UnityPoint Health - Trinity Weight Management Specialist - Moline

To be considered as a candidate for surgery, most insurance providers require that certain criteria be met. The following is a list of qualifications which may apply to you:

• BMI greater than 40.
• BMI of 35 to 39.9 with one or more obesity-related diseases or problems, also known as co-morbid conditions.
• Documented efforts at weight-loss through a medically safe, well-balanced diet.
• Absence of other medical conditions that would make surgery unsafe.
• A willingness to lose weight and make changes in your eating habits and physical activity.
• Must be willing to stop frequent eating and drinking of high-calorie foods and beverages.
• You must be evaluated by a psychologist trained in bariatric psychology.
• You must be willing to increase physical activity and exercise as weight loss occurs.
• A commitment to yourself and your surgeon to keep regularly scheduled appointments.

Learn more about Trinity's surgical weight loss solutions by attending one of its monthly seminars. Call (309) 779-4400 to find out when seminars are offered and to register.

The first step toward bariatric surgery is to complete our online seminar. If the patient meets the preliminary qualifications and is willing to proceed, an appointment is made to come into the office to begin the process. At this appointment, the surgeon and staff at the office will review your medical history and explain your weight loss options, including any guidelines set forth by your insurance company.

After all initial steps have been completed and surgery has been approved, Trinity Weight Management Specialists will coordinate the patient. Pre-surgical testing may include examination of the upper GI, a chest x-ray, EKG and lab work. The patient will also meet with the Bariatric RN and Bariatric Dietitian to complete pre-operative education and instruction.

We're able to choose from procedure options based on the patients need. Selecting the right option depends on the patient's condition, dietary habits and willingness to change eating behavior. This decision will be made together with the bariatric surgeon of your choice.

The decision to consider weight loss surgery is an important one. It's a lifetime contract with your surgeon, bariatric team, family and yourself. It is an important decision and we appreciate your interest in our program.

Our bariatric surgical team includes a dietitian, mental health professionals, nurses, nurse practitioner, insurance specialist, program administrator, surgeons and caring team members - all with many years' experience treating bariatric patients. We feel that expert care is only possible through this comprehensive team approach and we are committed to providing bariatric surgery in the safest manner possible.

A very important aspect of our program is patient education prior to surgery. Each patient will receive an individual evaluation to ensure that surgery is tailored to the patient's individual needs and goals. All patients in our program will receive dietary and exercise counseling specific to the issues associated with the change in their lifestyle after surgery. Patients will meet regularly with our dietitian or nutrition expert for help adjusting to their new lifestyle of healthy eating. Individual guidance about appropriate levels of exercise and intensity will be provided.

It is the beginning of a lifelong commitment to health. Dedication to proper diet, exercise and mental health is crucial to obtaining the best results. The surgery is a tool that improves the patient's ability to lose weight while following the recommended diet and exercise program as prescribed by the Bariatric Center multidisciplinary team. The Bariatric Surgical Program at UnityPoint Clinic® Surgery is a comprehensive program offering several important advantages for patients, including:

• A dedicated team of specialists who have many years' experience in caring for bariatric patients.
• Nutrition counseling to discuss the nutritional changes necessary for bariatric surgery.
• Exercise consultation will provide individual guidance about appropriate levels of exercise and intensity.
• Facilitation of quality care through immediate access to all areas of specialized physicians within UnityPoint Health - Trinity.
• Accessible, lifelong follow-up care.
• Follow-through with primary care physicians before and after surgery.

Contact your insurance to confirm weight loss surgery is a covered benefit under your policy. The number for customer service is on the back of your insurance card. We will need a copy of your insurance card both front and back. We will also call your insurance to find out the criteria for you to meet in order to be a candidate for surgery.

• Complete the FREE Surgical Weight Loss Seminar Online to obtain more information on our program.
• If you decide to join our program after watching this seminar, you will be asked to submit your information in an online form that is sent to our Bariatric Team. Our Experience Specialists will contact you to set up your first appointment with the surgeon as well as collect your insurance information so that we may check your benefits and requirements. This ensures that your first appointment is informative and meaningful. If you have had prior weight loss or bariatric surgery, please call (309) 779-4400. There is a separate process.
• At the appointment, you will review your weight loss options with the bariatric surgeon and determine the next most appropriate step for your weight loss journey. If the choice is to pursue bariatric surgery, we will collect the one-time $200 program fee. This fee covers printed materials and dietitian appointments.
• You will also need to participate in a visit with our registered dietitian to go over diet choices and food labels. The Weight Management Specialists team is dedicated to helping you learn more about healthy eating habits and reading labels. Our team will work with you to schedule this at your initial appointment.
• Most insurance companies require certain evaluations to ensure your success after bariatric surgery. This can include cardiovascular, pulmonology, and psychiatric evaluation. These appointments will be scheduled by the bariatric nurse during your first visit.
• Depending upon your insurance requirement, we may provide a form for a provider to fill out each month for six months up until the time of surgery to monitor your weight loss progress. Documentation will need to include specific diet and exercise plans. Trinity Weight Management Specialists require you to be weight stable and not increase your weight during this six month period.
• You may also be required by your insurance company to obtain a Letter of Medical Necessity from your family practice doctor stating support of your decision to have surgery and health related problems from morbid obesity. If you currently do not have a primary care physician, our office will be happy to refer you to one.
• Once all information is collected and approval from the Weight Management Specialists team is given we will submit your information to you insurance company for approval. The approval process may take two to six weeks.
• If surgery is approved your surgery will be scheduled. Two weeks prior to surgery you will come in for pre-surgical testing: labs and x-rays, nutritional instruction with a registered dietitian, and preoperative education.
• Trinity encourages surgical weight loss patients to work with a physical therapist on an exercise program specific for the patient's needs.
• Trinity's Weight Management Specialists surgical weight loss encourages you to meet for counseling with a psychologist one month and two months post-operative for support on your weight loss journey.

