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Cheat Sheet / Updated 03-25-2022

Weight loss surgery is a life-altering step, one that can dramatically improve your quality of life. But it’s not a quick fix or an easy answer to obesity. If you’re thinking about weight loss surgery, you’re probably wondering about the benefits. You’re also probably not sure what your insurance will cover or what’s involved in the surgery itself. You may be wondering if weight loss surgery is right for you or how to find a surgeon. All these questions are important ones to ask — and answer — as you consider the pros and cons of this important step.

Article / Updated 03-26-2016

When you're feeling a little down or uptight, give yourself a break by trying some of these helpful tips. Just breathe Typically, when you're distraught, your breathing quickens and becomes shallow. These changes in breathing are bound to add to your stress and make you more uncomfortable than you already are. You can counter such distress with this quick breathing technique: 1. Place one hand on your abdomen and the other on your chest. 2. Breathe in slowly, concentrating on inflating your abdomen first and then your chest. 3. Exhale slowly, quietly saying the word "relax" as the air goes out. 4. Repeat Steps 1 through 3 for at least ten breaths. Talk it out People are social creatures. When you connect with others, you're likely to feel better. If you're feeling down, call a friend and discuss what's bothering you. Or call someone just to chat. Whatever the reason you connect, it's likely to help. Get soaked Sitting in a warm bath or standing in a hot shower can comfort the body by loosening all those muscles that tighten up when you're stressed. (Hot tubs work pretty well, too, as do saunas, but not everyone has one of these handy.) As you feel the water rushing over or around you, think of yourself as wrapped up in a warm blanket. You'll feel safe, soothed, and serene. Feel the big chill This technique sounds pretty weird, but it works. When your distress feels intense, fill a sink or large bowl with ice water (that's right, ice water), take a deep breath, and immerse your face in the water for 30 seconds or so. It's not as terrible as it sounds. This calming technique is believed to work because it elicits what's known as the body's dive reflex. When you're in ice-cold water, the body slows its metabolism in order to spare vital organs. A slowed metabolism reduces tension, so when your face is in ice water, your metabolism slows, your tension goes down, and you stop fretting about the things that are bothering you and your negative mind chatter ceases. It sounds weird, but try it! Take a quick thought challenge To figure out exactly what's bothering you and consider it in relation to the big picture of your life's events, answer the following questions. 1. What's bothering me? 2. How important will this upset be to me in one year? 3. Do I have any evidence that would suggest my thoughts about the event are incorrect? 4. Is there a more reasonable way of looking at what happened? Exorcise with exercise The body responds to upset by producing stress hormones. However, you can quickly burn up those hormones by exercising at least 15 to 20 minutes. Try something aerobic such as running, jogging, or brisk walking. If it's a nice day, going outside gives you the added benefit of sunshine and fresh air. Or if it's more convenient, go to the gym and participate in an exercise class. Mellow with music Sound influences the mind and body. It can jar, startle, upset, or soothe you. When you feel distressed, try listening to music that you find relaxing, whether classical, jazz, or even heavy metal. Or you may listen to something pleasant and mellow but nonmusical, such as a fountain or the sounds of nature. Pacify with pets Studies have shown that pets promote better moods and possibly better health. In fact, one study suggests that petting dogs helps reduce blood pressure. Therefore, if you don't have a pet, consider getting one, or at least borrowing a friend's from time to time. Watching animals play is delightful, and petting them seems to soothe the body. Distract your distress When you're upset, usually the only thing on your mind is your discomfort. And focusing on that discomfort only makes things worse. For quick relief of minor stress, consider distraction. Try these activities: Reading a good novel. Going to the movies. Watching television. Surfing the Internet. Playing a game. Stay in the present Remember that most of what upsets you has to do with the past or the future. You may feel guilty and depressed about events from the past, and you may feel anxious about events that have not yet occurred and often never will. To snap yourself out of this trap, focus on what's actually happening around you right now. Notice your breathing. Feel your feet on the ground. Notice the firmness of your chair. Pay attention to the temperature. Look around you and observe. Don't judge. Just observe, and breathe.

