How to prepare for bariatric surgery

Whether bariatric surgery is the next step on your weight loss journey or you’re still deciding if it’s the right choice for you, it’s important that you feel ready.
A big part of bariatric surgery is the preparation, which includes understanding insurance requirements and making major lifestyle changes that you’ll continue post-surgery. Read on to learn how to prepare for bariatric surgery, and how our team will guide you through every step toward a healthier, better-quality life.
A good first step is understanding bariatric pre-surgery insurance requirements
A big question on many people’s minds is, “Does insurance cover weight loss surgery?” The good news is that most insurance companies cover one or more types of bariatric surgery.
However, requirements for bariatric surgery differ based on insurance plans. And it’s best to know what your insurance company covers before your first appointment at a bariatric surgery or weight loss center.
How to know what’s required by your insurance
Call the member services number on the back of your insurance card and ask about the coverage criteria for bariatric surgery. They’ll be able to explain what’s covered and may even send you a link to the coverage criteria you can take to your appointment.
Your care team will answer any questions about the coverage criteria during the first appointment. They’ll also talk about the pre-approval process and what comes next.
Activities that may be required before surgery
Once you’re approved, you may still need to complete certain activities before you can get bariatric surgery. These will depend on your insurance plan but may include:
Managing or losing weight before bariatric surgery
Many people don’t need to lose weight prior to surgery, but it may be required because of insurance or medical history. If you need to lose weight, your doctor will let you know how much, and your care team will help with pre-surgery weight loss.
Trying other weight-loss options first
Some insurance companies require at least six months of supervised weight-loss attempts through a medical weight management program. Prescription weight loss medications may be an option if you need to lose weight before surgery. These medications can reduce your appetite and cravings for certain foods or change how your body processes nutrients such as fat, so you metabolize fewer calories.
Nutritional counseling and education
It’s typical for insurance plans to require one or more meetings with a nutritionist or dietitian before surgery. They’ll work with you to put together an individualized plan for healthy eating as you prepare for surgery and the years to come.
Medical testing for bariatric surgery
Your doctor will use medical tests and wellness checks to get an accurate assessment of your health before surgery. Testing will depend on your health history and insurance requirements, but often includes lab work and imaging tests like chest X-rays and gallbladder ultrasounds.
Developing a plan to increase activity levels
Before surgery, you’ll meet with an exercise specialist or a physical therapist to determine your current level of fitness and develop movement goals for before and after surgery.
Meeting with a behavioral health specialist
Your attitudes and habits around food can get in the way of successful weight control. That’s why you’ll need to talk to a behavioral health specialist before you have bariatric surgery.
The goal is to identify and treat mental health barriers so you’re better able to form and maintain good habits and lifestyle changes before surgery. Examples include eating disorders (such as a binge eating disorder), using food as a coping mechanism for stressful or traumatic situations, substance misuse disorder, depression, anxiety and a bipolar diagnosis.
If you have a mental health condition, it doesn’t mean that you can’t have bariatric surgery. However, getting therapy before surgery can increase the chance of successful weight loss after surgery.
Preparing your body and mind before bariatric surgery
The bariatric pre-surgery insurance requirements will help you prepare for surgery and the changes that will follow. But there’s even more you can do to set yourself up for success.
Below, we cover details about changing your diet and what to eat to prepare for surgery, becoming more active, building a support system and other lifestyle habits that could be helpful to implement before surgery.
What to eat while preparing for bariatric surgery
Establishing healthy eating habits before bariatric surgery helps you physically prepare for the new lifestyle that you’ll maintain after the procedure. Your dietitian will provide an individualized plan based on your needs. You can expect recommendations such as:

Eating a variety of foods
Eating three meals a day
Eating lower fat foods
Eating less restaurant or fast food

Pre-surgery bariatric liquid diet
About 10 days to 3 weeks before surgery, you’ll start a liquid diet. The liquid diet helps reduce body fat and decrease the size of the liver. These body changes can reduce the length of surgery, recovery time and the chance of complications.
Your care team will work with you to ensure your diet provides the essential nutrients you need, while also preparing your body for surgery. Liquids must be clear, low-sugar and low-fat, and you’ll consume around 64 ounces a day. Appropriate liquids include:

Protein shakes
Low-sodium broth
Coffee or tea
Sugar-free popsicles or Jell-O
Sugar-free beverages with no carbonation (like Crystal Light)

Increasing activity levels can help prepare your body for surgery and for the changes you’ll need to make afterwards. Plus, if your heart and body are healthier, you’ll be able to recover faster and more quickly move into an active lifestyle.

A good goal is to work up to an hour of movement, most days of the week. When you start working out, focus on low-impact cardio exercises and incorporate strength training. Here are more suggestions that will help you be more active:

Work around mobility limitations – Start with exercises like chair yoga. All movements are done from a seated position, putting less pressure on your body and joints.
Add more movement into your day – Try cleaning the house, parking farther away at the mall or using the stairs instead of an escalator.
Get outside for a walk – If you’re new to exercise, start with a trip to the mailbox or walking around the block, then slowly increase the distance as you feel comfortable.

Setting goals and identifying your support system
Preparation for bariatric surgery goes beyond physical preparation. It’s just as vital to make sure you’re in a good place mentally and emotionally. Before surgery, take time to set realistic goals and identify the people who you can lean on after surgery. It’s important to:

Set realistic expectations – Weight loss surgery isn’t a quick fix, but rather a tool to help you reach your long-term goals. It’s important to prepare for periods of time when you’ll see big results and for the times you don’t. Everyone’s weight loss is unique, so try to avoid comparing your results to others.
Have a support system – It takes time and effort to lose and keep weight off after bariatric surgery. Having a strong support system of family or friends who understand your long-term goals, can help you stay motivated and cheer you on along the way.
Lean on your care team – Your care team wants you to be successful, so ask for help when you need it. Your dietitian or nutritionist can help you plan for eating changes, and your primary care provider can be a valuable support system post-surgery and beyond.
Get support for mental health concerns – Our team of behavioral health professionals is here to help you work through any mental health concerns that might hold you back from achieving your goals.

Why you should stop smoking before bariatric surgery
If you smoke, it’s often recommended that you quit at least four weeks before your surgery. Nonsmokers have better recovery rates after surgery than smokers and are less likely to develop pneumonia or other lung problems during recovery. You do not need to quit alone. Talk to your primary care doctor for tips and information about resources to help you quit smoking.
What to buy before bariatric surgery
Recovering from bariatric surgery takes several weeks or more. Gathering essential items before surgery can make the recovery process a little easier. Since you’ll be on a liquid diet for a few weeks after surgery, you’ll likely need to stock your pantry and fridge with different items. It’s also a good idea to invest in shaker bottles and food storage containers.
Hospital bag checklist
Before surgery, we recommend making your own bariatric surgery hospital checklist, so you have everything you need for a comfortable stay. We suggest including items like:

Comfy clothes or pajamas
Cellphone, tablet or e-reader and chargers
Thermos or water bottle
CPAP machine or other device for sleep apnea, if you have one

Bariatric surgery and weight loss support
We offer video visits for bariatric surgery and weight management services to make it easy and convenient for you to get the personalized support you need before and after surgery. During these visits, you can consult with your doctor and care team on a wide range of topics, including activity and fitness recommendations, nutrition and mental health support.