- Before Considering Surgery
- Alternative Solutions to Surgery
- Questions about Surgery
- Weight Loss Treatment Options
What are the Requirements for Surgery?
To be considered for surgery with Dr. Hargroder, the following requirements must be met:
- Be between 15 and 70 years old (over age 60 requires a special evaluation)
- Have a BMI of 30 or greater (BMI below 35 require special consideration) BMI below 35 is not covered by insurance.
- More than 60 lbs. overweight
- Patients who have had previous weight loss surgery require special consideration
If you meet the above requirement and wish to be considered for surgery, register on this website or call our office.
Where are procedures performed?
Dr. Hargroder is currently performing weight loss procedures in the following accredited facilities:
- St. Elizabeth Hospital in Gonzales, La
- Woman’s Hospital in Baton Rouge, La
- Cypress Pointe Surgical Hospital in Hammond, La
What is the cost? What is included?
St Elizabeth / Woman’s Hospital / Cypress Hospital:
$22,625.00 Laparoscopic Gastric By-Pass (Roux-en-y)*
$15,500.00 Laparoscopic Vertical Sleeve Gastrectomy*
$16,000.00 Laparoscopic Adjustable Gastric Banding*
*All prices include the office consultation, hospital and physician charges, standard pre-op screening, anesthesia, 90 day post-op complications for both the physician and the hospital, and 5 years office visits, as well as the physician assistant.
There are additional fees for revisions of previous bariatric surgeries. Please call and schedule an appointment for exact pricing.
What Financing Options Exist?
Financing is available! Whether you are looking to finance your entire procedure or just your out of pocket costs, these lenders can help.
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- Immediate decisions for loans under $35,000
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Efficacy of Non-Surgical Weight Loss Options
Published scientific reports document that non-operative methods alone have not been effective in achieving a medically significant long term weight loss in severely obese adults. It has been shown that the majority of patients regain all the weight lost over the next five years. The average medical weight reduction trial is a 10-12 week study with average weight loss of 2.5 kg. The use of anorectic medications has recently been advocated as a long term therapeutic modality in the management of what is clearly a chronic disease. In a nearly four year study, utilizing a two drug regimen of Phentermine and Fenfluramine, behavior modification, diet and exercise, the initial optimistic results have not been sustained, with a one third drop out rate and a final average weight loss of only three pounds in those who were followed for the four years of the study. This drug combination appears to have an unacceptably high association with cardiac valvular disease and has been withdrawn from therapeutic use because of these potentially life threatening sequelae.
Dietary weight loss attempts often cause depression, anxiety, irritability, weakness and preoccupation with food. The treatment goal for morbid obesity should be an improvement in health achieved by a durable weight loss that reduces life threatening risk factors and improves the performance of activities of daily living. Temporary fluctuations in body weight from calorie restricted diets should be avoided.
Exercise and Weight Loss
Starting an exercise program can be especially intimidating for someone suffering from morbid obesity. Your health condition may make any level of physical exertion next to impossible. The benefits of exercise are clear, however. And there are ways to get started. A National Institutes of Health survey of 13 studies concludes that physical activity:
- Results in modest weight loss in overweight and obese individuals
- Increases cardiovascular fitness, even when there is no weight loss
- Can help maintain weight loss
New theories focusing on the body’s set point (the weight range in which your body is programmed to weigh and will fight to maintain that weight) highlight the importance of exercise. When you reduce the number of calories you take in, the body simply reacts by slowing metabolism to burn fewer calories. Daily physical activity can help speed up your metabolism, effectively bringing your set point down to a lower natural weight. So when following a diet to attempt weight loss, exercise increases your chances of long-term success.
Examples to get you started:
- Park at the far end of parking lots and walk
- Take the stairs instead of the elevator
- Cut down on television
- Swim or participate in low-impact water aerobics
- Ride an exercise bike
Overall, walking is one of the best forms of exercise for weight loss. Start out slowly and build up. Your doctor, or people in a support group, can offer encouragement and advice. Incorporating exercise into your daily activities will improve your overall health and is important for any long-term weight management program, including weight loss surgery. Diet and exercise play a key role in successful weight loss after surgery.
