Bariatric Doctors: 4 Steps to Finding the Right Surgeon
Honing in on the best weight loss surgeon and team of bariatric doctors requires specific knowledge and proper guidance.
This page explains the 4 steps required to find the bariatric surgeon that’s right for you...
- Step 1: The necessary homework
- Step 2: Creating your initial list of potential surgeons
- Step 3: Narrowing your list
- Step 4: Interviewing and moving forward with your surgeon
Step 1: The Necessary Homework Before Beginning Your Bariatric Doctors Search
Hear it straight from the source
If you'd rather skip the reading and learn more about weight loss surgery and your specific options directly from a qualified surgeon, click here to find a qualified bariatric surgeon in your area. Most surgeons offer free seminars and one-on-one consultations to review your options and discuss your specific situation.
Before beginning your search for the ideal surgeon, you should have a solid understanding of the individual components of bariatric surgery and all the ways they will effect you. Click the following links to round out your research...
- Compare the types of bariatric surgery and choose the procedures that best fit your situation (try to narrow them down to 2 or 3 procedures)
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- Potential bariatric surgery complications
- Bariatric diet before and after surgery
- Life after weight loss surgery
If you don’t have a solid high-level understanding of the above points, it may be difficult to effectively select the best surgical team.
Step 2: Creating Your Initial List of Potential Bariatric Doctors & Bariatric Weight Loss Centers
Bariatric Surgeon vs. Bariatrician
They're not the same thing!
While bariatric surgeons perform weight loss surgery, bariatricians (sometimes called bariatric doctors) help patients lose weight without surgery. Bariatricians are a good first step before moving forward with surgery...ask your primary care physician (family doctor) for a referral.
There are thousands of great bariatric doctors to choose from, some that may have convenient locations right down the street and others located literally on the other side of the world.
The goal of Step 2 is to find at least two surgeons that have the necessary qualifications. Following are things to consider...
How you pay for surgery may influence your list of choices.
Insurance Tip
If you come across qualified surgeons that are not in your insurance company’s network, keep them on your list.
Similarly, if there are no or very few surgeons contracted with your insurance company in your area (or the contracted surgeons don’t pass your requirements as discussed on this page), there is a good chance that you can get the surgeon of your choice added to your insurance company’s network.
If you have insurance that covers weight loss surgery, you'll need to focus on surgeons that are either:
- Already in your insurance company's network, or
- Willing to join
After verifying that your insurance covers weight loss surgery...
- Go to your insurance company's website and search their list of in-network bariatric surgeons.
- Insurance company lists are not always up-to-date, so use the next two sections to find additional qualified surgeons, then contact their offices to find out if they'll accept your insurance.
If you will be paying for all or part of your surgery on your own, which surgeon you choose will likely depend - at least in part - on their costs and financing options.
Most surgeons offer free seminars and/or one-on-one consultations that teach you about your surgery and financing options. Use the sections below to find, contact and sign up for qualified surgeons' free seminars or schedule a free in-person consultation with each to learn your options.
You can also click here to learn the 7 options for financing weight loss surgery.
Contact qualified bariatric doctors.
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As mentioned above, most surgeons offer free seminars and/or one-on-one consultations that teach you about your surgery and financing options.
Click one of the following country links to find and contact qualified surgeons in your desired areas:
- United States
- Mexico (Bariatric Surgery Mexico)
- Canada (Bariatric Surgery Canada)
- Other Countries (aff)
Don't necessarily limit yourself to surgeons in your immediate vicinity. For example, if a similarly qualified out-of-town surgeon is willing to offer you interest-free financing and/or lower costs while a surgeon down the street is not, it may make sense to be treated outside of your home town.
Medical Travel for Weight Loss Surgery
If you are open to having surgery outside the country, you may be able to save as much as $16,000 or more while receiving treatment from a surgical team that is as good or better than what is available locally.
Our Weight Loss Surgery Mexico & Abroad page provides a complete analysis of medical travel for bariatric surgery outside of the U.S (also called "medical tourism") and how to go about finding the right international surgeon.
Ask for referrals.
