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When is the best time to perform your weight loss surgery?

Posted by: Dr. Rosales
July 1, 2019
Imagen_obesity1

First of all and as always, I would like to clarify that I write this blog for informational purposes in order to help the visitor to find their way when they are considering a weight loss surgery, be it the gastric sleeve, gastric bypass or any other of the many that exist today.

 

If you do not have much time to read this article, the answer to the question in the title is: The right time to have surgery is yesterday! (in the vast majority of cases).

 

Although we say it in a joking tone, the truth is that when the patient is considering and researching about obesity surgery, it is because he/she has been suffering and fighting against this disease and its comorbidities for years.

 

 

Article content: 

Profile of those seeking a solution in bariatric surgery
Common excuses for not deciding on gastric sleeve surgery and changing your life
Factors to take into account when choosing the ideal moment for your weight loss surgery

 



Profile of those seeking a solution in bariatric surgery

It is usually people who have tried by all possible means in search of a healthier life to achieve an adequate weight loss that is sustainable over time.

fat man on matressIt is important to remember that every patient who reaches a certain level of obesity suffers from a condition in which the organism enters a state of "self-regulation" in which, despite the great efforts and achievements that they may reach, it is only a matter of a few days or weeks to have weight regain. This occurs because the body enters a point where it no longer allows the person to lose more weight it is in a certain way, "programmed" with a "memory", in which if you lose weight, at the first neglect the weight comes back, situation that we manage to avoid with obesity surgery.

 

In short, what bariatric surgery achieves is to break this vicious cycle in which the patient is, which in most cases has been there for years or decades.

 

Following we analyze some situations, internal and external factors that lead the patient to delay his decision to once and for all make a radical and favorable change in his life.



Common excuses for not deciding on gastric sleeve surgery and changing your life

 

1. Money

Money is one of the main factors that people always keep in mind to delay the time of surgery. This is entirely understandable since bariatric surgery, when performed by a serious and committed bariatric group, is not cheap.

 

However, on many occasions, this moment is delayed because the patient is not completely determined to do so, and the economic issue is the perfect "excuse" to postpone it for an indefinite time. In these cases, we recommend defining if this is something you really want to do, and if the answer is yes, the next thing will be to determine how much you are willing to pay for your surgery.

 

The cost budgets of gastric sleeve surgery in Mexico have very variable range, and will depend on the quality of the material, facilities, and services offered.

 

The best recommendation regarding this topic is to budget a logical amount that assures you that you will receive the best possible care. The attention you deserve as it is not a vehicle, clothing, or anything material, it's about YOUR LIFE! Interestingly, the human being, in general, is willing to sacrifice quality in the service when it comes to the most important thing, their health, which is opposed to all logic.

 

Once you have defined your budget, you should get in touch with the bariatric groups that you think are viable according to what they offer their patients.

 

If you are waiting to have all the money from the surgery before contacting your prospects, you will be losing valuable time that you could take advantage of to advance the process, in addition to many bariatric groups, as in our case, we offer different types of financing; this allows the patient to schedule and plan the surgery without having all the money available at that moment. So do not hesitate and contact us when you are sure that surgery is something you really want.

 

 

2. Fear of gastric sleeve surgery

mujer sosteniendo balanza

This situation is something entirely natural and understandable, I tell my patients when they are already in the process, that the abnormal thing would be not being nervous or afraid of the procedure, because "in theory" is something that they themselves looked for and it is not an emergency surgery in which you have no choice but to agree to submit to it to save you in a life or death situation.

 

Regarding this point, we would like to comment that bariatric surgery, after being practiced worldwide for several decades, has become a branch of surgery that enjoys one of the lowest rates of complications and mortality.

 

The experience that has been acquired and the improvement of the technique that has been achieved over time has allowed to reduce these ratios considerably, making bariatric surgery a very safe operation, provided it is with the appropriate means and with expert bariatric surgeons.

 

How to determine this? Observing the costs, make sure they are not ridiculously low, and check for good references and comments from previous patients. Personally, whenever a patient is uncertain, I offer them to get in touch with our previously operated patients so that they can share their experience (clearly with the patient's prior consent). Check our article on this topic. 

