Your Role in the Patient Journey
As the physician responsible for referring, it is important to fully understand your role in your patients' weight loss journey. You are often the first person an obese patient comes to for information and support.
Here are some tips on guiding your patients along their weight loss journey:
- Encourage obese patients to first try to lose weight through diet and exercise, pharmacotherapy, and behavior modification before considering surgery
- Educate about the risk and benefits of surgery
- Underscore that the LAP-BAND® System is not a quick cure. It is a tool that can help patients lose weight and requires a long-term commitment to lifestyle change
- Encourage patients to visit www.lapband.com to learn more about bariatric surgery and the LAP-BAND® System. You can also access patient education materials by clicking here
- Refer appropriate patients for LAP-BAND® System surgery
- in your patients' ongoing medical care Use the surgeon locator to find a LAP-BAND® System surgeon for patients who meet the indications for the LAP-BAND® System and also appear to understand the procedure
- Assure patients that you will be involved in their weight loss journey every step of the way. Although the surgeon who performs your patient's LAP-BAND® System surgery will be responsible for the surgical aftercare, you should remain actively involved
- Remain aware of the possibility of postoperative complications8
Resources available to help referring physicians to manage their obese patient's care include:
- Patient Support Resources - post surgical services available to LAP-BAND® System patients
- Obesity On-line - the education resource for clinicians, researchers and educators with an interest in obesity and its related disorders
- The Obesity Society - the leading scientific society dedicated to the study of obesity. Since 1982, The Obesity Society has been committed to encouraging research on the causes and treatment of obesity, and to keeping the medical community and public informed of new advances.
- Registration required (free)
- CME credits available
Once you partner with a bariatric practice, your patient will have access to the following services:
If you are referring your patients to a surgeon who is part of a designated Bariatric Surgery Centers of Excellence (BSCOE) program, these elements may already be in place.
Indications for Post-operative Complications
Indications for early post-operative complications include:
- New, sustained pulse rate of more than 120 beats/min for at least four hours
- Inadequate weight loss
- Persistent severe gastrointestinal symptoms (diarrhea, vomiting, nausea, abdominal pain)
- Malnutrition
Criteria for post-operative hospital admission include:
- Severe malnutrition
- Gastrointestinal complications in patients not amenable or responsive to medical therapy
Revision or removal is recommended in the following circumstances:
- Presence of medical complications clearly resulting from the surgical process and not amenable or responsive to medical therapy (for example, malnutrition)
- Inadequate weight loss or weight regain in patients with persistent weight-related comorbidities who previously underwent a restrictive process
- When serious complications related to previous bariatric surgery cannot be managed medically and are not amenable to surgical revision
This list is not exhaustive and best medical judgment should prevail.
Patient Education Seminars
Encourage your LAP-BAND® System candidates to attend a Patient Education Seminar. Seminars are hosted throughout the US by local LAP-BAND® System providers and hospitals. During the seminar, patients will learn more about various surgical options, including the LAP-BAND® System. Find a Seminar.
Obesity Management Team
Obesity management is a multidisciplinary task involving not only your skills and expertise, but also those of other healthcare professionals. The bariatric practice works together with the obesity-management team, which should include the following:12
Referring Physician
Bariatric Surgeon
Anesthesiologist - responsible for anesthesia during surgery and aware of the unique complications induced by morbid obesity during anesthesia
Radiologist - responsible for the post-operative percutaneous stoma adjustment
Endoscopist - detect anatomical particularities and pathologies of the upper gastrointestinal (GI) tract and identify post-operative complications
Psychiatrist, Psychologist - conduct testing to determine personality structure and behavior, contraindications, and assess the need for post-operative psychological follow-up
Dietician - implement and ensure compliance with required dietary modifications
Nurse, Patient Liaison, Patient Educator - provide explanations, education, reinforcement, comfort, trouble-shooting, and advocacy
Physiotherapist (Exercise Therapists/Trainers) - establish regular physical exercise habits
Billing/Insurance Manager - assist with coverage and financing
Patient Support Groups
The Obesity Action Coalition (OAC) recognizes the importance of support groups in managing and treating obesity. For additional support groups and general information about support groups, the OAC also recommends the International Bariatric Support Center.
The National Institutes of Health (NIH) provides information on weight control, obesity, physical activity, and related nutritional issues.
