We accept most insurances and have a cash pay option available for those who may not have coverage through their insurance company. We have a financial counselor who will work with you and your insurance company throughout every step of the surgery process. We’ll review your insurance policy to identify what we need to do to get your weight loss surgery financed in the most efficient way possible.
Gastric sleeve surgery, also known as sleeve gastrectomy or bariatric surgery, is a procedure aimed at helping individuals with severe obesity achieve sustainable weight loss. However, like any major surgery, there are important requirements and considerations to ensure that it is a safe and effective option for you. If you're contemplating this surgery, you must undergo a comprehensive evaluation. This evaluation is crucial for determining whether gastric sleeve surgery is suitable for your situation, given the potential risks involved.
General Eligibility Criteria
While insurance requirements may vary, to be considered for gastric sleeve surgery, you generally need to meet the following criteria:
Severe Obesity: You must have a Body Mass Index (BMI) of 40 or higher, indicating Class III obesity. Alternatively, you may qualify if your BMI is between 35 and 40 and you have related health conditions, such as type 2 diabetes, high blood pressure, or severe sleep apnea. In some cases, individuals with a BMI of 30 to 34 may also qualify if they have serious weight-related medical conditions.
Previous Weight Loss Attempts: You must have made genuine efforts to lose weight before considering surgery. This typically involves having participated in medically supervised weight loss programs. You may need to complete three to six months of such a program as a prerequisite for insurance coverage.
Age Requirements: Candidates must usually be between 18 and 65 years of age. This age range is considered optimal for the risks and benefits associated with the surgery.
Mental and Physical Preparedness: Being mentally and physically prepared for surgery is critical. This means you should be ready to make significant lifestyle changes, including alterations in diet and exercise habits. Before surgery, you'll consult with a team of healthcare professionals, including dietitians and psychologists, who will evaluate your readiness and provide necessary counseling.
Commitment to Lifestyle Changes: Gastric sleeve surgery is not a standalone solution; it requires a commitment to lifelong lifestyle changes. You must be willing to engage in ongoing follow-up care that focuses on monitoring nutrition and medical conditions.
Absence of High-Risk Medical Conditions: You must not have medical conditions that would increase the risks associated with anesthesia or surgery. Common conditions that could pose a risk include uncontrolled diabetes or severe cardiovascular issues.
Specific Requirements
To provide a more detailed picture, here are specific requirements you may need to fulfill:
Nicotine and Substance Use: You must be nicotine-free and free from substance abuse. Some insurance companies require testing for drugs and alcohol as part of their approval process.
Psychosocial Evaluation: You will undergo a psychosocial-behavioral evaluation within 12 months before the surgery. This evaluation will assess your mental health history, eating behaviors, and readiness to change.
Medical History and Examination: A comprehensive medical history and physical examination must be completed within six months of your approval request. This includes documentation of any prior weight loss attempts, current medications, and any obesity-related conditions.
Commitment to Avoid Pregnancy: You must avoid pregnancy before the surgery and for at least 18 months afterward to ensure both your health and the health of your baby.
Comorbid Conditions: If you have obesity-related medical conditions, such as sleep apnea or high blood pressure, these must be documented, and their management should be optimized before surgery. This could involve consultations with specialists, such as cardiologists or pulmonologists.
Gastric sleeve surgery can be a life-changing option for those struggling with Class III obesity. However, it's essential to understand the extensive requirements and commit to the necessary lifestyle changes. A successful outcome depends not just on the surgery itself but also on your willingness to embrace a healthier way of living. Always consult your healthcare provider for personalized advice and guidance tailored to your unique circumstances.
Nearly 5% of the U.S. population meet the criteria for weight loss surgery, including those with a BMI (body mass index) of 40 or greater and those with a BMI of 35 or greater with severe health complications.
Millions of Americans have found that diet, exercise and medications alone are not sufficient to lose their excess weight. Years of failed dieting and weight gain and loss often change a person’s metabolism, making it more difficult to lose weight and keep it off.
Based on your insurance and our program requirements, we will let you know from the start whether you are a candidate for surgery.
Choosing your weight loss surgery surgeon is one of the most important decisions you can make in your journey to decide if surgery is right for you. The process can seem daunting. Don’t be afraid to ask questions about your provider's practice and experience, your life post-surgery, and anything else you’re concerned about. At Iowa Weight Loss Specialists, we’re here to address your concerns to ensure you are comfortable and confident with your decision.
Our dedicated bariatric surgeon, Dr. Todd Eibes, received his medical degree from the University of Iowa Carver College of Medicine, training with Dr. Ed Mason who is considered one of the founding fathers of Bariatric surgery. An accomplished doctor for over 20 years, Dr. Eibes began performing bariatric surgery in 2001.
