Steps to Get Started - Bariatric Surgery | Ohio State Medical Center

Step 1: View the Online Information Session

The first step in the bariatric surgery process is viewing the mandatory online information session.

If you are facing challenges with weight or have been unsuccessful with more traditional weight-loss methods, choosing to explore bariatric surgery is not "giving up" or "taking the easy way out." Bariatric surgery takes just as much commitment to be successful, but it may be the best option for you.

Before we determine if you are a good candidate for bariatric surgery, it's important that you understand the surgical process, as well as the risks and the personal responsibilities that come before and after surgery. To learn more about these components, we invite you to view our online information session.

During our free information session you will learn:

Why Ohio State is the best choice for your surgical weight loss team
Who is a candidate for bariatric surgery?
The benefits of bariatric surgery, including the role it can play in reducing other chronic issues, like diabetes and hypertension
What to expect before and after surgery
Your road map to the bariatric surgery procedure

Step 2: Check Insurance Coverage

Contact your insurance provider to see if bariatric surgery is covered for you. Here are some questions you can ask:

Does my insurance policy cover bariatric surgery? (Your provider may also call this “treatment for morbid obesity” or “weight-loss surgery.”)
Are Ohio State surgeons Bradley Needleman, MD, Sabrena Noria, MD, PhD, Stacy Brethauer, MD and Vimal Narula, MD covered in my policy?
What are the medical necessity criteria for covering bariatric (weight-loss) surgery?
Do I need a primary care referral for bariatric surgery to be covered?

Download insurance information for prior authorization:

CareSource, Molina, other Medicaid HMO's

Medicare

Step 3: Begin a Weight Management Program

Each insurance provider has different requirements that must be met before approving your bariatric surgery. Some require you to complete a weight management program for a specific amount of time before they will grant approval. You are encouraged to speak with your insurance company and meet with your primary care provider to get this process started as soon as possible.

Step 4: Complete Surgery Application

The application packet is a necessary step of the journey and is very detailed: you must identify the medications you take, any prior surgeries and every diet plan you’ve tried to follow.

Download and complete application.
Return completed application to the Ohio State Bariatric Surgery Program:

Email: ObesitySurgery@osumc.edu
Mail or Drop Off: Martha Morehouse Medical Plaza, 2050 Kenny Rd, Concourse Suite 1222, Columbus OH, 43221

Special notice on email:

The Health System recognizes that patients may prefer email as a way to communicate with us.

Please be aware that information sent using email may not be secure. These is a possibility that information about you may be intercepted and read by other people. We will ask your permission before using unsecure email to communicate with you about your health care that involves your health information.

If you give us your email address, we may email you information about our products and services, tips about healthy living or when we open a new location.

Patients also ask us if they can email their providers about their health care. Whenever possible, we prefer that patients use MyChart to securely communicate with health care providers because of the inherent risk that email communications are unsecure.

Step 5: Bariatric Counseling and Consultations

After viewing an information session, learning about your insurance coverage and submitting your application for surgery, you’ll get to meet with some of our experts so they can learn more about your individual needs.

This complete counseling and consultation process includes:

Bariatric counseling – All candidates for bariatric surgery at Ohio State will have a consultation with a psychologist. During this appointment, a psychologist will review and interpret a few tests to learn more about you and the ways you cope with life events and stress. You and the psychologist will also discuss your current and past lifestyles and how weight has affected your decisions. This is a required part of the process and will help us make sure you are successful before and after surgery.

Medical and dietary evaluations – Once your completed application has been received and your bariatric counseling has been scheduled, we will contact you to schedule consultations with our team of dietitians and clinical experts. During these visits, we will learn about your overall health and current to determine if you are ready for weight-loss surgery, and if so, which procedure will best meet your needs.

A dietitian will meet with you to determine whether you’re nutritionally ready for surgery.

Blood will be drawn for some tests, and other procedures may be ordered to ensure that you receive all the care your need to prepare safely for surgery.

At the end of these visits, you will have a written plan to decrease your personal health risks for surgery (including medical testing and goals), as well as the items your program coordinator has identified as insurance requirements.

You must work with your program coordinator to complete your developed plan and meet your medical requirements before you can move forward in the surgical process; once these are finalized, we will request insurance approval for surgery.

Step 6: Pre-Operative Consult with Your Surgeon

Step 7: Day of Surgery

Typically, patients are admitted to the hospital on the morning of their surgery. Your procedure will last about one to two-and-a-half hours.

Your stay in the hospital may last between one and three days. During that time, you’ll be placed on a clear-liquid diet to help your stomach and intestines return to their normal function and to reduce the possibility of leaks as you heal

Step 8: Support After Surgery

Bariatric Surgery FAQs

Will my insurance cover the surgery?
Most insurances have bariatric surgery coverage.
If my insurance requires a weight management program when should I get started?
Right away. Start making appointments with your primary care provider (PCP) to discuss weight, diet and exercise.
I’ve been working on weight management with my PCP for years. Does that count?
It depends on your insurance plan. Most plans accept weight management notes within 12 months or 24 months. Some plans require 3 – 6 consecutive months.
How long is the weight management program?
Programs will vary based on insurance requirements and program requirements. Typically, insurance requirements can range from 3 – 12 months.
Do I need to complete insurance requirements if my PCP states the surgery is medically necessary?
Yes. Insurance companies list bariatric surgery as an elective procedure so all requirements must be met to get insurance approval.
How long does it take to get to surgery?
Time to surgery varies from person to person and insurance requirements. Average time is 6 – 9 months and is related to the time it takes to complete the weight management portion of insurance requirements.
Can I pick my surgeon?
Yes. You may choose from the list of our four surgeons.
Will my insurance cover protein shakes/vitamins?
Most insurance companies don’t cover supplements. Our office doesn’t do prior authorization for protein shakes or vitamins.
What is the self-pay cost?
Depending on the procedure, self-pay ranges between $17,200 for gastric sleeve to $19,750 for Roux-en-Y.

