Frequently Asked Questions

Q:        How do I get started in the program?

A:         Please complete a  new patient packet , the General Surgery Health Assessment form , and the Insurance Verification Form for the surgeon to review and obtain an initial consultation. 

Q:    How long does it take from the time my packet is received until I have my individual consultation with the surgeon? How long does the entire process take from the point you receive my completed packet?

A:    If, after reviewing your materials, you are considered an appropriate WLS candidate, it might take only 2-3 weeks for you initial consultation with the surgeon. The entire process takes about 60-90 days depending on an individual’s preoperative requirements.

Q:    How long does the insurance authorization process take?

A:    It can take anywhere from 1 to 6 weeks, depending on your specific insurance provider. The process can be prolonged if all necessary medical records are not made available to us.

Q:    What is the Total Cost and out-of-pocket expense for each type of surgery and will expenses need to be paid for up front before the surgery?

A:    Out-of-pocket expenses vary depending on your insurance policy. However, regardless of your policy, all out-of-pocket expenses should be paid in full prior to surgery.

Q:    What is the recovery period for each type of surgery?

A:    Lap-band® – 1-3 weeks, Sleeve Gastrectomy -- 3-6 weeks, RNYGB – 2-6 weeks

Q:    What insurance companies do we accept? Do we accept Medicaid and Medicare?

A:    Most all insurance companies are accepted at WFUMS. Yes, we accept Medicare and Medicaid.

Q:    What is meant by a person’s BMI?

A:    BMI or Body Mass Index is a measure to determine if a person is at a healthy weight in relation to their height. (link to BMI Calculator)

Q:    How do I know if my insurance covers weight loss surgery?

A:    Though we will do our best to assist you, the ultimate responsibility for determining if weight loss surgery (WLS) is a covered benefit with your insurance company rests with each person. We suggest you review your insurance policy carefully and also speak to someone in your company’s Benefits’ Office to confirm coverage. Be sure to write down the name of the person with whom you speak just in case your coverage is later questioned. Complete the Insurance Verification form, and our program can contact your insurance provider to determine coverage. 

Q:    If I have a hiatal hernia, do I still qualify for weight loss surgery?

A:    Yes. 

Q:    Why am I limited to meeting only with this program’s psychologist and dietitian? If I have already been seen or am currently under the care of a psychologist or dietitian, can their evaluations substitute for the ones this program requires?

A:    At Wake Forest Baptist Medical Center (WFBMC), we offer a multidisciplinary team approach to weight loss surgery. Our psychologist and dietitian are both trained in the care of WLS patients, and they will follow you long term to ensure that you are successful in making the various lifestyle, behavior, and dietary changes required after WLS.

Q:    Are the fees associated with the psychologist’s services covered by insurance?

A:     Responsibility for the psychologist’s fees varies based on the type of insurance coverage and will need to be discussed on a patient by patient basis with Dr. Jeff Smith.

Q:    If I receive an appointment with the surgeon, can I then schedule appointments for my psychological and nutritional evaluations prior to seeing him?

A:    Yes, but confirm that the weight loss procedure in which you are interested is covered by your insurance policy.

Q:    What is considered a weight loss attempt?

A:    Diets such as Weight Watcher’s, Atkins, Slim Fast, portion-control, and a physician-prescribed program, exercise, and medications such as Phentermine, Xenical/Alli, and Meridia. 

Q:    What will my diet look like after surgery?

A:    After surgery, you must learn how to eat again. You will consume Full liquids (soups, protein drinks, and yogurt) for 1-3 weeks, pureed foods for 2-3 weeks, then soft, regular foods. The dietitian will outline the post-operative diet progression in detail at the nutrition education class prior to surgery. 

Q:    How long will I be out of work?

A:    Each patient is different. It can be anywhere from 1-6 weeks depending on the type of work you must perform.

Q:    How do I know which surgery to choose?

A:    First, we encourage each person to research both the Adjustable Gastric Band (AGB) and the Roux-en-Y Gastric Bypass (RYGB) via the internet. Second, consider attending one of our monthly Support Group meetings to ask questions of post-surgical patients. Third, come prepared to discuss this decision at your individual consultation with the surgeon. 

Q:    How long is the insurance authorization process?

A:    The insurance authorization process can take anywhere from 1 to 6 weeks depending on the insurance provider and which state they are based out of. The process can be prolonged if all needed medical records are not turned in to us.

Q:    Is there any financial assistant for people needing help with their out-of-pocket expenses/deductibles?

A:    Currently there is not.

Q:    How can I learn more about weight loss surgery?

A:    Information seminars are offered regularly in Winston-Salem area.

Q:    When is the next support group meeting and where is it held?