Dr. Eibes has performed over 500 gastric bypasses, 650 lap-bands, and over 2,800 sleeve gastrectomies. Dr. Eibes’ patients typically lose 60-70% of excess weight after surgery with hard work and ongoing support from our weight management team. Dr. Eibes’ risk for major complications fall within the national average of 1-2% occurrence rate.
There are three major weight loss surgeries available today: the Gastric Sleeve, the Lap-Band, and the Gastric Bypass.
Iowa Weight Loss Specialists performs the Gastric Sleeve on our patients, because we believe the advantages of the surgery are greater than any of the other options and the downsides are far less. The risk of major post-operative complications with the Gastric Sleeve are less than any other weight loss surgery.
Please click on each link below to review the list of pros and cons of each procedure.
For many people with type 2 diabetes, weight loss surgery can dramatically improve blood sugar control. Here’s how:
Significant Weight Loss
Most patients lose a large amount of weight after surgery, which can improve insulin sensitivity and help manage blood sugar levels.
Hormonal Changes
The surgery alters gut hormones, increasing hormones like GLP-1 that help with insulin production and improving how your body uses glucose.
Rapid Improvement
Patients often notice better blood sugar control soon after surgery, sometimes even before losing significant weight.
Diabetes Remission
Many individuals can achieve remission, meaning they no longer need diabetes medications after surgery.
How Does Weight Loss Surgery Work?
Weight loss surgery is typically recommended for individuals who are severely overweight and have not had success with lifestyle changes like diet and exercise. If you have type 2 diabetes and your weight is affecting your health, you may be a candidate. It’s essential to discuss your situation with a healthcare professional to determine the best option for you.
The surgery works by:
Reducing stomach size: This limits food intake, making your stomach feel full more quickly.
Changing how nutrients are absorbed: It decreases the number of calories your body can absorb.
Altering gut hormones: This leads to better insulin sensitivity and more stable blood sugar levels.
Is Weight Loss Surgery a Permanent Cure for Diabetes?
While weight loss surgery can lead to significant improvements and even diabetes remission, it’s not always a permanent cure. Patients must maintain a healthy lifestyle after surgery. If weight is regained, diabetes symptoms may return, and medication might be needed again. However, many patients experience long-term success by making lifestyle changes.
How Quickly Can I Expect to See Blood Sugar Level Improvements?
Many patients notice improvements in their blood sugar levels soon after surgery. In fact, some see changes within days or weeks, even before losing a lot of weight. This can lead to a reduced need for diabetes medications shortly after the procedure.
Many people know that obesity can lead to chronic health issues like heart disease and diabetes, but fewer realize it can significantly affect fertility. Maintaining a healthy weight is crucial for women looking to conceive. Being overweight or obese can disrupt hormonal balance and interfere with ovulation, making it harder to get pregnant.
Excess weight affects hormones
Excess weight can lead to hormonal imbalances, particularly in women. Fat cells produce estrogen, and as body weight increases, so does estrogen production. An excess of estrogen can disrupt the hormonal signals that regulate the menstrual cycle, which may lead to irregular ovulation or even prevent ovulation entirely. This means that even if you are ovulating, the quality of your eggs might be affected.
The Effects of Being Overweight During Ovulation
Ovulation is crucial for conception. Studies show that women with a Body Mass Index (BMI) above 27 are three times more likely to experience anovulation, where no egg is released. If you are overweight, your chances of conceiving can significantly decrease. Weight loss has been shown to improve fertility in obese women.
Additional Benefits of Weight Loss Before Pregnancy
Significant weight loss before pregnancy can reduce the risk of serious complications, such as gestational diabetes and hypertensive disorders like preeclampsia. For women with conditions like Polycystic Ovary Syndrome (PCOS), weight loss can also alleviate symptoms and improve fertility.
How Does Obesity Affect Pregnancy Loss Rates?
Being overweight not only makes it harder to conceive but also increases the risk of miscarriage. Studies have shown that obese women face higher rates of pregnancy loss, which can be emotionally devastating for couples trying to start a family.
Weight and IVF Fertility Treatments
If you are considering fertility treatments such as in-vitro fertilization (IVF), it’s important to know that excess weight can lower success rates. Research indicates that women with a higher BMI may have lower chances of achieving a live birth through IVF.
How Does Insulin Resistance Affect Fertility?
Excess weight can lead to insulin resistance, where the body struggles to manage blood sugar levels. This condition can further disrupt hormone levels and lead to issues like PCOS, which is a common cause of infertility characterized by irregular periods, obesity, and elevated male hormones.
How Much Weight Loss is Needed to Improve Fertility?
Even a modest amount of weight loss can enhance fertility. Losing 5-10% of your body weight can help restore hormonal balance, regulate ovulation, and improve egg quality.
For more information watch the YouTube video below.
