I guess I am just alittle confused with the beginnings of pursuing a gastric sleeve.....

For the past 2 yrs or so I have had my PCP make referrals on my behalf for weight loss management whether I wanted it or not. I went for a colonoscopy and only saw that Dr one time which was the day of my colonoscopy. Next thing I know after the colonoscopy Im getting phone messages from the weight loss management section of the hospital telling me I have several referrals and to contact them.

To say I was pissed is mild lol. I guess I wanted to make the move myself and not be thrust into it. Of course Im way over weight, of course my health is suffering not to mention my mobility is next to none. Im just a procrastinator.

I have been on several weight loss journeys within that 2 yr period. I did have a medically supervised diet for 5 months that I did. I lost weight but quickly started gaining it back after I fell last Christmas and injured my knee. Fast forward to July of this year and I had a gall bladder attack and made a trip to the local ER and yep you guessed it....by Monday morning I had another weight management referral......blah lol plus a referral to a general surgeon regarding the gall bladder. This lady was a real trooper lol she got to hear me complaining about all these referrals and my weight loss struggles; ironically the more I talked about it with her the more infuriated I got for getting all these referrals for a gastric bypass that I didnt want. Luckily I suppose she listened so Im going for a gastric sleeve appointment next week Thursday.

She told me she wouldnt require a supervised diet and that I could just move on to the surgery itself. I guess Ill find out next week if she remembers telling me that or not.

As far as I am aware I am going for a preop educational appt but from what Ive read in here there seems to be alot more to it. I see ppl say their surgery dates are in the far future and not anything soon.

What are some of the timelines any of you are experiencing? I think I may have a rude awakening come next week Thursday lol

Edited October 22, 20214 yr by Crisscat

It really depends on what your surgeon and your insurance requirements are. Mine was 6 months supervised diet and testing. I know some who have just made an appointment for pre-op assessment and then have a surgery date. Good luck at your appointment!

it was about a year for me - I also had to have a six-month supervised diet before I was even accepted by the program - then it was lots of clearances (EKG, nuclear stress test, labs, sleep study, etc). I know it's a pain to wait, but I'm glad I had to. The supervised diet (required by my insurance company) helped me ease into the way I'd be eating post-op so it wasn't quite such a radical change after the surgery - and I lost about 40 lbs from it to boot. Also, with the clearances, the surgeon just wants to make sure you're healthy enough for the surgery - because being obese can be a surgery risk.

Edited October 22, 20214 yr by catwoman7

My wait was about 5 months. My insurance required six visits of supervised weight loss but I had already satisfied one of these visits.

It was around 4 months from initial consultation to surgery for me. Insurance only required proof from PCP that I attempted weightloss prior not a designated period. The surgeon required a minimum of 2 pre surgery educational courses at their practice.
The preop specialist clearances I needed were cardiology, pulmonology/sleep study, psychological assessment, gastroenterology/endoscopy and labs.

First, I'm not sure if I read your post correctly? Do you actually want WLS surgery? Or are you feeling pressured into it? Or is it that you DO want it, but that you want the sleeve but feel pressured into Rny?

Second to answer your timeline question, I'm from Canada so it may be a little different fyi...I didn't have to do any sort of supervised diet. I had actually cancelled my surgery twice out of fear/trepidation, BUT if I hadn't, the time elapsed from date of referral to the probable first (cancelled) surgery date would have been 9 months. If you include my cancellations, then it was 19 months till I got my surgery.

I had to:

• attend a 3 hour info session
• get an EKG (twice cuz I cancelled)
• lab work (twice cuz i cancelled)
• sleep study (this was actually kinda cool, lol)
• 1 20-30 min. appt each with: a nurse, dietitian, social worker
• meet with surgeon (twice cuz i cancelled)

My requirements were much like ms.sss', but faster (I am in the US). I did not have a supervised diet, just had to furnish weight history and an affidavit that yes darn it I have tried and failed. First consultation with the surgeon was 2 July 2021, surgery was 14 September 2021, so basically ten weeks. In that time, I had to:

• Have an introductory class of one hour
• Have one session with a support group
• Have one session with a dietitian
• Have a 1:1 session with the surgeon
• Have a psychological clearance (more on this later)
• Have an EKG
• Have blood work
• Have an appointment with my PCP to clear me for surgery

Once I got all of that done, my insurance turned around the approval in 3 days and I was scheduled for surgery about 5 weeks later.

I had the same history you do: lots of referrals, lots of resentment, lots of "this time I'm doing it FOR SURE". Now that I'm done with the surgery and losing weight hand over fist, I wish I'd listened the first time I was referred. I will say that they could do a heck of a lot better job talking through the ^$#%ing surgery instead of just "oh well call the weight clinic". If someone had pointed me at, say, this site, I might've bit the bullet and salvaged some of my youth. Oh well.

Maybe the first question to ask is “why am I so angry?” You admit to being overweight. Another way to think of it is that you are being offered a tool to help with this significant health issue. Now is the time to take the helping hand and reach for something better. Wishing you great success and all good things.

8 minutes ago, waterwoman said:

Maybe the first question to ask is “why am I so angry?” You admit to being overweight. Another way to think of it is that you are being offered a tool to help with this significant health issue. Now is the time to take the helping hand and reach for something better. Wishing you great success and all good things.

I'm not the OP but I can certainly say that the "being offered a tool" often—usually, even—comes with a HEAPIN' HELPIN' of judgment and "why can't you just do this on your own you fat-?"... and that's before we even get into the stigma society heaps on this surgery.

Sites like this ought to be the first line of thinking for physicians who truly do want the best for their patients. "Look, promise me you'll spend an hour reading on BariatricPal.com" (or whatever site). There's nothing like feeling that you're not alone in this.