Article / Updated 03-26-2016

Everyone worries and experiences sadness but when these feelings consume you and affect how you relate to people and situations, you could be dealing with anxiety and depression. Go through this list of possible indicators of emotional distress and check all that apply to you (the more you check, the more serious the possible problem): I worry all the time. I feel like a total loser. My appetite isn’t what it should be. I feel like I can’t catch my breath. I don’t look forward to anything. I’m a very nervous person. I can’t think as well as I should. I feel a lot of guilt. I’m not interested in doing anything. I feel hopeless. I have a lot of fears. My sleep is disturbed. I’ve been having thoughts about death lately. I avoid friends and social situations. I can’t make decisions about anything. I don’t have any energy lately. My mood has been really low. Sometimes I feel panicky. My heart races for no reason at all. If you think you may have a problem with serious depression, anxiety, or thoughts of suicide, please seek a professional consultation promptly.

Article / Updated 03-26-2016

Feeling guilty about things that have happened in the past or thinking that something horrible is just around the corner is central to most anxious and depressing thoughts. To keep yourself in the here and now use these techniques: Sit quietly and take note of your surroundings. Notice the light, sounds, and everything around you. Avoid the temptation to judge or evaluate, and just observe. Notice your breath going in and out of your body. Notice how your body feels as you sit. Sit, breathe, observe, and be in the present. If your thoughts start to dwell on worries or concerns, just pull yourself back to the present.

Article / Updated 03-26-2016

Use these techniques when you’re feeling stressed or a little down as a way to lighten your mood and rid yourself of that “not quite right feeling.” Exercise. Take a brisk walk, jog, or dance for at least 15 to 20 minutes. Increasing your heart rate for a while burns off anxious feelings and increases endorphins, which lift your mood. Chill out. Fill a sink or bowl with ice water. Now take a deep breath and put your face in the water for 30 seconds or so. Believe it or not, you’re likely to feel more relaxed (and maybe a bit chilly) when you’re done. Get grateful. Stop what you’re doing right now and ponder what makes you feel grateful. Appreciate the small things — a good parking spot, the ability to read this cheat sheet, flowers, good music, a cute dog, whatever. Make a list of these things, and review it when you’re feeling down and out. Breathe better. Take a slow, deep breath. Hold the air for a few moments, and then let it out very slowly while you silently count to eight. Repeat this breathing exercise four or five times when you feel the need to decompress.

Article / Updated 03-26-2016

Weight loss surgery is just a broad category for several different weight loss procedures. Here are some basic descriptions of the most common weight loss surgeries: Roux-en-Y (pronounced roo-en-why) gastric bypass: A procedure in which the stomach and intestines are divided and rearranged to make a new small stomach (known as a pouch) and bypass part of the stomach and the intestines. Initially after the surgery, you’ll eat very small portions. This procedure is the most common weight loss procedure being done today. Adjustable gastric banding: A procedure in which an inflatable silicone band or ring is placed around the upper part of the stomach. The band has a port that is placed under the skin, which is used to inflate the band. The port is accessed with a needle through the skin, and saline is added or removed; this is known as a fill or adjustment. Adjustments are given to reduce hunger and portion size and increase weight loss. The procedure is usually done laparoscopically. Sleeve gastrectomy: A procedure in which up to 70 percent of your stomach is removed. The pylorus, which regulates the entry of food into the intestine, is not removed, and food enters the intestine normally. Initially after the surgery, you’ll feel less hungry and eat a lot less. This procedure has been increasing in numbers. Biliopancreatic diversion: A procedure in which part of the stomach is removed and a significant intestinal bypass is performed. The biliopancreatic diversion can be performed in two ways, and the difference between the two procedures lies in which part of the stomach is removed. In the first version, known simply as biliopancreatic diversion, the lower part of the stomach is removed, and the remaining stomach is hooked up to the part of the small intestine that is closer to the colon, known as the ileum. In the second version, biliopancreatic diversion with duodenal switch, the outer curve of the stomach is removed, and the first part of the small intestine is hooked up to the ileum. Approximately 90 percent of the small intestine is bypassed in both the surgeries, resulting in significantly fewer calories and nutrients being absorbed. Weight loss is maximized, but nutritional deficiencies can occur more frequently than with the other weight loss procedures, so you need to take nutritional supplements for the rest of your life.

