What To Expect Before Your Procedure

Four convenient clinic locations: Honolulu, West O`ahu, Kona, Hilo.

Pre-Bariatric Surgery Evaluation and Education

Each patient has an extensive medical, nutrition, and psychological evaluation by our multidisciplinary team of professionals.  The team works closely with patients to assist them in making the necessary lifestyle and behavioral changes to be successful with a surgical approach to weight loss.

  • The initial consultation/evaluation visit includes back-to-back appointments with the bariatrician, dietitian, and psychologist as well as psychological testing and a functional assessment with the physical therapist.
  • The nutrition evaluation assesses the patient’s current nutrition knowledge and eating habits. Nutrition education teaches skills that allow the patient to make healthier food choices to achieve a balanced diet. Education covers basic food groups, portion control, label reading, and the post-op diet. This includes the types of foods that will not be tolerated after surgery and must be eliminated from their diet.  Most patients will be able to complete this education in 3 pre-op visits with the dietitian.
  • The psychological evaluation includes psychological testing. The psychologist determines whether there are any psychological or social issues that would preclude the patient from being an appropriate surgical candidate. The psychologist also utilizes cognitive behavioral therapy to assist the patient in gaining insight into their eating patterns and coping mechanisms, and facilitate and reinforce positive behavior change.
  • The physical therapist conducts a functional assessment and determines the patient’s ability to participate in an exercise program. Recommendations are made for physical or aqua therapy when appropriate. All patients must be able to walk 5,000 steps a day, or perform an equitable alternative exercise (e.g.) water based exercise, prior to surgery.
  • The bariatrician provides oversight of the patient’s pre-op treatment plan and medically supervised exercise program. He/she will work together with you on your patient’s’ obesity-related medical issues to optimize the patient for anesthesia and surgery.
    • Initial laboratory screening tests include: complete blood count, comprehensive metabolic profile, lipid profile, HA1C, thyroid stimulating hormone, ferritin and iron studies, vitamin D and parathyroid hormone, Nicotine and drug screen as indicated, and H-Pylori as indicated
    • The American College of Sports Medicine Cardiac Screening criteria are utilized to determine cardiac risk and recommended cardiac studies.
    • Epworth Sleepiness Scale is utilized to screen for possible Obstructive Sleep Apnea and the need for a sleep study.
    • Consultation is requested as needed from Cardiologist, Pulmonologist, Oncologist, Neurologist, Endocrinologist, etc.
  • Consultation with one of our bariatric surgeons is scheduled after the patient has completed the pre-op evaluation and education program.
  • Pre-operative work-up includes: Chest X-ray and EKG, Complete blood count with platelets,  Comprehensive metabolic profile (fasting), HA1C (if diabetic), Urine HcG (for child-bearing women), pre-op visit with the bariatrician for preoperative History and Physical examination, and a pre-op visit with the surgeon to sign consent forms.

Following your weight loss surgery, you can expect to lose a lot of weight.  In addition, other weight-related medical conditions will likely improve. It is important to note that surgery is not a quick fix. Whatever type of surgery you have, weight reduction will be gradual, and you will be required to make lifelong changes in your lifestyle and diet to remain successful. You will have frequent medical checkups to monitor your health in the first several months after weight loss surgery; these may include laboratory testing, blood work and various exams. Long-term follow-up is essential to maintaining your outcomes.