Congratulations! This is just a beginning of a new life for you!

You will start losing weight immediately after surgery. You may not notice any loss until the second week. The weight loss after each surgery occurs at a different rate. Each patient also will have a different weight loss rate dependent upon their adherence to the program and level of physical activity. A minimum rate of 1 to 2 pounds per week is minimally expected.

With any weight loss surgery, weight loss typically continues for two years and then plateaus. It is very important that you follow the instructions given to you by the dietitian on how and what to eat. Failure to follow the recommended diet and exercise program will result in weight gain with any weight loss surgery.

It is unusual for a person to become too thin after weight loss surgery surgery. These procedures allow you to ingest and absorb a sufficient amount of nourishment so you do not become too thin.

Morbidly obese patients are at a higher risk when having any surgery due to their excess weight. Often the patient may feel normal prior to surgery, but may have underlying medical problems that they simply did not recognize. Long term poor nutrition that has led to morbid obesity often leads to poor heart and lung health.

Long-term complications include hair loss, dumping syndrome, diarrhea, vomiting, ulcers, bile gastritis, hernias, foreign body reaction, infection and virtually any other post-operative problem. Fortunately, these reactions are not common.

Some patients develop severe difficulties in coping with their weight loss. These difficulties may include depression, separation from spouse, divorce and even suicide gestures or actual suicide. Generally the person who is well-adjusted and is helped through the procedure with a strong support system has a better outlook for a good recovery. On the other hand, a person with mental health difficulties pre-operatively may continue to have them post-operatively and they may even worsen.

Our team is committed to making your surgery as safe as possible. Advancements in the care of surgical weight loss patients over the past 20 years have allowed us to perform these surgeries with very low complication rates. Your personal risks will be individually evaluated at your consultation with your surgeon. It is important to remember that the risks of staying morbidly obese far outweigh the risks of surgery.

In the Roux-en-Y gastric bypass, the rest of the stomach is sectioned off from the new pouch but left intact. It still has a blood supply and drains any small amount of fluid through the small intestine, or duodenum. Because it is not used, it shrinks in size and stays dormant.

In the sleeve gastrectomy, approximately 75% of the stomach is permanently removed leaving a smaller banana shaped stomach that holds approximately ½ cup of food per meal.

We suggest that you wait for at least 18 months after surgery to have a child. Even after that, you must make sure that your obstetrician is aware of your weight loss surgery and that you and your baby should be followed closely.

After much weight loss, you may find yourself with excess skin. Some people find the excess skin a nuisance or unappealing. Weight loss after surgery continues for about 18 to 24 months. After that, your body is ready for additional surgery for excess skin removal. This is typically performed by a plastic surgeon, who will evaluate you and decide with you what areas may need work. This cosmetic surgery may not be covered by insurance. Documentation of health problems related to the excess skin may be required. These may include rashes, back pain, or difficulty maintaining reasonable hygiene.

You will have a 10 to 20 pound weight restriction for 2 weeks following surgery. We encourage you to exercise as soon as you feel ready, and this can be as early as one week. Some people have returned to work on the fourth day after surgery. However, most patients find that they need one or two weeks before going back to work. You may feel tired during the first week, but you will feel more energetic as you lose weight.

You will need to call the number on your insurance card and ask if you have obesity surgery coverage. Trinity Weight Management Specialists will contact your insurance for verification of benefits for the surgery only.

We have several non-surgical weight loss options available.

1. Educational Seminar
   
   
2. Initial consultation with Registered Nurse/Insurance Specialist
   i. Health History Review
   ii. H. Pylori testing
   iii. Finance & Insurance review
   iv. Measurements & goal setting, Lab Work
   
   
3. Group Dietician
   
   
4. Cardiac clearance
   
   
5. Pulmonary clearance
   
   
6. Support Group Meeting
   
   
7. Pre-Op Dietary Counseling
   i. Visit one
   ii. Visit two
   iii. Additional visits as needed
   
   
8. Program approval - Multidisciplinary meeting monthly
   
   
9. Consultation with Surgeon
   
   
10. Insurance approval and surgery scheduled
    
    
11. Pre-surgical teaching appointment (2 weeks prior to surgery)
    i. Pre-op testing
    
    
12. Office visit prior to surgery with Surgeon (within 30 days of surgery date)
    
    
13. Surgery (Current block Wednesday AM)
    
    
14. Surgical follow-up visits (NP or Surgeon)
    i. 2 and 6 weeks
    ii. 3, 6, 9, and 12 months (dependent upon progress & surgery type)
    iii. Yearly and as needed
    
    
15. Post-op Dietary Counseling at follow-up visits
    i. 2 and 6 weeks
    ii. 3, 6, 9, and 12 months
    iii. Yearly and as needed
    
    
16. Vitamin Levels & Labs at follow-up visits
    i. 3, 6, and 12 months
    ii. Yearly and as needed
    
    
17. Psychiatric follow up at 5 and 10 weeks and as needed
    
    
18. Monthly support group
    
    
19. Monthly walk-in weigh-ins during office hours