Diet and Behavioral Modification
There are literally hundreds of diets available. Moving from diet to diet in a cycle of weight gain and loss – yo-yo dieting – that stresses the heart, kidneys and other organs can also be a health risk. Doctors who prescribe and supervise diets for their patients usually create a customized program with the goal of greatly restricting calorie intake while maintaining nutrition. These diets fall into two basic categories:
Low-Calorie Diets (LCDs): individually planned so that the patient takes in 500 to 1,000 fewer calories a day than he or she burns.
Very Low-Calorie Diets (VLCDs): typically limit caloric intake to 400 to 800 a day and feature high-protein, low-fat liquids.
Many patients on Very Low-Calorie Diets lose significant amounts of weight. However, after returning to a normal diet, most regain the lost weight in under a year. Ninety percent of people participating in all diet programs will regain the weight they’ve lost within two years. It is for this reason that so many are turning to weight loss surgery as a permanent solution for extended weight loss.
Behavior modification uses therapy to help patients change their eating and exercise habits. Like low-calorie diets, behavior modification, in most patients, results in short-term success that tends to diminish after the first year.
If diet and behavior modifications have failed you and weight loss surgery is your next option, it is important to understand that diet and behavior modification will be instrumental to sustained weight loss after your weight loss surgery. The surgery itself is only a tool to get your body started losing weight – complying with diet and behavior modifications required by most surgeons would determine your ultimate success.
Over the Counter and Prescription Drugs
New over-the-counter and prescription weight loss medications have been introduced. Some people have found them effective in helping to curb their appetite. The results of most studies show that patients on drug therapy lose around 10 percent of their excess weight and that the weight loss plateaus after six to eight months. As patients stop taking the medication, weight gain usually occurs.
Weight loss drugs can have serious side effects. Still, medications are an important step in the morbid obesity treatment process. Before insurance companies will reimburse/pay for weight loss surgery, you must follow a well-documented treatment path.
“Since many people cannot lose much weight no matter how hard they try and promptly regain whatever they do lose, the vast amount of money spent on diet clubs, special foods and over-the-counter remedies, estimated to be on the order of $30 billion to $50 billion yearly, is wasted.” (New England Journal of Medicine).
Pre-Operative Psychological Testing
There are two possible reasons for pre-operative psychological testing prior to bariatric surgery. One is to weed out those with significant psychopathology in whom surgery would be contra-indicated, the other to pre-select those in whom the surgery is likely to be a success.
Studies of severely overweight persons conducted before their undergoing bariatric surgery have shown: a) that there is no single personality type that characterizes the severely obese. b) that this population does not report greater levels of psychopathology than do average-weight control subjects; and c) that the complications specific to severe obesity include body image disparagement and binge eating.
Studies conducted after bariatric surgery and weight loss have shown 1) that self-esteem and positive emotions increase; 2) that body image disparagement decreases; 3) that marital satisfaction increases, but only if a measure of satisfaction existed before surgery, and 4) that eating behavior is improved dramatically. The results of bariatric surgery are superior to those of dietary treatment alone. Practitioners should be aware that severely obese persons are subjected to prejudice and discrimination and should be treated with an extra measure of compassion and concern to help alleviate their feelings of rejection and shame.
Accordingly, routine pre-operative psychological evaluation should be required in patients who have a history of severe psychiatric disturbance or who are currently under the care of a psychologist/psychiatrist or who are on psychotropic medications. Such patients, and those under the age of 18 years should be required either to have psychiatric clearance in writing from their counselor or to undergo a psychiatric evaluation before bariatric surgery. Other patients who wish to have the benefit of psychologic counseling before surgery should be encouraged to do so.
