One day a rather large biker came into my office. He was six feet tall and weighed over four hundred pounds. He had never been on a diet in his life. He had never even thought about losing some pounds until his bike needed some repair and another biker pointed out the dent he was making in his bike seat. When he came to see me, he didn’t even know that an operation was an option. He had to wait for his procedure, however, until he had been on a physician-supervised diet for six months.

Some people are super organized, save a copy of every diet they have ever been on—with physician supervision and without—and they know how many pounds they lost and how many they regained. Such individuals are rare. As difficult as it may be, put your diet history together. It will be helpful to your bariatric surgeons as they approach the insurance company.

Remember, your obesity is not a personal failure, it is not lack of willpower. It is simply a matter of your biology not working in your favor. Weight loss surgery is a way of getting your inner biology to work for you.

Results Not Typical

Disclaimer seen underneath most diet advertisements

About every fourth infomercial is about some diet program showing a very attractive person who has lost 60, 80, or 100 pounds. However, look at the bottom of the screen—”results not typical.” My favorite involves one of my employees. Mary is a very attractive woman who had settled into a routine of eating out and cleaning her plate. A few extra pounds crept on—not enough to warrant weight loss surgery, just enough to be concerned, so she went into this rather expensive diet program. She lost the pounds and the sponsors of the diet program liked her so much they used her for one of their commercials. One day I was sitting in the doctor’s lounge, getting ready to do some weight loss surgery when I looked up at the television and saw my employee in this ad—now that was a bit of irony.

I always enjoy seeing those commercials. Usually you see a person jogging on a beach and telling the world how this drink, diet program, or device made them into the slim person they are now. Again, these results are not typical, but the commercials generate income from people hoping it will work for them.

Compliance with your gastric sleeve or Lap-band surgeon’s program

Compliance means that you, the bariatric patient, will do what your weight loss doctors ask you to do. If you do that, you have the optimal chance for success with the procedure. Compliance is almost impossible to measure pre-op. I ask weight loss surgery patients to sign a contract with me. In it, they agree to come to bariatric support groups, stop smoking, and do a number of healthy things. Some insurance companies want an indication that a patient will be compliant following weight loss surgery, but this is, at best a guess. Ask any bariatric surgeon—we are surprised at how well some weight loss surgery patients comply and how others buy donuts at the corner store on the way home from the hospital. There are always bariatric patients who will not be compliant even though they know the risk of harming themselves is staggering.