Other professionals to ask for referrals
- Specialists that you have seen for any obesity-related health problems
- Your local pharmacist
- Nutritionist
- Mental health professional
- OB/GYN
Try to obtain a referral or two from your primary care physician (PCP) or another trusted doctor.
As an important side note, your PCP should be kept in the loop throughout your bariatric treatment as he or she will be an integral part of your long-term follow-up care.
PCP Push-Back
Unfortunately, not all primary care physicians support weight loss surgery. If this is the case with yours, don’t be discouraged. Your PCP may not be up to speed on the latest bariatric surgery techniques, lower risks and the positive impact on obesity health problems.
Before writing off an unsupportive primary care physician, present information and research to try to change his or her opinion. Continuing your relationship with your current PCP will be easier and smoother than getting a new one up to speed before surgery.
To convince your PCP, discuss your obesity health problems (many of which he or she should be familiar with) and how they impact your life. Include both medical problems as well as more private issues such as trouble sleeping, personal hygiene, infertility, sexual problems, obesity discrimination and mental health issues.
Talk about your previous weight loss attempts, both medically supervised and non-medically supervised. In addition, click the following links, print the studies and provide copies to your PCP for review...
- Pennington Biomedical Research Center – Weight Loss Surgery Extends Lifespan
- Journal of Occupational & Environmental Medicine - A Comprehensive Exam of Comorbidities in an Employed Population
- Cleveland Clinic Journal of Medicine – Risks and Benefits of Bariatric Surgery: Current Evidence
- Agency for Healthcare Research and Quality - Review this entire page and include studies that will support your case. There are many studies relating to specific populations – if it applies to you, include it. There are also several impactful general studies.
If your primary care physician cannot be persuaded, you may have to find another one who understands the necessity for your surgery. A supportive PCP will be important during your after-care.
Verify that each of the weight loss surgeons on your list has the appropriate credentials.
Additional 3rd Party Verification
Working with a weight loss surgery center that has received 3rd party accreditation is not absolutely necessary, but it should be a consideration (as discussed in the box at the end of this section).
To take it one step further... if your surgeon performs surgery in one of the 19 states that collects bariatric surgery patient outcome data, your safest choice is likely to be a surgeon that works with a hospital that received the Bariatric Surgery Excellence Award from Healthgrades.
Click here for the updated list of hospital recipients by state, and click here to learn more about the award and what it means to you.
To stay on your list past Step 2, your potential bariatric doctors should each:
- Have an
up-to-date license from their state’s medical
board.
Click here to search the Administration in Medicine’s (AIM) DocFinder for your surgeon’s license status. Once on their site:- First use the search box on the left under “Participating State Licensing Authorities”
- If you don’t find your surgeon, find your state’s link on the right side of the page under “States with links only”, then follow the doctor search instructions on your state’s website.
- The list of bariatric doctors that you find with the same last name should provide clickable links to more information about each doctor. Click on your doctor’s link to view his or her information.
In addition to confirming that each surgeon’s license is active, the doctor information provided should tell you their:
- License type – should be both Physician and Surgeon
- License status – should be renewed and current
- Primary practice area – should be surgery-related
- Public record actions – look for surgeons who have none against them
- Board certification – only work with surgeons who have been board certified
- Be board certified.
Board Certification gives you confidence in your potential surgeon’s focus on bariatric surgery because board-certified surgeons must, according to the American Board of Medical Specialties (ABMS)...
“Participate in an ongoing process of continuing education to keep current with the latest advances in medical science and technology in his or her specialty as well as best practices in patient safety, quality healthcare and creating a responsive patient-focused environment.”
To confirm that your surgeon has been board certified, you will need to register for a free account with the ABMS. If requested during sign up, choose the “State Medical Board or State Board of Medical Examiners” option. You can also leave the “Other Information” section blank that asks for your company name, address, etc.
See the American Board of Medical Specialties' website for more information about board certification.
- If any bariatric doctors on your list have an outdated license, have public record actions listed against them or are not board certified, remove them from your list.
Accredited Weight Loss Surgery Centers:
ASMBS Centers of Excellence &
American College of Surgeons Level 1 Bariatric Surgery Centers
While not absolutely necessary, a bariatric surgeon's or weight loss surgery center's designated status either as a Bariatric Center of Excellence (COE) by
the American Society for Metabolic and Bariatric Surgery (ASMBS) or as a Level 1 Bariatric Surgery Center by the
American College of Surgeons (ACS) should be a consideration when choosing your surgeon.
