Screening Evaluation
Preoperative Medical and
Surgical Screening
All patients considering
surgical treatment for obesity undergo a thorough
medical evaluation prior to surgery. A primary
care physician can perform a portion of this
medical evaluation by insuring that all of
your routine well adult care is up-to-date.
During an initial surgical consultation, the
surgeon will review a patient's medical
and surgical history. The patient
will undergo a series of tests if it is suspected
that a medical issue is the cause of a patient's
obesity. In addition, tests are performed to
determine if a patient has any obesity-related
diseases such as diabetes, heart disease, hypertension,
pulmonary disease, sleep apnea, vascular disease
or depression and how these disorders impact
their health.
Depending on your medical conditions(s), your
surgeon may recommend several preoperative tests.
The following tests may be needed prior to surgery:
- Upper GI
- Abdominal Ultrasound
- Cardiac Clearance
- Medical Clearance
- Liver Function Tests
- Sleep Study
- Pulmonary Function Tests
- Chest X-ray
- EKG
- Pre-operative Blood Work
A surgeon will evaluate other criteria to determine
if a patient is an appropriate surgical candidate.
Patients with advanced heart or lung disease
may not be appropriate surgical candidates.
Preoperative
Nutrition Screening and Diet Counseling
During
nutrition screening, patients complete a weight
and diet history questionnaire in which they
provide information regarding previous attempts
at weight loss. Such attempts may include a supervised
weight loss and exercise program and/or the use
of popular diets. Patients also keep a food diary
to record their daily food intake.
A bariatric dietitian specialist evaluates the
patient's weight loss history and current
eating behavior. The specialist then makes recommendations
regarding how the patient can change his or her
diet to best prepare for surgery.
The goal of the pre-op nutrition screening is
to focus on changing eating behavior and food
selection practices to facilitate adjusting the
post-op diet. This aids patients in using the “tool” of
bariatric surgery to best assist in weight loss
success.
Prior to surgery, each patient is required to
meet with the bariatric dietitian specialist
to learn the principles of the post-op gastric
bypass. During this nutrition counseling session,
patients learn about the post-op dietary progression,
protein and fluid requirements, and lifelong
vitamin and mineral supplementation.
Nutrition counseling is scheduled at the end
of your pre-op evaluation closer to your surgery
date. There is $200 fee for the nutrition counseling
session.
Preoperative
Psychology Screening
We recognize that morbid
obesity is a complex problem and that undergoing
surgical treatment changes a person's
relationship with food. Therefore it is essential
as part of the preoperative assessment process,
that all patients undergo a psychological evaluation.
The psychological evaluation is scheduled with
mental health professionals at the University
of Pennsylvania Weight and Eating Disorders Program.
The evaluation is used to assess a patient's
psychiatric history and current psychological
functioning, to determine if there are any psychological
reasons why surgery is not an appropriate treatment.
In
addition, the evaluation includes an assessment
of a patient's weight and dieting history,
as well as current eating behaviors and level
of physical activity. Patients also have the
opportunity to learn more about the behavioral
changes necessary to ensure good postoperative
results, as well as any psychological changes
that can be anticipated after surgery.
Many patients interested in bariatric surgery
are already working with a mental health professional
and may want to complete the assessment with
their current provider. However, because of the
unique expertise of the professionals at the
University of Pennsylvania Weight and Eating
Disorders Program, patients are asked to complete
the psychological evaluation with a member of
that program. There is a $200 fee for this evaluation.
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