Many women elect to have a Gastric Sleeve, because their obesity is preventing them from getting pregnant. You may become more fertile as you lose weight. Often, your obesity causes abnormal estrogen levels that can return to normal as you lose weight.
It’s important that you wait until it’s safe for you to be pregnant after your surgery. Your birth control pills may not work around the time of your surgery due to the medication you receive with surgery. Remember to use other methods of birth control (barrier contraceptive) and talk with your family physician about this.
You should avoid pregnancy for the first 12 months after surgery due to your rapid weight loss. A pregnancy that occurs soon after weight loss surgery can have severe consequences for both the mother and the baby. Once you are over a year, your risks during pregnancy fall to significantly less than when you were morbidly obese. Your risk of gestational diabetes and preeclampsia are much lower than when you were morbidly obese. If you require a C-section during the delivery, the surgical risk is significantly less once you lose your excess weight.
An advantage of the Gastric Sleeve is that you continue to absorb nutrients normally, so your risk of vitamin deficiency is much less than with a gastric bypass. When all factors are considered, once you have your Sleeve and you have time to get your weight under control, your fertility increases and pregnancy becomes much safer for both mother and baby.
However, please do take the following precautions:
Pay attention to overall nutrition during first trimester
Talk to high-risk OB/GYN for monitoring during pregnancy
Check homocystein levels (Neural tube defects can occur from folic acid deficiency)
Limit daily intake of Vitamin A to no more than 10,000 IU/day (Fetal malformations have been linked to daily exposure of 20,000 IU of Vitamin A from supplements)
If you struggle with sleep apnea and are overweight, you are not alone. Morbid obesity can cause sleep apnea and other respiratory problems that may result in chronic fatigue.
Obesity is one of the most important factors for the development of sleep apnea, which is when breathing suddenly stops because soft tissue in the back of the throat collapses and closes during sleep.
Studies have shown that weight loss surgery is an effective tool for treating obesity, and for preventing, treating and even resolving sleep apnea.
By losing just 10% of your body weight, you can decrease your risk of developing sleep apnea by over 25%.
Successful bariatric surgery is associated with the improvement or complete resolution of obstructive sleep apnea. Individuals that have had weight loss surgery report significant reductions in snoring and daytime sleepiness. Many individuals who had to use a CPAP before surgery do not require it months after their weight loss procedure.
Depression and anxiety are common among morbidly obese patients who have weight loss surgery. In a 2011 study, Jonathan Finks, an assistant professor of surgery of University Michigan and his co-authors observed that 46% of the patients receiving weight loss surgery had a psychiatric disorder.
They examined data from the Michigan Bariatric Surgery Collaborative that contains data of more than 26,000 patients who have undergone weight loss surgery since 2006. The surgeries included gastric bypass, gastric sleeve, gastric banding, and the duodenal switch (similar to gastric bypass, but keeps some stomach and passes most of the intestine).
Before the surgery, 72% of patients with depression used antidepressants. A year after bariatric surgery, the percentage of people taking antidepressants dropped to 60%. Finks added that the percentage of people responding to the surveys a year later dropped to just 31%.
While weight loss alone can’t cure clinical depression, most post-surgical patients do report a significant improvement in their mood and outlook on life.
According to the Arthritis Association, studies have shown that even a modest amount of weight loss can have a significant effect on osteoarthritis pain for individuals who are overweight. Osteoarthritis pain is characterized by pain at the knee on beginning motion, such as arising from a chair, and increased pain with prolonged use.
In the early stages of osteoarthritis, the pain is relieved by rest. As the disease progresses, the pain can persist after activity and even interfere with sleep.
Weight loss surgery reduces knee pain in obese people, and the results are similar to those seen in patients who have had a knee replacement, according to a 2014 study.
The study included 20 obese patients who had weight-loss surgery and 40 patients who had total knee replacement due to arthritis. One year after their procedure, the patients who had weight loss surgery reported significant improvements in knee pain. Their results were comparable to the patients who had a knee replacement.
Class III obesity is a serious medical condition where a person's weight is significantly higher than normal. Healthcare providers use Body Mass Index (BMI) to determine obesity levels. A BMI of 40 or higher indicates morbid obesity, while a BMI of 35 or higher can also qualify if there are related health complications.
Understanding BMI
Body Mass Index (BMI) is a calculation based on your height and weight. It helps categorize individuals into different weight classes. A BMI of 40 or more is classified as Class III obese, meaning that the individual has an increased risk of serious health issues. BMI is a useful tool, but it's important to remember that it doesn't capture all aspects of health.
Health Risks Associated with Class III Obesity
Class III obesity may significantly raise the risk of several serious health problems, including:
Type 2 Diabetes: Excess weight can lead to insulin resistance, a key factor in developing type 2 diabetes.
Heart Disease: Obesity can increase the likelihood of heart conditions, including heart attacks, congestive heart failure, and strokes.
