I asked my doctor for a referral. I want to discuss bariatric surgery with a doctor. I want to see what is the best option - Sleeve or Lap Band. The name he gave me is to a general surgeon. Is there a difference between general surgeon and bariatric surgeon? Also, Sleeve or Lap Band?

A general surgeon is fine if they have a lot of experience in bariatrics. Your surgeon will guide you to the right choice but it should be between RNY and sleeve. Lapband should not be part of the equation. It is outdated technology that doesn’t last for the long term and has been shown to cause multiple complications

You should be looking for a bariatric surgeon; most bariatric surgeons are also general surgeons, but not vice versa. general surgeon may be able to point you in the right direction of which procedure might be best for you, but a bariatric surgeon should be looking at the whole picture - surgery, diet, psych issues, eating disorders, etc. Not that they will handle everything, but they will be more aware of all the issues that typically afflict seriously obese patients and provide some guidance in those areas.

The lap bands are falling out of favor very quickly owing to their high long term complication rates and poor overall performance, though there will be some special circumstances where they may still be appropriate. The RNY and sleeve gastrectomy are the two most common procedures now, though there is also the duodenal switch which works better than either in more extreme cases that you should be aware of, though it is less commonly performed owing to its greater complexity.

Here in the states, you want to look for a surgeon who is a member of ASMBS - the American Society of Metabolic and Baritric Surgeons - as a guide as to who is serious in the field.

a bariatric surgeon specializes in bariatric surgery. General surgeons do that plus other types of surgeries as well. As long as the general surgeon has done a lot of bariatric surgeries, he/she is probably fine. I personally would rather work with a specialist, but that's a personal preference.

you'd have a hard time finding a surgeon who'll place a lapband these days. They've fallen out of favor and aren't done much anymore.

In addition to a bariatric surgeon, I would want to be with one who is noted as a Center of Excellence surgeon. That means they do a specific minimum of bariatric surgeries per year with a very low rate of problems and they do it at a hospital recognized as a COE hospital. The rate of risk is much lower for you and they know what they are doing. They also end up tracking you for 5 years beyond surgery with follow up care of varying intensity.

I guess a general surgeon could do bariatric surgery, as they do all kinds of different procedures, but I'd want someone who specialized in bariatric surgery, had a proven track record, was Board Certified, and had done it thousands of times.

A general surgeon did one of my endoscopies, came out Looney as heck, sore throat, sore chest, felt drunk for a day and half, don't k,ow if he gave me enough sedation to perform a hysterectomy, but learned my lesson. Bariatric Surgeons or gastroenterologist from now on, when I tried to talk to him about my reactions he was NASTY, basically told me to shut my ? mouth. He'll Never Touch my body again!

So, I found out my insurance won't cover bariatric surgery. Disappointed considering that I thought insurance companies were covering it.

Anyone have any recommendations to proceed?

55 minutes ago, MrMagic said:

So, I found out my insurance won't cover bariatric surgery. Disappointed considering that I thought insurance companies were covering it.

Anyone have any recommendations to proceed?

some do some don't. It's definitely not universal. I'm not sure you're going to be able to get them to cover it if there's an exclusion in your policy. Some folks go to Mexico when they're in that situation since it's usually a lot cheaper

I did a search and found that Tijuana does the procedure. My question is how safe would it be there and what would the recovery be like.

Hmmm.

https://www.yelp.com/biz/bariatricpal-tijuana

On the insurance front, companies may well cover WLS, but the employers who buy the policy may choose to exclude that benefit to lower their (short term) cost. If you are dealing with job provided insurance, there may be other providers available during the open enrollment period that do provide the WLS benefit, or it may be worth your while to go with an outside policy that does cover it (though I suspect that it wouldn't be worth the cost, but worth checking out,) or changing providers if you are already on private insurance if the costs work out.

On Mexico, there are lots of people who have a very positive experience and there are plenty of good surgeons there; however, you don't have the recourse there if something doesn't work right - surgically or contractually - which is a big part of the reason that they are cheaper. Due diligence is the word of the day. In the States, you can shop around and see who has the friendliest self pay programs; IIRC, there is a program around Las Vegas that seems to have fairly friendly rates of around $10k or so for a VSG, which isn't that much higher than the better MX programs.

Be sure to look around find a place with a good reputation.