Article / Updated 03-26-2016

So, you want to explore the option of weight loss surgery. You’ve tried diets in the past and regained all the weight you lost. This type of yo-yo dieting is common — you’re not alone. Here are some ways to get more information about the different types of procedures that are out there: Tell your primary-care doctor or gynecologist that you’re thinking about weight loss surgery. Your doctor may have other patients who’ve undergone weight loss procedures and be able to share with you the results. Your doctor also may be able to refer you to a respected weight loss surgeon in your community. Read as much as possible about the different procedures. Exercise caution when it comes to what you read online — some sites are more accurate than others. You may want to start with the website of the American Society for Metabolic & Bariatric Surgery (www.asmbs.org), where you can get info about risks and benefits of weight loss surgery. Attend an information session at a local hospital or at a weight loss surgeon’s practice. Here you can hear firsthand how the surgeries are done and get your questions answered. If you know someone who has had weight loss surgery and if he or she is open to talking about it, ask about the experience. Find out what kind of procedure the person had and what the pros and cons have been.

Article / Updated 03-26-2016

Weight loss surgery is not for everyone, but it does offer many benefits. Losing a significant amount of weight — and keeping it off — can impact numerous medical and physical aspects of your life. Here’s a quick rundown on some of the things that improve after weight loss surgery: All patients see a significant decrease in joint pain. Every pound you lose is like taking 3 pounds off your knees! Up to 90 percent of patients see a remission of or improvement in their type 2 diabetes. Up to 80 percent of patients see a remission of or improvement in their high blood pressure. Up to 70 percent of patients see a remission of or improvement in their sleep apnea. Some patients see a lessening of their gastroesophageal reflux disease (GERD) symptoms. Some patients see an improvement in their fertility. On average, patients experience greater weight loss than with diet, exercise, and medication.

Article / Updated 03-26-2016

So, you’ve decided to go ahead with weight loss surgery. One of your first steps should be to check your insurance policy to make sure you’re covered for the procedure you want to undergo. You can do this online or by calling your insurance company’s customer service number. Here are a few additional steps you can take to help improve your chances of getting your insurance company to cover the procedure: Write down all the different diets you’ve been on, how much weight you lost, and how much you regained. Document whether you’ve ever taken any weight loss medication. Get office notes from any doctors or dietitians you’ve seen to help you lose weight. If you know your insurance company wants a six-month doctor-supervised diet, get started! Ask your doctor to see you every month and document your weight, what kind of diet you’re on, and what kind of behavior modification or exercises you’re undertaking. If you can’t exercise because of physical limitations, have your doctor document your physical disabilities.

Article / Updated 03-26-2016

You’ve decided to have weight loss surgery — or at the very least, look into it further. Finding a surgeon is one of the most important steps in this process. Here are some ways to find a reputable weight loss surgeon: Go to the website of the American Society for Metabolic & Bariatric Surgery (www.asmbs.org) or the American College of Surgeons (www.facs.org). Both of these websites have a “Find a Surgeon” tool that you can use to find surgeons in your area who are board certified and have experience in weight loss surgery. Ask your primary-care doctor or gynecologist for a referral to a weight loss surgeon. They’ll likely have patients who have undergone weight loss surgery, seen their success, and can help guide your choice of surgeon. Go to ObesityHelp (www.obesityhelp.com) and the websites of the weight loss surgeons you’re considering. Read patient testimonials about surgeons to find the one that’s best for you. Ask family, friends, and acquaintances for referrals. If you know people in your area who’ve had weight loss surgery, ask about their experiences with their surgeons, the hospitals where they had their surgeries, and their surgeons’ staffs.