Self-pay covers the cost of initial psychology, NP and dietitian appointments. It also covers the cost of the preop surgeon appointment, surgery, hospital stay and any follow-up appointments in our clinic for 90 days postop. All other requirements for bariatric surgery will not be included in the self-pay cost and will vary based on the necessary requirements.

There is not a self-pay option for revision surgery.
Do you have payment plans for self-pay?
No. Self-pay is paid in full prior to the surgery date.
When will someone be calling me to schedule my appointments?
After we get your completed application and check with your insurance, we’ll call you in 7 – 10 days to schedule your appointments.
Are my visits in person?
Visits are by telephone, video and in person.
What can I eat after surgery?
Successful bariatric surgery requires lifelong changes. A registered dietitian will go through all the restrictions and dietary guidelines over the course of several telephone visits.
I have several medical conditions; can I still have bariatric surgery?
Many patients who seek bariatric surgery have medical conditions, and there are very few that would prevent you from getting surgery. However, your providers will go over your medical history and determine your eligibility for surgery.
How long will I be in the hospital after surgery?
Typical hospital stay for laparoscopic bariatric surgery is 1 – 1 ½ days. Discharge criteria includes pain control, nausea control, being able to drink enough to maintain your hydration, being able to walk around, and understanding the Step 2 diet and when to call the clinic.
When can I return to work after surgery?
Recommended time off after surgery is 4 – 6 weeks. This allows for healing and adjusting to dietary changes. You’ll be evaluated two weeks after surgery and may discuss return to work with the surgeon during your scheduled visit.
Can I have skin removal after surgery?
At 18 – 24 months after surgery, if your weight loss has stabilized, you may be evaluated by our providers for a referral to plastic surgery.
How much weight should I expect to lose?
Roux-en-Y procedure:
You can expect a realistic weight loss of 50 – 80% of excess weight by two years after surgery.
For example: A person who weighs 300 pounds and whose ideal body weight is 150 pounds (150 pounds of excess body weight) would have a successful weight loss at two years of 75 to 120 pounds. This person would then weigh 180 to 225 pounds.
- 300 pounds (current weight) – 150 pounds (ideal weight) = 150 pounds (excess weight)
- 300 pounds – (50% x 150 pounds) = 300 pounds – 75 pounds = 225 pounds
- 300 pounds – (80% x 150 pounds) = 300 pounds – 120 pounds = 180 pounds
Ideal body weight is equal to 100 pounds for the first 5 feet plus 5 pounds for each added inch for women. For men, it is equal to 106 pounds for the first 5 feet plus 6 pounds for each added inch

Sleeve gastrectomy procedure:
You can expect a realistic weight loss of 50 – 70% of excess weight by two years after surgery.
For example: A person who weighs 300 pounds and whose ideal body weight is 150 pounds (150 pounds of excess body weight) would have a successful weight loss at two years of 75 to 105 pounds. This person would then weigh 195 to 225 pounds.
- 300 pounds (current weight) – 150 pounds (ideal weight) = 150 pounds (excess weight)
- 300 pounds – (50% x 150 pounds) = 300 pounds – 75 pounds = 225 pounds
- 300 pounds – (70% x 150 pounds) = 300 pounds – 105 pounds = 195 pounds
Ideal body weight is equal to 100 pounds for the first 5 feet plus 5 pounds for each added inch for women. For men, it is equal to 106 pounds for the first 5 feet plus 6 pounds for each added inch.
What are activity restrictions after surgery?
No lifting > 10 – 15 pounds for four weeks after surgery. Don’t drive until you’re two weeks postop or after your first follow-up appointment. You may walk and do stairs. No water exercise until incision sites are well healed (no scabs).
What is dumping syndrome?
Dumping syndrome happens when your stomach contents are “dumped” into your small intestine too quickly. Usually, you notice these symptoms soon after eating and they can range from mild to severe. In most cases dumping improves on its own. This can happen if you eat and drink at the same time, take too big a bite or have more than 10 grams of sugar at a time.

SYMPTOMS: (immediately – 1 hour after eating) nausea, vomiting, abdominal pain, cramps, diarrhea, dizziness, lightheadedness, bloating and/or belching
LATER SYMPTOMS: (1 – 3 hours after eating) sweating, weakness, fatigue, anxiety, heart palpitations, fainting, mental confusion and/or shakiness
Why do I have to give up smoking?
Under no circumstances should you smoke or use nicotine-containing products after surgery. Nicotine and the toxins from smoking will increase your risk of developing ulcers and possible perforation (hole in the connection between the pouch and small bowel).
Can I become pregnant after having the surgery?
Women of childbearing age should avoid pregnancy for 18 – 24 months after surgery. Rapid weight loss and potential nutritional deficiencies can harm a developing fetus. If you do become pregnant, please notify our office and your obstetrician.

Steps to Get Started on your Journey to Weight Loss