 

3. Family

familia tristeThis topic could give us enough material to make a complete article, but in summary the family plays a significant role in the decision to proceed or not with surgery, the reasons why the family can influence negatively are multiple, we expose you here some of the most commonly heard in our practice commented by the  patients:

 

"Don't have surgery, you're fine, why do you want to lose weight?"

ANSWER: The objective of losing weight is not only a matter of aesthetics, but of health and wellbeing, at this point generally, the patient has already tried everything before without success.

 

"Don't have surgery, just stop eating!"

ANSWER: This is one of the comments we least understand because we know that the patient has tried for years to lose weight without success and if he/she continues to eat is because he/she has been disappointed, frustrated and feels defeated in many cases. Even if you stop overeating and eat properly, because of that "memory" your body has, you cannot lose weight. If you want to read a little more about this topic, we invite you to read our article about society’s ignorance about this subject

 

"It's not worth the expense in a surgery like this, it's very expensive!"

ANSWER: As mentioned before, gastric sleeve surgery, when performed by a respectable bariatric group, which uses adequate human and material resources, is not cheap, but it is not expensive either if we consider that it is a question of improving considerably the health, well-being and even the survival of the person. It is demonstrated that weight loss surgery increases the years that the patient lives approximately from 8 to 10 years.

 

Besides, it will always be much more expensive to treat and control chronic diseases, and their complications such as diabetes mellitus,  high blood pressure, osteoarthritis, obstructive sleep apnea, etc. during the rest of the patient's life, a situation that in many cases reverts or at least improves once they have surgery, often reaching a point where they do not even require medical treatment with pills.

 

"If you get the surgery you will change so much that you will leave me."

ANSWER: We do not have an answer here, we only know that it is something that is commented on by the couple that is reluctant for the significant other to have the surgery done, it is a delicate and multifactorial issue so we can not say much. However, it is something that exists in some instances, whether the couple admits it or not.

 

"Your cousin had surgery, and you know how things went!"

ANSWER:  what we can tell you is that the fact that a relative or acquaintance has been presented with an adverse situation during or after surgery does not mean that it will happen to you, each case is different, and it will be necessary to determine why the experience of said acquaintance was not good.

 

We say it with certainty because the thousands or millions of patients operated worldwide who are extremely happy and satisfied with the results speak more of the results of this procedure than the experience of a particular individual. In these cases, the best recommendation is that you choose wisely your bariatric surgeon. We invite you to read our article regarding this topic

 

"I'm afraid of missing, what will happen to my children?"

ANSWER: This comment goes hand in hand with the fear of surgery, what we can tell you is that there should be more fear to allow obesity to cause diseases that are already well known and linked to the obesity epidemic, since these diseases  put you at a much higher risk in the long term than a safe bariatric procedure.




4. Work

oficinista abrumadoOn this subject, one of the main questions and limitations is when they can return to work and their regular routine, the response is variable and depends on the nature of the patient's job. However, in summary, the patient who works in an office may return as soon as he/she feels ready for it, which may be between 4 to 7 days after surgery; however, we always suggest them to wait a week to return. We invite you to read about the recovery time in this article.

 

If your boss or the company where you work is not flexible enough to support you with your plans to have surgery, in most cases, there are ways and means of doing something about it. It's just a matter of demonstrating the justification and the reasons why you need to operate.

 

After gastric sleeve surgery, for example, our patients are surprised just after a couple of weeks how good they feel, already recovered and twice the energy, which makes them more efficient and productive in their daily lives and work, which makes it a win-win situation for both parties,  you must make your employer see this.

 

We offer our patients the necessary paperwork to demonstrate that they came for surgery for health issues and we are always open to explain and fill out the forms your employer requires to justify your absence, although as mentioned, it is usually quite short.

 

On the same subject, sometimes some patients who have surgery worried that the operation will affect their performance, especially when it comes to jobs that require physical effort such as police officers, jail officers, workers of oil wheels where they have to load large pipes, etc.

 

What we can explain in this regard is that, at least with the case of the gastric sleeve, the weight loss that will be achieved is basically from the decrease in body fat deposits, so even though their bodies will change and they will look thinner, this does not mean they will be weaker, but on the contrary, they will be able to apply their strength more efficiently by not having to carry that extra weight in their skeleton, and if in addition to this, they add regular physical activity, they will be stronger and healthier than ever.



