Presurgical Evaluation and Postoperative Care for the Bariatric Patient

As rates of obesity continue to increase and bariatric surgery becomes increasingly prevalent, more and more specialties encounter bariatric patients during presurgical evaluation and postoperative care. These patients usually have multiple comorbidities and need a comprehensive multisystem evaluation preoperatively and a similar followup postoperatively. Bariatric surgery is truly a multidisciplinary management paradigm with involvement of primary care providers, surgeons, bariatricians (medical physicians with expertise in bariatrics), psychologists, nutritionists, and other health care professionals. The safety of bariatric surgery has gradually improved with the evolution of technique and choice of operations, experience with the procedures, and overall improvement in perioperative care. 1 Presurgical evaluation is multidisciplinary and can be divided into 3 main components: surgical, medical, and psychological. Unlike most other surgeries, the psychological/behavioral component is very significant because of the lifelong behavior change and commitment that undergoing bariatric surgery requires. The preoperative phase includes not just the evaluation and suitability phase but, equally important, the preparation phase. The preparation phase involves group sessions, individual sessions, seminars, dietary behavior modification, and so on, which are both to test the patients and to make sure that these patients make a well-informed decision if and when they decide to proceed with surgery.