Sleep Apnea: This condition, often associated with obesity, causes breathing to stop and start during sleep.
Certain Types of Cancer: Being Class III obese is linked to an increased risk of various cancers, including breast, colon, and uterine cancer.
High Blood Pressure: Extra weight strains the heart, leading to hypertension.
Osteoarthritis: Excess weight can lead to joint pain and deterioration, particularly in weight-bearing joints like the knees and hips.
Gastroesophageal Reflux Disease (GERD): Obesity can worsen acid reflux and heartburn.
Infertility: Obesity can impact hormonal balance, affecting fertility in both men and women.
Impact on Life Expectancy
Individuals who are Class III obese may have a reduced life expectancy. Studies suggest that they can live up to 14 years less than those who are at a normal weight. This reduction in life span highlights the critical nature of addressing morbid obesity.
Physical Limitations
Class III obesity can severely limit mobility. Everyday activities, such as walking, climbing stairs, or even playing with children, can become challenging. This physical limitation can lead to a more sedentary lifestyle, which causes additional health issues.
Additional Assessment Tools
Healthcare providers often use other measurements to assess obesity. One such tool is waist circumference. For women, a waist size greater than 35 inches and for men, a waist size over 40 inches indicates a higher risk for health problems related to obesity. This measurement complements BMI and provides additional insight into an individual’s health.
Managing Morbid Obesity
The good news is that Class III obesity is manageable and treatable. Along with lifestyle changes, bariatric surgery has emerged as a safe and effective method for meaningful weight loss. Many patients experience improvement or even resolution of obesity-related medical conditions after undergoing surgery.
Take the First Step, Seek Treatment
Understanding Class III obesity is crucial for addressing this significant health issue. It’s essential to recognize that Class III obesity is not just a personal failing; it is a complex medical condition that requires comprehensive treatment, lifestyle changes, and support. Overcoming the stigma and adopting effective management strategies will improve health outcomes and quality of life.
Your timeline for surgery will all depend on your insurance requirements, as well as your compliance with program requirements. The number of required supervised diet visits varies based on individual insurance policy. Your participation in supervised diet visits and progress toward goals set by our providers is critical to moving forward in the surgery process.
On average, most patients return to work in 2-3 weeks. You may need more time off if you have a strenuous, physical job like a firefighter or construction worker.
How long you will be off work after surgery is mostly determined by how weak and tired you feel. Your calories will be limited, plus you will be healing from a big surgery. The patients who don’t push their recovery find they have the fewest issues and challenges and actually get back to work the quickest.
Patients absolutely cannot return to work if still requiring medications that impact alertness and decision making.
As with any surgery, there can be immediate and long-term complications and risks. Over the last 20 years, we have found that weight loss surgery has become increasingly safe. When you look at the diseases that most patients live with such as diabetes, heart disease, renal problems, and sleep apnea, it’s by far safer now to have surgery than to live with these medical problems.
Possible risks can include, but are not limited to:
Bleeding
Complications due to anesthesia and medications
Deep vein thrombosis
Dehiscence (separation of areas that are stitched or stapled together)
Infections
Leaks from staple lines
Marginal ulcers
Pulmonary problems
Spleen injury
Stenosis (narrowing of a passage, such as a valve)
Due to experiencing significant weight loss over a relatively short period of time, bariatric surgery patients are often left with excessive amounts of hanging skin. This excess skin can create a multitude of problems such as daily hygiene concerns and finding clothes that fit properly.
Reconstructive surgery is not required after a weight loss procedure; however, many patients begin to consider it as their health improves. We recommend waiting at least 12-18 months after gastric sleeve surgery to consider reconstructive surgery.
Patients typically can expect to lose 50-70% of their excess weight. However, this can depend on patient factors such as starting weight, age, and post-surgical lifestyle adjustments.
While some patients do regain some of the weight lost after bariatric surgery, we strive to prevent this by offering comprehensive weight loss services. From medical weight management (such as behavioral health support) to patient support groups and community resources, we’re here ensure you achieve and maintain your weight loss goals.
During the Gastric Sleeve procedure, a bariatric surgeon removes approximately 75% of the stomach laparoscopically, so that the stomach takes the shape of a sleeve. This helps with weight loss by restricting food intake and reducing hunger.
Ideally, with proper diet, exercise, and support, bariatric surgery patients will not need medications for weight loss. However, in some cases due to lifestyle choices in the years after weight loss surgery, patients may be prescribed medications for weight loss.
As a leading Iowa weight loss clinic, we offer comprehensive weight loss programs to meet your specific goals. From your initial weight loss class and patient consultation to your weight loss surgery and ongoing support, Iowa Weight Loss Specialists is here to help you achieve your weight loss goals!
Have a question that was not listed? Contact us today, and we’d be happy to provide you with any additional information!