5. Lack of information 

More than lack of information we consider that you should avoid misinformation, on the internet you will find countless websites, blogs, forums, comments, and experiences in which you can find reliable and updated information. However, there are also others where you will find information that, instead of helping you, will create confusion.

 

The best recommendation is that you check the type of page, do not get carried away by negative information, as we tend to pay more attention to the bad than the good, if you have specific doubts it is better to contact the bariatric surgeon who inspires you the most trust and ask him to talk to you personally.  I personally believe this is a crucial factor because if a surgeon is willing to spend several minutes to speak with you is really interested in helping you to be more calm with your decision. I always tell those who contact me what the least we can do considering that they, as patients, are thinking of literally putting their life and health in our hands and that resolving their doubts personally is the least we could do in reciprocity to that trust is.

 

In summary, visit trustworthy, formal pages of institutions and associations recognized in your country or internationally such as American Diabetes Association, American Society for Metabolic and Bariatric Surgery (ASMBS), International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), American College of Surgeons (ACS), in Mexico societies such as Colegio Mexicano de Cirugía para la obesidad y Enfermedades Metablicas (CMCOEM) (which, by the way, is the body that certifies and endorses the competence of bariatric surgeons in Mexico).

 

On the other hand if you visit the pages of bariatric groups and bariatric surgeons like a this one, make sure that they show interest not only in selling you and convince you to operate with them but that they reflect a genuine interest in helping you clarify your questions through detailed but understandable information that focuses on you as a patient. Do not let yourself be carried so much or exclusively by stamps or papers that are obtained thanks to the disbursement of a considerable amount of money, belonging to associations is a useful and relevant factor but not necessarily the only nor the most reliable.



Factors to take into account when choosing the ideal moment for your weight loss surgery

 

1. Emotional moment

mujer frustrada ejercicio

This aspect is essential because sometimes we have met potential patients who decide to have surgery at a sensitive moment in their lives in which it is not optimal to make such an important decision.

 

The importance of this point is due to the fact that it is a commitment to oneself in which you must bear in mind that surgery will most likely represent the last and best attempt to change your life and health, so taking the decision in a moment of anger, frustration or loss is not ideal or most advisable. Outside of these circumstances, if the patient is aware that the procedure will lead him to make changes in his/her lifestyle, in his/her eating habits and his relationship with food, then it is a good time.

 

- It should be noted that as part of the preoperative evaluation process, it is the protocol to perform a psychological evaluation to ensure precisely that the patient's emotional and mental state is suitable for the time of surgery. There are cases in which the patient does not understand the reason for said "requirement," but more than a requirement is a safety measure, that many other formal bariatric groups and we offer their patients, always with the purpose of providing the greatest possible safety to the patient. Recall the definition of health provided by the World Health Organization: "Health is a state of complete physical, mental and social well-being, and not only the absence of diseases or illnesses." 

 

 

2. Psychological status

As we said in the previous point, it is important that an adequate psychological evaluation is performed before undergoing this type of procedure, there are mental health disorders that if they are not under control, contraindicate surgery, some examples would be major depression, obsessive-compulsive disorder, a history of substance abuse, bipolar disorder, schizophrenia, etc. Even when you do not suffer or have not suffered any of the previous ones, it is part of the evaluation protocol (by formal bariatric groups) a psychological evaluation to ensure that this procedure will not bring any alteration to your mental health status.

 

 

3. Economic moment

This topic, let's say, depends more on the patient than on any other person involved since factors outside the bariatric group or surgeon of your choice come into play. There are those who think that the most important thing of all with this respect is to save as much money as possible, others who believe that the cost is not the most important thing but the quality of the service they will receive without it leading to bankruptcy and others who believe that no matter how much you need surgery to improve their quality of life and health, it will always seem to be a hefty expense so they will continue to postpone their decision indefinitely.

 

  • When the patient seeks to save as much as possible, it is crucial to consider that when the procedure of their interest is being offered at a price well below the average, this will invariably be due to the use of lower quality materials and facilities that are not suitable for a bariatric patient, we will not expand more on this issue because you can check our point of view in the following article

 

  • When the patient wishes to obtain quality service at a reasonable cost, it is the type of patient that has the highest chance of getting a well-performed procedure in a suitable place and with the best possible quality materials. In our case, we think that we fall into this category because as we settle it in other parts of our page and blog, we offer our patients the best possible treatment, and equally important, the material used is the same as that used in first world countries such as the United States, Canada and several countries in Europe. When it comes to a person who comes from another part of the country or the world and puts their life in our hands the least we can do is offer the best in terms of materials, make our best and most significant effort in terms of dealing with human warmth and empathy as well as facilities suitable for this type of procedure.