A:    We have information about several Support Groups available to you.

Q:    Do we do post-operative care for individuals who did not have their surgery done at our medical center?

A:    That decision is made on a case-by-case basis. A prospective patient will need to complete a  new patient packet  and the General Surgery Health Assessment form for the surgeon to review and obtain an initial consultation with the surgeon. 

Q:    How much do the weight loss procedures cost for individuals wanting to pay out of pocket?

A:    For individuals without coverage for weight loss surgery, a significant discount may be given for prompt and up front payment off the full rate for either the adjustable gastric band or the Roux-en-Y gastric bypass.

Q:    Does the Laparoscopic Adjustable Gastric Band (Lap Band or Realize) require frequent office visits after surgery?

A:    Follow-up appointments with your surgeon are a normal and very important part of bariatric surgery in general. For patients choosing the Laparoscopic Adjustable Gastric Band, follow-up adjustments are performed during some of these visits.

Q:    Does the Laparoscopic Adjustable Gastric Band limit any physical activity?

A:    The Adjustable Gastric Banding System should not hamper physical activity, including aerobics, stretching, and strenuous exercise.

Q:    How is the Laparoscopic Adjustable Gastric Band adjusted?

A:    Adjustments are often carried out in the clinic. Sometimes they must be performed in the X-ray department. They are done there so the access port can be clearly seen. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes and most patients say it is nearly painless.

Q:    Do I have to be careful with the access port just underneath my skin?

A:    The access port is placed under the skin in the abdominal wall, and once the incisions have healed, it should not cause discomfort or limit any physical exercise. The only sensation you may experience from the port occurs when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.

Q:    Can other people see that I have a port?

A:    The port is placed under your skin and is generally not noticeable even if that area of your abdomen is exposed.

Q:    Can the Laparoscopic Adjustable Gastric Band be removed?

A:    Although the Adjustable Gastric Banding System is not meant to be removed, it can be removed laparoscopically. Surgeons report that the stomach generally returns to its original shape once the Laparoscopic Adjustable Gastric Band is removed. After the removal, though, you may gain more weight.

Q:    Will I need plastic surgery for the surplus skin when I have lost a lot of weight?

A:    That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation since the skin will sometimes mold itself around the new body tissue. Give the skin the time it needs to adjust before you decide to have more surgery.

Q:    Is it true that the Laparoscopic Adjustable Gastric Band seems “tighter” in the morning?

A:    This is a fairly common feeling. During the day, the water content in the body changes and this may cause the Laparoscopic Adjustable Gastric Band to feel “tighter” some of the time. Some women have also noticed that the Laparoscopic Adjustable Gastric Band feels tighter during menstruation.

Q:    Will I feel hungry or deprived with the Laparoscopic Adjustable Gastric Band?

A:    The Laparoscopic Adjustable Gastric Band helps you eat less and feel full in two ways—first by reducing the capacity of your stomach, and second, by increasing the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived. Remember that the Laparoscopic Adjustable Gastric Band is a tool to help you change your eating habits.

Q:    What will happen if I become ill?

A:    One of the major advantages of the Laparoscopic Adjustable Gastric Band is that it can be adjusted. If your illness requires you to eat more, the Laparoscopic Adjustable Gastric Band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the Laparoscopic Adjustable Gastric Band can be tightened by increasing the amount of saline. If the Laparoscopic Adjustable Gastric Band cannot be loosened enough, it may have to be removed.

Q:    What about pregnancy?

A:    Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the Laparoscopic Adjustable Gastric Band can be loosened. After pregnancy, the Laparoscopic Adjustable Gastric Band may be made tighter again and you can resume losing weight.

Q:    Will I need to take vitamin supplements?

A:    Yes. It’s possible to not get enough vitamins from three small meals a day. At your regular check-ups, we will evaluate whether you are getting enough vitamin B12, folic acid, and iron.

Q:    What about other medication?

A:    You should be able to take prescribed medication, though you may need to crush pills or open capsules. Always ask the doctor who prescribes the drugs about this. You may need to avoid taking aspirin and other non-steroidal anti-inflammatory pain relievers because they may irritate the stomach. The problems these drugs may cause could result in Laparoscopic Adjustable Gastric Band removal.

Q:    What if I go out to eat?

A:    Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.

Q:    What about alcohol?

A:    Alcohol has a high number of calories and breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.

Q:    Can I eat anything in moderation?

A:    After your stomach has healed, you may eat most foods that don’t cause you discomfort. However, because you can only eat a little, it is important to include foods full of important vitamins and nutrients, advised by your surgeon and/or dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of “empty” calories, such as milkshakes, the effect of the Laparoscopic Adjustable Gastric Band may be greatly reduced or even cancelled.