To receive COE designation, surgeons are required to perform at least 50 surgeries per year while COE hospitals/clinics must perform at least 125 per year. COE surgeons also have strict continuing education requirements and COE facilities must meet specific resource and care standards.
To receive ACS Level 1 designation, bariatric surgery centers must have conducted at least 125 surgeries in the last 12 months, be a full-service Joint Commission-approved, American Osteopathic Association-approved, Det Norske Veritas-approved or state-approved hospital and have key staff members including a bariatric surgeon, Director of Surgery and Bariatric Surgery Coordinator (each of whom must meet certain requirements).
While working with centers/surgeons that have earned one of these designations is desirable, there are qualified, talented and experienced surgeons/clinics who have
not obtained COE designation, many of which meet or exceed the COE/Level 1 standards.
In addition, the actual outcomes for patients receiving treatment at bariatric Centers of Excellence/Level 1 center may (see this study) or may not (see this study) be any different than those receiving treatment from non-COE providers, depending on which studies are referenced. This study, which had by far the most participants of any that we reviewed (over 32,500 patients), concluded that "a definite volume-outcomes relationship exists when hospital-level data are analyzed" (in other words, the more procedures that a center performs, the better the outcomes are likely to be) but it also found that "low-volume centers with extremely low complication rates can be identified and, conversely, there are high-volume centers with elevated rates of complication."
Bottom line? All else being equal, choose the ASMBS COE or ACS Level 1 provider. Experience, minimum care standards and continuing education are important, and COE/Level 1 designation is an easy way to "check the boxes" for those requirements when interviewing your potential surgeons.
But if you receive a strong referral outside of the Centers of Excellence/ACS Level 1 circle, keep them on your list. Ask them why they chose not to apply for COE/Level 1 designation and how their practice stacks up against the COE/Level 1 requirements.
Step 3: Narrowing your list to bariatric doctors with the highest likelihood of a successful outcome
During Step 2, you should have narrowed your list of potential bariatric doctors down to one or two well-qualified surgeons. Now it’s time to dig a little deeper...
Step 3 determines which bariatric doctors on your list are worthy of face-to-face interviews...
- Call each surgeon's office and sign up to attend their next free seminar
- Print out our Bariatric Surgeon Questionnaire (one for each surgeon on your list)
- While attending the seminar, take notes on the printed questionnaire, and be sure to ask any of the questions that are not covered
In addition to meeting the surgeons and learning more about their practice, responses to the following questions (also provided on the questionnaire with blank spaces for your notes) will either remove a weight loss surgeon from your list or give you a better idea of what to ask during them during face to face interviews in the 4th and final step.
- What percentage of your practice’s patients are bariatric surgery patients?
The higher the percentage, the better. Bariatric surgery is a complicated procedure that demands complete attention and expertise. Finding a practice that is primarily focused on bariatric medicine and related treatment ensures that their expertise is not spread too thin.
- What types of weight loss procedures does the surgeon perform?
Considering Vertical Banded Gastroplasty or Mini Gastric Bypass Surgery?
If you are considering vertical
banded gastroplasty (VBG)
surgery, try to find bariatric doctors who are also
experienced in
other types
of bariatric surgery. In most cases, other types of weight
loss surgery are recommended over VBG,
so (generally speaking) a surgeon who only performs VBG may not be
familiar with safer and more effective treatments.
If you are considering mini gastric bypass surgery, try to find a doctor who has experience with both Roux-en-Y and mini gastric bypass (MGBP). MGBP is still relatively new, and experienced surgeons are often familiar with more established procedures.
Find out not only which procedures they focus on but whether they perform the majority of them open or laparoscopically. Laparoscopic surgery is generally preferable, although there are circumstances where open surgery may be necessary.
During your preliminary research, you should have honed in on one or two weight loss surgery procedures that you feel fit you best. If one of the bariatric doctors on your list focuses primarily on surgeries that you are not interested in, remove that surgeon from your list.
