How to Use Your Bariatric Preapproval Period to Build Healthy Habits That Last

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A 2022 study of over 73,000 bariatric patients reported median waits for surgery of between 127 and 157 days across two patient groups. If you were given a few months to maximize the outcome of your bariatric surgery, what would you do?

Before surgery, you’ll typically see several healthcare professionals and, depending on your insurance, complete a supervised weight-loss program. Those appointments can help you understand what’s ahead, while your own efforts take shape between visits. Providers approach preparation differently, but you can begin putting their advice into practice with meals, routines and arrangements that fit your life.

What Happens Between Your Referral and Bariatric Surgery Date

In a statewide registry study of 60,791 patients, the median wait time for bariatric surgery increased from 86 to 159 days between 2006 and 2016. Medicaid coverage was associated with longer waits in the same study. For you, the time before surgery may include several stages, each with its own paperwork, appointments and decisions.

Prepare for these steps:

  • Referral: Your clinician may connect you with a surgical program, where you can begin discussing your options.
  • Insurance review: Depending on your plan, approval may involve reviewing your records and completing requirements such as supervised weight management.
  • Required evaluations: You may meet with different professionals to discuss your health, eating patterns and readiness for surgery.
  • Scheduling: Once requirements are complete, your team can work with you to arrange a surgery date.

The American Society for Metabolic and Bariatric Surgery reports that roughly 1 in 4 patients considering surgery are denied coverage three times before approval. Having to wait for another decision can be frustrating, especially when you’re ready to move forward. However, because the exact process and schedule vary so widely, seeing how it works in one particular state may be helpful.

What to Expect During Your Wait

For eligible patients, Washington’s three-stage authorization process moves from an initial assessment through evaluations and a supervised weight-loss regimen to surgery. The regimen lasts at least six months, but your insurer, provider and clinical circumstances will shape your own timeline.

Case Study #1: Center for Weight Loss Surgery’s Approach to Patient Prep (Washington State)

The wait for bariatric surgery in Washington State can be lengthy, but your provider will explain their own stages, so you should never feel lost. For example, the Center for Weight Loss Surgery begins with an initial consultation, followed by pre-surgery testing, endoscopy and review. It continues with a pre-surgery education class to help prepare you and your support person for the procedure. Its team also works with you and your insurer to understand coverage as you prepare.

The Center for Weight Loss Surgery encourages participation in support groups both before and after surgery, noting that these can significantly improve long-term weight-loss outcomes for participants. It also offers advice on setting realistic expectations and on seeking professional care for depression, substance use disorders or other mental health conditions. Finally, it suggests practical planning for meals, childcare and transportation.

Together, these considerations are a crucial part of your preparation. The next step is building them into your everyday life.

Building Habits That Set You Up for Surgical Success

Ask your care team for advice on where to start, then think about how helpful suggestions fit into an ordinary day.

Choose a change you can practice before your next appointment, such as:

  • Food routines: Talk with your dietitian about your usual meals and agree on a change you can try when planning or shopping for food.
  • Movement: Choose an activity with your team’s guidance, then look for a realistic time to fit it into your week.
  • Sleep: Give some thought to your evenings and the routine you’d like to follow as you wind down and try to get some good sleep.
  • Smoking and alcohol: Be open with your clinicians about your use so you can discuss their requirements and any help you need to reduce or stop.
  • Mental preparation: Keep a note of concerns as they come up and bring them to your next visit rather than trying to remember everything on the day of your consult.

Regular check-ins give you a chance to discuss how those changes are going. Some programs build that conversation into the months leading up to surgery.

Case Study #2: UPMC’s Presurgical Lifestyle Program (Pennsylvania)

At the University of Pittsburgh Medical Center (UPMC), you can attend monthly classes through a six-month structured lifestyle program before surgery. You work on eating patterns and activity with a team that includes surgeons, nutritionists, psychologists, behaviorists and exercise specialists.

UPMC’s guidance includes eating 1,200-1,500 calories a day or following a range discussed with your doctor, plus avoiding caffeine for approximately one month before surgery. These instructions help patients set concrete goals to build healthy, lasting habits.

Your own team will have specific advice for you on setting food targets or changing what you eat and drink. However, beyond lifestyle changes, you will likely need a mindset shift, too. The wait for bariatric surgery can be nerve-wracking, as much as you may be excited, so it helps to have others around who understand what you are dealing with.

Leaning on Support While You Wait

Making room for new routines can also mean asking for help. You might invite someone you trust to an appointment, talk through your concerns with a friend or ask about a ride when you need one. These conversations deserve as much attention as changes to food or activity. Shameless plug – helping people upgrade their nutrition is kinda exactly what we do, so feel free to reach out for a free strategy call.

When you’re unsure which appointment comes next or what your insurer still needs, it also helps to know whom to ask. Some programs give you a named contact for those questions.

Case Study #3: Cleveland Clinic’s Bariatric Surgery Program (Ohio)

At Cleveland Clinic, those awaiting bariatric surgery have a dedicated patient navigator to turn to throughout their journey. That person answers questions and offers encouragement while helping you through the qualification process.

Cleveland Clinic also includes one-on-one education and support groups as part of your personalized plan. Having someone to ask, people to talk with, and practical arrangements underway can help you feel more prepared as you work on your habits.

Frequently Asked Questions About Bariatric Surgery Preparation

These answers bring together a few details to keep in mind as you prepare.

What can happen during the insurance approval process?

Your insurer may review your eligibility and require supervised weight management before approving surgery. A denial may mean another review before you can move forward.

Which habits can you start building before surgery?

Discuss meals, activity and smoking or alcohol use with your care team to decide where to begin. You can also give attention to sleep routines and emotional preparation.

How can you organize support while you wait?

Ask someone you trust for help with a specific task, such as transportation, and check whether your program offers support groups or a named contact for questions.

Turn Your Waiting Period Into Your Head Start

The months before surgery give you time to try a different routine, talk through concerns and make plans for recovery. You can work on these preparations a little at a time as your appointments move forward. Choose one thing to take care of today. Write down a question for your dietitian or ask someone about a ride to an appointment, starting with whichever would make the coming week a little easier as your new life approaches.