Thanks to all the replies.....I think I have a rude awakening come Thursday next week lol ?

Ill try to respond to each of you in one post:

catwoman7: sounds like you went through a process with everything you had to do but thats not a bad thing. At least you had the piece of mind of knowing things were good to go ahead with the surgery, Kudos to you

GreenTealael sounds like you had alot to do as well. Best to have everything done it seems

ms.sss I guess I was angry and frustrated mainly because Im aware I am overweight and I suppose I just got tired of being told about my weight problem or in the case of the Dr for the colonoscopy, that Dr just sent a referral without even talking to me about it. Most Drs meet with their patients before they do any procedures or surgeries if possible. This Dr cancelled my consultation and had her nurse see me instead. I saw the Dr for the first time as I was going in 1 day surgery to get the colonoscopy. She didnt even follow up with me and cancelled my post op appt and had her nurse call me to see if I was good. Then I got a call from the weight management dept asking me to contact them for the referral they received from the Dr who did the colonoscopy. So yeah that angered me immensely.

I thought I could lose weight on my own. I was in denial I guess because no matter how much I tried I would lose weight only to regain it back again. So I was angry with myself as well for failing at something I thought I could get a grip on my own.

I decided to go ahead with the sleeve surgery after meeting and speaking with the gastric surgeon. She made me feel better about my obesity and made me feel like she would listen where others just kept filling out referrals. So I finally decided to go through with it and I have filled out mountains of paperwork x's 2 (they gave me the wrong ones at first) When all the paperwork was finally done I scheduled my appointment after watching an informational video first. I was sent even more paperwork to fill out and I mailed that back to them so I am happily waiting for next week Thursday to come. Im sure there will be more to it then I initially thought in comparison with what others have had to do. At least now I have an idea so I wont be so shocked after the visit.

vikingbeast Im pretty sure its a group meeting on Thursday and afterwards its supposed to be a 1 on 1 visit with the Dr. But anything beyond that Im not sure of yet. I was hoping to schedule surgery first or second week of January but I may be over zealous for that date lol

waterwoman I was angry because I felt I was being told the obvious and I didnt like to face the truth I suppose. I knew and know finally that I must do something to get my food addiction under control. Im eating just to be eating Im not even sure its to comfort myself. I just eat because I like food period. So I have to overcome that way of thinking so I can try to undo years of bad habits in eating.

So here's to happy reading on this site to fill my mind with how all this works and hopefully Ill find even ground to be able to get the things I need to do done and schedule the surgery. I want to be able to be more active and shed this burdensome weight!

Thanks for all the comments its much appreciated ?

8 minutes ago, Crisscat said:

vikingbeast Im pretty sure its a group meeting on Thursday and afterwards its supposed to be a 1 on 1 visit with the Dr. But anything beyond that Im not sure of yet. I was hoping to schedule surgery first or second week of January but I may be over zealous for that date lol

I don't think that's overzealous at all. My surgeon scheduled about a month or six weeks out. That gives you a month to get everything done.

Requirements for surgery approval vary widely, as do the testing and evaluation appointments. Rushing or delaying isn't the issue here.

What I hear in your posts is a lot of anger and denial. Doctors see an issue and offer the options, they look at it logically and not emotionally. We all have emotional experiences related to our weight and doctors do not usually address it from that standpoint, especially surgeons. You do need emotional support, I suggest counseling to investigate your relationship with food, everyone that is obese has a distorted relationship with food. It is also physical, our body responds chemically to food, more sugar and starch = more cravings. You have to know why you want the surgery.

Try getting the book 'The Obesity Code' by Dr. Jason Fung. View his youtube videos, as well as Dr. Cwyes. This is a very intense journey that you need to be sure you want, it takes a lot of head work. Good luck.

Edited October 23, 20214 yr by Sosewsue61

Like everyone else said it varies. My insurance did not require anything. My doctor required:

1 pre-op nutrition meeting, 1 psych evaluation, EKG and Blood work, and because I have gastroparesis I had to have a MRI and X-ray.

I have now completed all that so we will be setting a date next week.

14 hours ago, Crisscat said:

ms.sss I guess I was angry and frustrated mainly because Im aware I am overweight and I suppose I just got tired of being told about my weight problem

Understandable. We are only ready when WE say we are ready, not when anyone else tells us so.

Success is better achieved when we are in the mindset to achieve it.

Good Luck! ❤️

16 hours ago, Crisscat said:

ms.sss I guess I was angry and frustrated mainly because Im aware I am overweight and I suppose I just got tired of being told about my weight problem or in the case of the Dr for the colonoscopy, that Dr just sent a referral without even talking to me about it.

I agree that just randomly issuing a referral without having discussed it with you is unusual and potentially annoying. My PCP was more like "You know, being overweight is hard on the body, have you considered weight loss surgery?" Only when I indicated that I was open to the idea did he send a referral. But then, my PCP doesn't send ANY kind of referral without talking to me first.

Just a follow up to the original post, I had my appt today. Pretty much aligns to what others were saying their requirements were.

I have support sessions I have to attend (3 of them)

Lab work, chest xray, cardiologist, an ED scope and meet with Psych & Dietitian. I have to be in the program for 3 months before surgery can be scheduled.

Everything else I have recently done so I was able to meet the rest of the requirements to the program.

Insurance wise I was pretty lucky, no strict guidelines. Seems pretty clear and straight forward.

No surgery date until well into 2022 though. They mentioned in our educational meeting today that surgeries

are backed up and no openings are left before the end of the year due to Covid restrictions.