- How many bariatric procedures of each type does your practice AND the surgeon perform per year?
To meet the Surgical Review Corporation’s Bariatric Centers of Excellence criteria, each bariatric weight loss center must conduct at least 125 weight loss operations per year and have at least two credentialed and experienced bariatric surgeons who perform at least 50 weight loss operations per year.
What's more, it appears that the more cases a surgeon performs per year, the less likely the patient is to experience complications.
One study of over 3,400 patients and 31 surgeons found that for each additional 10 surgeries per year a surgeon performed, the risk of a serious complication decreased by 10%.4
In another study, a surgeon was evaluated over his first 300 patients. When comparing patients 201 to 300 with patients 1 to 200, the 201-300 group had 89% fewer reoperations (1 vs. 9), 50% fewer coversions to open surgery (1 vs. 2) and was in surgery for 69 fewer minutes on average.5
- What are the surgeon’s complication and mortality rates?
In general, the rates should be in the same range as the rates reviewed on our Bariatric Surgery Complications page. Keep in mind that some surgeons specialize in treating higher risk patients (i.e. patients with a body mass index over 50), and those specialists understandably have higher complication and mortality rates.
- How long will you have to wait for surgery after you get approved?
Depending on your level of urgency, a long wait time may be unacceptable. However, you might want to consider that a long wait time could be due to the surgeon’s good reputation and therefore a positive thing
- Are the professionals on the surgeon’s pre- and post-care
team
well-qualified?
Following are the professionals you will be working with in addition to your weight loss surgeon: - Bariatric program coordinator/director
- Bariatric nurses supporting the surgeon before, during and after surgery
- Anesthesiologist - how many years and how successfully has the anesthesiologist worked with obese patients? Get the anesthesiologist’s name and click here to confirm that they have been certified by the American Board of Anesthesiology (ABA).
- Psychologist – make sure there is one on staff or in close partnership with your surgeon and that they specialize in bariatrics. The psychologist will work with you before surgery and should be available for counseling afterwards.
- dietitian or nutritionist – ensure that your surgeon works closely with a registered dietitian or nutritionist for pre- and post-surgical consultations. They are an extremely important resource for both helping you establish your short and long-term diet plans and overcoming any bariatric diet related obstacles.
- Fitness advisor – do they work directly with anyone who can help you establish an appropriate weight loss surgery exercise program or, at a minimum, refer you to a personal trainer experienced in working with bariatric patients.
- Weight loss surgery support
group – does their office have pre- and
post-surgery
support
groups in place? If so, is there just one, or are there different
groups for different needs (i.e. diet, exercise, recovery,
procedure-specific, etc.).
Patients who regularly attend support groups have been shown to have better long-term outcomes. While you can and should find additional offline and online weight loss support on your own, working with a surgeon or bariatric weight loss center that has their own programs will make finding and joining one near you much easier. - Insurance coordinator (if you have insurance) – as reviewed on our Bariatric Surgery Insurance page, getting surgery approved is often a grueling process. Offices with a coordinator on staff can make the process a whole lot easier.
- Will another doctor be assisting the surgeon during surgery? If so, what are the assistant’s qualifications and how involved will he/she be in your treatment?
Make sure that the surgeon will be the one coordinating and performing the surgery. In addition, any staff or nurses assisting the surgeon should be primarily focused on assisting bariatric surgery patients (again, you don’t want the professionals operating on you to be spread between multiple areas of expertise) and be taking continuing education classes relating to the care of bariatric patients.
- Does the surgeon have a short and long-term follow up program to work with you after surgery?
There should be a detailed plan in place to help you transition to and maintain a healthy life after weight loss surgery with the involvement of many of the professionals listed above.
- Are your facilities equipped to handle obese patients?
Not only will things like bigger waiting room chairs and hospital beds along with a staff trained in obesity empathy make you feel more comfortable and relaxed, they also show you that you are dealing with a compassionate surgeon who has your best interests in mind.
During Step 4, you will interview each of your remaining surgeons in person in order to choose the one that’s right for you.
