The Process

Helpful links

Bariatric Solutions – adult bariatric surgery program
Nutrition Solutions – nutrition resource center for weight loss patients
Obesity Help – online support group for weight loss surgery patients
Obesity Action Coalition

A lot of things will happen before you have surgery – this is called a pre-surgical evaluation. Remember – our teen obesity surgery program is a tool to help with weight loss. We need to help you get ready for surgery – a long time before the procedure. That’s the best way for you to be successful!


  • Each patient in the teen obesity surgery program will undergo a complete history and physical examination by the operating weight-loss surgeon. At the time of evaluation, all office notes from the patient’s primary care physician, as well as notes from any specialists involved in the patient’s care (e.g. Endocrinology, Gastroenterology, Cardiology) will be reviewed.
  • Each patient will be evaluated for obstructive sleep apnea using a standard screening questionnaire. If the doctor thinks the patient could have OSA, the patient will be referred for a sleep study and pulmonary consultation.
  • Each patient will also undergo cardiac evaluation for pre-operative cardiac clearance.


  • A bariatric dietitian will evaluate each patient and obtain a detailed diet history at the time of enrollment in the teenage obesity surgery program. Each patient will be provided with a unique diet program designed to limit carbohydrate intake, wean from caffeine and help with pre-operative weight loss.
  • Four weeks prior to the surgical procedure, each patient will be started on a low-calorie, low-carbohydrate diet (Optifast or similar) under the direction of the surgeon and program dietitian. These diets have been shown to optimize pre-surgical nutrition, reduce liver volume, shorten hospital stay and return to normal activity, and improve wound healing.

Psychological assessment

The initial step in pre-operative treatment for the teenage obesity surgery program will include:

  • Testing that examines cognition, psychopathology and quality of life.
  • An interview assessing previous weight-loss attempts, eating styles/problems, physical activity level, motivation for change and current coping strategies.
  • Once the patient has been deemed appropriate for treatment, he/she will participate in a series of sessions to enhance motivation for change and treatment compliance.


  • Once a patient is OK’d for teen obesity surgery, the patient and parents will attend multiple educational sessions with members of the Adolescent Bariatric Surgery team. These sessions will be designed to educate the patient and parents about the surgery process, types of surgery (adolescent gastric banding, adolescent gastric bypass, or adolescent sleeve gastrectomy), and the dietary and physical requirements following completion of surgery.

Patient and parent motivation for change

  • Motivational interviewing will be used to assess and enhance the patient’s and parents’ motivation for change. Particular emphasis will be on the necessity of lifestyle change for the entire family system to ensure the success of the individual patient. Depending on the patient’s and parents’ motivational state, this process could involve between one to three therapeutic sessions.