You’re overweight and want to live a healthier life. Does that automatically make you a good candidate for gastric sleeve surgery? To a surgeon who has your best interests, your safety, and your long-term success in mind, the answer is “no.” To be considered an ideal patient at Endobariatric, I look at a number of important areas.
Have you tried other weight loss methods?
Surgery should never be the first course of treatment for obesity. Most people have, in fact, tried the traditionally prescribed diet-and-exercise routes for years with little to no success. Some of our patients have also tried prescription medications for weight loss without meaningful results. But if they haven’t attempted other avenues and are hoping that gastric sleeve will be a “quick fix,” they’re not a good candidate for the procedure.
Don’t worry that if you’ve tried—and failed—at other methods that it will be held against you. Few overweight and obese individuals realize that science backs what they already know: It doesn’t work for everyone. In particular, diet and exercise alone hasn’t proven to be a good option for morbidly obese people.
Are you ready for what comes next?
My team and I thoroughly educate patients about what their new life will look like as part of the evaluation process. Because the reality is that gastric sleeve isn’t a magic pill. It requires major lifestyle changes that you must sustain over the course of your lifetime if you want to maintain a healthier body.
What kind of changes are required? The most difficult for most people is diet. The post-op diet I recommend is largely based around protein; 70 to 75 percent of a patient’s calories, in fact, should come from protein in the form of eggs, fish, tofu, and/or lean meats. Non-starchy veggies should account for much of the rest of your calories. Know what doesn’t make the list? Many carbohydrates, especially bread, pasta, sugar, and many other foods you probably love. Are you willing to overhaul your diet in that way? Believe me, we’ll talk about it a lot!
Exercise is also a big part of the lifestyle. Once you’re cleared for it, I recommend swimming, bicycling, walking, and/or weight lifting most days of the week.
Is your weight right?
This one sounds odd, but you have to be in the “goldilocks” range in order to be an ideal candidate for sleeve surgery. My patients need a BMI (Body Mass Index) above 40 or between 30 and 40 in the presence of associated diseases that may improve with weight loss. High blood pressure, diabetes, sleep apnea, painful joint conditions, and arthritis are a few examples of those diseases. On the other hand, surgery on very obese people is trickier for a long list of reasons, including the risks associated with fatty liver (“hepatic steatosis” in medical terms). There’s a direct relationship between the patient’s weight and his or her liver size. This means that the heavier the patient is, the bigger the liver grows. Operating on a very enlarged liver decreases the chance of success, as surgeons wouldn’t be able to visualize the patient’s anatomy well during the procedure.
That’s why I prescribe a pre-op diet designed to decrease the patient’s BMI and, thus, prep the liver for surgery. Patients with a BMI over 47 are required to follow the 800- to 1,000-calorie diet for 14 days, with the length decreasing as the BMI decreases. Patients with a BMI lower than 35 aren’t required to diet at all.
What doesn’t impact your candidacy?
There are some other factors—I won’t operate on patients who are alcohol- or drug-dependent, and they must have been overweight for more than five years—but these are the big ones. So what isn’t usually part of the equation? Age, for one. Our youngest patient was twelve at the time of surgery, and our oldest patient was 74. In general, I prefer that patients be at least 14 and under 65, but I consider everything on a case-by-case basis. The other thing you don’t have to worry about is whether you have insurance. Most U.S.-based carriers don’t cover surgery outside the country anyway. And because our hospital is just over the Texas border in Mexico, we’re able to provide a world-class gastric sleeve procedure for $8,900. Thanks to the reasonable price and payment plans, cost isn’t usually a factor for our patients.
Ready to explore whether you’re a good candidate for gastric sleeve surgery at Endobariatric? Get in touch with our team today!
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“Changing lives…one sleeve at a time”.