Step 4: Interviewing the remaining bariatric doctors on your list and choosing your surgeon
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In all likelihood, each of the surgeons that passed Steps 2 and 3 will be an excellent choice. Step 4 is all about:
- Choosing the surgeon and bariatric weight loss center that “just feels right” and
- Learning more about what to expect
To begin Step 4, find out if you can attend a bariatric surgery support group offered by the surgeon’s office. In addition to giving you a first hand account of what it was like for other patients to be treated by your surgeon, attending a support group meeting will give you a much better understanding of what’s to come.
After you attend the support group meeting, it’s time to schedule your face-to-face interview with each surgeon. The purpose of your interview is to get answers to your remaining questions and to get a better feel for the surgeon.
The questions in the Face-to-Face Interview section on the Bariatric Surgeon Questionnaire will get you started, but they are only a general guideline. Ask any and all questions that come to mind. Good bariatric doctors will be glad that you are doing your research and will be happy to provide answers.
Procedure-Specific Questions
Consider asking these additional questions depending on which procedures you are interested in...
Roux-en-Y gastric bypass surgery: What steps do you take to ensure that no leaks occur after surgery? In order to prevent leaks, your surgeon should check the surgical connections a number of different ways before completing the operation, including (1) blowing air into the connection and observing whether any gets through and (2) using a dye to check for a leak.
Lap band surgery: What technique do you use to place the band: pars flaccida or perigastric? Bariatric doctors performing the pars flaccida technique (PFT) when placing the band see up to 22% fewer lap band reoperations than doctors using the perigastric technique (PGT).1
Duodenal switch surgery: I’ve read that DS surgery can be especially appropriate and effective for the super-obese, but its higher complication rate coupled with a super-obese patient’s increased risk for complications demand careful consideration. What is your feeling about this? Also ask about leaks as indicated under gastric bypass above.
Gastric sleeve surgery: Since there is limited long-term research available for gastric sleeve surgery, can you help me understand why you think this procedure will continue to be effective over the long-term? What procedures are you familiar with for tightening a stretched stomach? Also ask about leaks as indicated under gastric bypass above.
Vertical banded gastroplasty: Other procedures appear to have similar or better outcomes than VBG with lower risks. What is your opinion? Also ask about leaks as indicated under Gastric bypass above.
Mini gastric bypass surgery: Why would this procedure be recommended over Roux-en-Y gastric bypass? In what situations would you recommend Roux-en-Y instead? Also ask about leaks as indicated under gastric bypass above.
After interviewing each of the bariatric doctors, how do you decide which one to choose? It comes down to how personally comfortable you are with each surgeon.
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Maybe one office was more relaxing and their staff more welcoming. Maybe one of their aftercare plans seemed more well-planned and thorough. Maybe one surgeon’s former patients seemed more pleased with their experience. Maybe one surgeon “just felt better.”
Regardless of which one you choose, if they passed the above 4-Step process, their support group had positive things to say and you felt good about them during their seminar and the interview, you should feel confident that you have chosen a great surgeon.
For additional research, search for your topic...
Also see...
References
- Bueter M, Maroske J, Thalheimer A, et al. Short- and long-term results of laparoscopic gastric banding for morbid obesity. Langenbecks Arch Surg. 2008;393:199–205.
- Centers of excellence in bariatric surgery: design, implementation, and one-year outcomes. Don W. Bradley, Bal K. Sharma. Surgery for Obesity and Related Diseases - September 2006 (Vol. 2, Issue 5, Pages 513-517, DOI: 10.1016/j.soard.2006.06.005)
- Edward H. Livingston. Bariatric Surgery Outcomes at Designated Centers of Excellence vs Nondesignated Programs. Arch Surg. 2009;144(4):319-325.
- Smith MD, et al. Relationship between surgeon volume and adverse outcomes after RYGB in Longitudinal Assessment of Bariatric Surgery (LABS) study. Surgery for Obesity and Related Diseases - 4 March 2010 (Vol. 6, Issue 2, Pages 118-125, DOI: 10.1016/j.soard.2009.09.009)
- Pournaras DJ, et al. Three Hundred Laparoscopic Roux-en-Y Gastric Bypasses: Managing the Learning Curve in Higher Risk Patients. Obesity Surgery. DOI 10.1007/s11695-009-9914-7
[Last editorial review/modification of this page: 1/24/2012]
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