Gastric bypass surgery is a major life-changing decision. Surgery to produce weight loss is a last-resort option. Before applying for weight loss surgery, it is imperative that you are well informed and understand how surgery will affect your life. If you believe weight loss surgery at the University of Michigan Health System (UMHS) is appropriate for you, you need to follow the steps below.

1. Before calling the program or registering online, call your health insurance company to verify if bariatric surgery is a covered benefit. Some insurance companies exclude all types of weight loss surgery. Also, ask if your plan requires a referral to our program.
2. Thoroughly review all the information about the University of Michigan Adult Bariatric Surgery Program. Patients are required to have a comprehensive evaluation by their primary care provider within the past year. Documentation to include a complete physical exam, screening for treatable causes of obesity, all non-surgical attempts at weight loss over a minimum of 2 years, and lab studies. It is the patient's responsibility to ensure this information is received by the bariatric surgery program prior to an information session.
3. Carefully review program criteria. You must meet the criteria to be considered a candidate for the UMHS Bariatic Surgery Program. If you meet all the requirements and have obtained the required documentation, please call the program to schedule an Information Session.
4. Weight Loss Surgery Information Session. All patients interested in weight loss surgery must attend an information session. Patients will meet the bariatric surgery program team including post-gastric bypass patients. A presentation on the gastric bypass surgery, benefits and risks, and permanent life-modifying changes required after surgery will be reviewed. The meeting convenes with a question and answer session.
5. Medical, Psychological, and Nutritional evaluations. After registering, the program administrative assistant will contact you to schedule the psychological and nutritional evaluations.
   • Medical Evaluation. The Medical Director/Physician Assistant will perform a health evaluation to determine current health status. Based on clinical findings, additional tests or evaluations may be requested to prepare you for surgery.
   • Psychological Evaluation. The evaluation is in two parts: a written test and a psychologist interview. The written test is use to help determine your abilities to cope with life events or stressors. The psychologist will review current and past life experiences and how your weight has affected your choices in life. (Note: There may be an out-of-pocket expense for this evaluation).
   • Nutritional Evaluation. A dietitian will obtain a diet history of your past weight loss successes and failures, current eating habits, and review post-surgery dietary changes.
6. Review Committee. Upon receiving requested medical information from your referring physician, and completion of the psychological and nutritional evaluations, a bariatric committee will review your case to determine readiness for surgery. The surgeon, program director, psychologist, dietitian and other health professionals make up the review committee. The committee may make recommendations for further evaluations or therapies. You will be notified of the committee's decision by phone or secured messaging.
7. Nutritional counseling. Once the review committee has determined you have met the UMHS Bariatric Program criteria, you will be scheduled for nutritional classes. These classes will instruct how to change eating habits before and after surgery, how to avoid nutritional deficiencies, and to stress the life time commitment to dietary change. Nutritional counseling continues after surgery with post-operative follow-ups.
8. Preoperative Evaluation. You will meet with the surgeon and physician assistant to review the risks and benefits of surgery, and to answer any questions regarding the surgery. This usually occurs after nutritional counseling has been completed and surgery has been authorized by your health insurance plan. A pre-operative history and physical and surgical consent will be obtained as well as preoperative instructions explained. The surgery date will be determined during this visit. An anesthesia pre-operative assessment will also be preformed. We encourage you to bring a support person to this appointment.
9. Day of Surgery. Follow the instructions provided at your pre-operative evaluation.