Are You a Candidate for Weight Loss Surgery?

• Our program is for patients over the age of 16 and under the age of 63.
• In accordance with the National Institutes of Health Consensus Panel, patients must have morbid obesity with a BMI of 40 kg/m or BMI > 35 and obesity-affected medical problem(s):
• Diabetes requiring medication
• Hypertension requiring medication to control
• High cholesterol or high lipid levels
• Sleep apnea, obesity hyperventilation syndrome or other respiratory problems
• Joint problems related to obesity
• Skin breakdown
• Fluid retention
• Must have failed to lose and maintain weight loss on supervised weight reduction program. Some health insurance companies have specific requirements for documentation and what medical management must have been tried.  For Aetna patients, as an example, a current regulation is that they have six months of physician supervised weight loss with in two years. This must include weighing and visiting with a nutritionist.
• Specific authorization from the insurance company must be obtained before surgery can be scheduled. Some plans specifically exclude obesity surgery. Others are very resistant to granting authorization and have numerous requirements for consultation that must be met.
• Must not have contraindications to surgery:
• Other correctable causes of obesity discovered during work-up
• Unacceptable surgical risk due to complication medical conditions
• Psychological instability
• Lack of social support mechanisms (stable family, etc.)
• Unable to understand and/or accept the risks of surgery (short/long term)
• Unable to discontinue smoking
• Unable to discontinue sweets, high caloric liquids (soda pop)
• Unable/unwilling to comply with follow-up regimen
• Must agree to participate fully and responsibly in the program, including prolonged follow-up, and to quit smoking permanently.

The Start of the Process:

The process starts with a seminar, where Dr. Simpson explains weight loss surgery and the risks and benefits of the surgery. Once that free seminar is finished, then patients get to think if this is the route they wish to take. Click here to see our current schedule. While most come with the thought that this is what they want, and want to have the surgery the following day, there are some hesitations.

The second way is to purchase the book by Dr. Simpson – which goes through some of the information in the seminar. We find this useful for patients who are from out of town or who have a busy schedule. If you email us we will send you a special promotional code to get the book at a discount, or you can pick it up from our office at a discount.

The Second Visit:

If, after the seminar, you wish to continue in the process, an appointment will be scheduled for you to see Dr. Simpson. During this process patients will have their insurance companies checked to see their specific insurance requirements. Following this you will be enrolled in our weight-loss program. The program fee is not covered by insurance. The program fee for the lap band is $650. For self-pay patients the program fee is included in the total surgery cost, but is due up front. We feel that pre operative education is critical to the success of our program. The program fee is non-refundable. In the event that your insurance company denies coverage, we will apply the program fee to the cash price for the surgery. If a patient decides to not have the surgery, and has not gone through the program, the fee, minus $250, will be refunded.

For patients who pay cash for the procedure, the actual cost is determined when you pay for the procedure, at which time we will also schedule your surgery date. We negotiate with the hospital, anesthesia, and others to fix their price. Currently the cost is about $16,500 and includes the hospital fee, surgeons fee, anesthesiologist, and first assistant's fee. These fees are subject to change (such as the recent increase in the cost of the lap-band from Inamed). For patients who pay cash be aware that if fills can be done in the office, the cost of fills are covered for the first year.

What you can do to get ready for the process:

Get a list of all the weight loss plans you have been on: Atkins, Weight Watchers, Jenny Craig. Some of these programs have kept records and these would be helpful.

If you have not been in a physician supervised weight loss program, then begin a formal one with your primary care physician. Make certain that this includes a visit with a nutritionist, as well as weigh-ins. Keep a record of any prescriptions given to you for weight loss.

If you have been in a physician supervised weight loss program, have your primary care physician draft a letter attesting to such. If this included the use of prescriptions (which is not a requirement) make certain this is included in the letter.

Your Primary Care Doctor:

Your primary care physician (PCP) is critical in the process. They must be behind you, and willing to follow you with necessary blood work as time goes on. If your primary care physician is unfamiliar with the procedures have them visit our website, or get a copy of Dr. Simpson’s book. In Dr. Simpson’s book is a chapter for primary care physicians, what laboratory values they need to order for their patients, and the various surgeries which are done for weight loss surgery.