’s family, friends, or coworkers, build a support network for all aspects of your life. Those supporting you are dedicated to helping you achieve better health and wellness. Show your appreciation by accepting their help and allowing yourself to heal.

How Long Is Recovery?
The recovery period varies among patients and is dependent on many different factors. For example, many patients choose to have laparoscopic, or minimally invasive, gastric bypass surgery because the recovery period generally is shorter than with open surgery. In some patients, the laparoscopic, or minimally invasive, approach to surgery cannot be used. The decision to perform the open procedure is a judgment made by your surgeon either before or during the actual operation, and is based on patient safety.
Other factors for recovery time include pain tolerance, preoperative health, preoperative BMI, any complications that may occur, and even the patient’s level of compliance to the surgeon’s recovery instructions.

For people suffering from the lifelong disease of morbid obesity, gastric bypass surgery can be a powerful tool that allows people the ability to manage their condition. The surgery works using both malabsorption and restriction; therefore, patients do not absorb some calories and nutrients and are satisfied with smaller portions of food.
Of course, gastric bypass surgery is a tool, not a cure. For the surgery to be effective long term, it must be used properly. Through lifestyle changes such as regular exercise and a healthy food plan, many patients are able to make a long-term change for better health.

Health insurance is one of the most common benefits offered by employers to their employees. A few health insurance companies have made it a policy not to offer bariatric surgery coverage. However, it is often the case that larger employers decide what health services and procedures are covered under their benefit plan, not the insurance company that administers the health benefits.
If you find that your employer does not offer gastric bypass surgery as part of its benefits package, there are steps you can take. Find out why it’s not covered. It might be beneficial for you to provide your benefits administrator or human resources representative with information about the many benefits of gastric bypass surgery. Often, a quick meeting with the person will tell you how much your administrator knows about the advantages of gastric bypass surgery, such as increased energy levels and a decrease in health problems.
You may find that a combination of your own story, your medical history, and peer-reviewed articles from reputable medical journals will help your benefits administrator understand that morbid obesity is a chronic disease and that gastric bypass surgery is a medically accepted treatment of the disease. By finding statistics that detail the costs of obesity, including the costs of treating obesity and its co-morbidities, and lost productivity, you can create a powerful financial argument stated in dollars and cents. Using this information, the benefits administrator can share your story and the need for insurance coverage with others who will make the final decision.
Getting coverage approved by an employer can be a time-intensive process that may require several meetings. Educating coworkers about the surgery and its importance helps to fight society’s obesity bias, and you may find that other people are interested in gastric bypass surgery, too.

If the insurance company turns down your request for gastric bypass surgery, you may be able to appeal the decision. Many people do not take advantage of the appeals process or know of the laws that govern insurance companies in their state. Your health is worth the time and energy it takes to advocate coverage.
It’s critical that you understand your health insurance policy thoroughly, including the number of appeals you are allowed and what, exactly, constitutes an appeal. The number of denials varies among policies and is detailed in your Certificate of Coverage.

Working with Your Bariatric Program
Assistance is key. It is critical that you work with your bariatric program to determine the correct approach to appealing a denial. Your program is there to assist you in this very important process and to help you adhere to your policy’s requirements.

Your Options
Even when patients have exhausted their appeals processes, they may still have options. Options can include an independent review board, arbitration, and litigation.

Here is some more information about how these three options work:

Independent Review Board
This option is available to people in more than 40 states. Look on your state’s website for filing instructions. No lawyer is required. Judgments usually are issued in 60 days.

Arbitration
Some health plans require patients to use a third party—other than the patient’s lawyer and the insurance company—instead of going to court.

Litigation
This option is expensive and takes a lot of time. Bariatric surgery is expensive, but patients’ decisions are based on their own resources and desire.

Few people are able to pay cash up front for gastric bypass surgery. If you do not have health insurance coverage for gastric bypass surgery, but would like to have it, there are alternative financing options available to you.

Medical Loans
A popular option is financing with a medical loan. Many bariatric surgery programs work with financing companies to offer a variety of loans to their patients. Your program coordinator and the staff of the bariatric program can tell you more about the specifics.

Important Information for Self-Pay Patients
Self-pay patients, should consider the expense of complications. It’s a good idea to hope for the best and plan for the worst. If you do have health insurance (even if it does not cover gastric bypass surgery), be sure to read your policy. You may find that your insurance company will cover medical costs from complications due to the surgery.

If you are considering gastric bypass surgery and need to find an alternative source of financing, the options are out there.

Talk to Your Bariatric Program Coordinator
If you are interested in alternative financing options, please ask to speak with your bariatric program coordinator. Your bariatric program coordinator should have experience in working with health insurance companies and helping patients find financing for their gastric bypass surgery.

The majority of people who consider gastric bypass surgery do so after years of unsuccessful dieting attempts, including participation in diet programs, taking weight loss medications, and exercising. After years of losing weight and gaining it back, it is not unusual to blame yourself. Many gastric bypass patients who have been on several diets have felt like a failure and were demoralized. However, many in the healthcare community would argue otherwise: The patients were not failures. It’s important for sufferers of morbid obesity to understand the medical science behind morbid obesity.
Morbid obesity is a disease requiring lifelong treatment. Gastric bypass surgery is a treatment option that permanently alters the patient’s anatomy and physiology, while allowing for significant weight loss and the reversal or improvement of co-morbid conditions.
Gastric bypass surgery is not a cure-all and never should be regarded as such. However, as an effective tool, it helps patients attain a feeling of satiety, or fullness, because the stomach has been partitioned into a pouch. For many gastric bypass patients, dieting was frustrating because the feeling of satiety was missing. So, satiety can be the unique result of the surgery, helping patients to feel full and satisfied with less food. Gastric bypass surgery also includes a malabsorptive aspect, where some of the calories and nutrients taken in by the patient are not actually absorbed by the patient’s body. While this assists in significant weight loss and other long-term health benefits, it also requires that the patient supplement his or her diet with vitamins and other important nutrients.
Successful gastric bypass surgery patients use the surgery as a powerful tool to help control their hunger. Along with exercise and a healthy diet, gastric bypass surgery can help patients feel full and attain their goals of health and wellness.

The medical community views morbid obesity as a lifelong disease. Individuals suffering from morbid obesity generally are genetically predisposed to the condition, and they face environmental, social, and psychological factors that can increase the likelihood of morbid obesity.
Gastric bypass surgery has a history of helping patients effectively manage their disease. The surgery uses two methods to help patients lose weight: restriction and malabsorption. During the gastric bypass procedure, the stomach is partitioned and a small stomach pouch is formed. Then, the small intestine is rerouted to allow for malabsorption of calories and nutrients. Gastric bypass surgery uses these two mechanisms to help patients experience satiety, or fullness, with less food, while also reducing the amount of calories and nutrients absorbed.
Most bariatric programs teach patients that gastric bypass surgery is a tool designed to help patients manage their disease. As a tool, gastric bypass surgery has impressive long-term weight loss results and benefits patients with the reversal or improvement of co-morbid conditions. However, the achievement is not completely due to the surgery.
While most gastric bypass patients are able to lose excess body weight and improve or resolve their co-morbidities, they still must use the tool effectively long term. This includes following a healthy and balanced food plan with additional nutritional supplements, as well as regular physical activity. These lifestyle changes contribute to patients’ overall health and can be embraced before surgery, with your doctor’s approval, to prepare you for the changes ahead.
It’s important to view gastric bypass surgery as a tool that can help you transform your health.

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