 

  • For those people who postpone the decision to perform the procedure because they consider it a significant expense, the only thing we can advise is that they should not see this decision as an expense but as an investment, since the best investment they can make is in their own health. Patients suffer from chronic diseases associated with obesity such as diabetes mellitus, hypertension, obstructive sleep apnea, etc.; this leads them to spend thousands of dollars annually on medicines, dr office appointments and devices for monitoring and managing these diseases. These patients should keep in mind that bariatric procedures will cause considerable improvement in their health status, in many cases achieving remission of severe and lethal diseases such as those mentioned above. And if they do not suffer from any of them they can still prevent its occurrence, there is no better medicine than prevention.

 

  • If you still hesitate with the decision to proceed to make that call or that consultation with your bariatric surgeon, you just have to consider that various studies calculate that between the amount of money that is not spent on extra food, medications and dietary programs, the patient will be saving 4 to 6 thousand dollars per year, so in a period of two to three years this savings will pay for the surgery itself.

 

 

3. Health status

mujer sobrepeso y delgada

Concerning health, people frequently contact us asking if they are candidates for surgery even if they have diabetes or high blood pressure, the answer is AFFIRMATIVE. When you are a right candidate for surgery the best time to have it done is before developing these diseases, but the next best time is now, before these diseases deteriorate your state of health so much that it is no longer safe to undergo a major surgical procedure. What we do in order to offer the highest safety to the patient is to request preoperative evaluations from different specialties depending on their medical history:  cardiology, endocrinology, pneumology, internal medicine, etc., the question is that if after said evaluations there is no contraindication for surgery then you will be a good candidate and you must make the decision to proceed as soon as possible before health worsens.

 

In summary, a deteriorated state of health is not usually a contraindication (as long as the diseases are controlled to a certain extent) for surgery, but on the contrary, is an important reason for you to decide to change your life in a positive way forever.



4. The moment in the life cycle

This detail depends a lot on the personality of the person in question, and their way of looking at life, the case of adolescents is a separate issue that we will deal with in a future article, but in summary, during adolescence, surgery is something viable and  is done with safety provided that the patient is mature enough psychologically speaking, since it has been proven that from a biological point of view, a restrictive procedure such as gastric sleeve, beyond affecting its development, favors an optimal development based on a better state of health and better hormonal balance.

 

In the other moments of the life cycle of a person (single, married, with children, senior adult), as we say, depends a lot on the way of seeing the life and circumstances of the person, there are those who fear to miss for their children if they undergo surgery, however, considering the minimal risk that bariatric surgery represents in appropriately selected, evaluated patients with dependable bariatric groups, it is more likely to think that they may be missing precisely because of complications related to obesity, more than as a consequence of a bariatric surgery.

 

 

5. Patient's Age

There is no defined upper or lower limit to determine if the patient is a candidate for the bariatric procedure since this is left to the discretion of the bariatric surgeon and his multidisciplinary team (the limits, in an arbitrary degree, is between 15 and 65 years). It is proven that both, adolescents and elderly patients, when properly evaluated, are excellent candidates for weight loss surgery without necessarily implying a higher risk of complications; however, every case must be analyzed individually.

 

 

6. Family/work situation

Some patients fear surgery because there is someone else who needs them for their daily life, be it family members with disabilities or senile, which is an entirely valid fear. What we can say about it is that it only takes a few days to recover from surgery and return to your usual daily activities except for loading weights over 30 pounds for a period of 30 days after surgery. Same situation when for work reasons they must regularly travel or drive long distances, in a period of 5 to 7 days they could be back in their work activities without practically any difficulty, the only thing they must ensure is to be able to ingest enough liquids at all times to maintain an adequate state of hydration.




Did what you read help you have a clearer idea of what to expect from gastric sleeve surgery or any other bariatric procedure? We invite you to contact us or share your opinion/questions in the comments.