Questions for Your Primary Care Doctor
You should work with your doctor to document your weight loss attempts, including all previous weight loss programs or efforts in which you have participated. You should also carefully record any obesity-related health conditions you suffer from that may be alleviated with weight loss surgery.
- Are these health conditions getting worse?
- Are you continuing to sleep poorly?
- Are you having more and more trouble walking?
- How high is your blood pressure compared to two or three years ago?
- Is your Body Mass Index in the 40-60 range?
- Is your Body Mass Index in the 35-39 range with life threatening co-morbidities?
- Are you 75 lbs. overweight?
These records will help you decide if weight loss surgery is an option for you. They will also help provide the health history necessary to obtain insurance reimbursement for weight loss surgery.
Other questions to ask your doctor:
- How would I benefit from weight loss?
- What are my best options now?
- Am I a candidate for weight loss surgery?
- What are the next steps I should take?
- Can you refer me to a bariatric surgeon?
Questions for Your Bariatric Surgeon
Being a well-informed patient is good for you and good for your doctor. Here are some of the questions you should your bariatric surgeon:
- What types of weight loss surgery procedures have you performed?
- How many of each bariatric procedure have you performed?
- Can bariatric surgery be performed using minimally invasive techniques?
- Can I be considered a candidate for bariatric surgery even though I have one or more associated health conditions related to my obesity?
- Which procedure is best for me?
- Why?What are the risks involved?
- How long will I be in surgery?
- What is the length of my anticipated hospital stay?
- How long will it be before I can return to pre-surgery levels of activity?
- How will my eating habits change?
- Do you have information about bariatric surgery costs and payment options?
- What are the typical excess weight loss and improvement of associated health conditions for your other patients?
- Do you have patients who are willing to share their experiences, both positive and negative?
- What information can you give me to help family and friends better understand bariatric surgery?
- What type of long-term, aftercare services (such as support groups and counseling) can you provide for me?
- What do you expect from me if I decide to choose a surgical solution?
For anyone who has considered a weight loss program, there is certainly no shortage of choices. In fact, to qualify for insurance coverage of weight loss surgery, many insurers require patients to have a history of medically supervised weight loss efforts.
Most non-surgical weight loss programs are based on some combination of diet/behavior modification and regular exercise. Unfortunately, even the most effective interventions have proven to be effective for only a small percentage of patients. It is estimated that less than 5% of individuals who participate in non-surgical weight loss programs will lose a significant amount of weight and maintain that loss for a long period of time.
According to the National Institutes of Health, more than 90% of all people in these programs regain their weight within one year. Sustained weight loss for patients who are morbidly obese is even harder to achieve. Serious health risks have been identified for people who move from diet to diet, subjecting their bodies to a severe and continuing cycle of weight loss and gain known as “yo-yo dieting.”
The fact remains that morbid obesity is a complex, multi-factorial chronic disease.
For many patients, the risk of death from not having the surgery is greater than the risks from the possible complications of having the procedure.
That is the key reason that in 2000, approximately 40,000 weight loss surgical procedures were performed and why the American Society for Bariatric Surgery estimates that 63,000 weight loss surgical procedures were performed in 2001. Patients who have had the procedure and are benefiting from its results report improvements in: their quality of life, social interactions, psychological well-being, employment opportunities, and economic condition.
In clinical studies, candidates for the procedure who had multiple obesity-related health conditions questioned whether they could safely have the surgery. These studies show that selection of surgical candidates is based on very strict criteria and surgery is an option for the majority of patients.
Andrew Hargroder, MD
16851 Jefferson Highway, Suite 3B
Baton Rouge, LA 70817
Monday 8:00 am - 4:00 pm
Tuesday 8:00 am - 4:00 pm
Wednesday 8:00 am - 4:00 pm
Thursday 8:00 am - 4:00 pm
Friday 8:00 am - 12:00 pm
SUPPORT GROUP MEETS:
Third Wednesday of the Month, 5pm – 6pm