Select a Medical Service | Center for Surgical Weight Loss

When you come to the Center for Surgical Weight Loss, you can be sure you’re getting the most complete care available from a specially trained group of physicians, nurses and support personnel.

There are certain criteria required for you to qualify for weight-loss surgery. They include:

A BMI of 40 or greater or at least 100 pounds overweight
A BMI of 35 or greater accompanied by one or more comorbid conditions
A history of documented dietary weight-loss attempts
A dietary evaluation
A psychological evaluation
A lifelong commitment to follow-up care

If you think you meet these criteria, you’re ready to begin pursuing weight-loss surgery. There are a series of specific steps required of Center for Weight Loss Surgery patients, which have proven to be the most effective way for you to receive the appropriate education, counseling and care before your surgery.

As a patient of the Center, you will:

Attend a mandatory information session
Contact your insurance company
Make an appointment
Attend an all-day consult
Undergo nutritional and diagnostic testing
Attend post-consultation nutrition follow-up
Attend two support group meetings
Attend final presurgical appointments
Undergo surgery
Maintain post-surgical care

Please note: Smoking greatly increases the risks associated with surgery. You must quit smoking at least two months prior to surgery or surgery will not be performed. You must commit to continue smoking cessation after your surgery.

Step 1: Mandatory Information Session

Everyone who is interested in weight-loss surgery is required to attend one of the Center's information sessions before calling to make an appointment. Sign-in is required at these meetings. This is your opportunity to meet our surgeons, David Brams, MD, and Dmitry Nepomnayshy, MD, and have your surgical questions answered.

Information sessions take place on the second Monday of each month at 4:30 pm in the Alumni Auditorium at Lahey Clinic Medical Center, Burlington.

Step 2: Contact Your Insurance Company

We request that you inquire as to whether your insurance company covers the cost of laparoscopic adjustable gastric band and/or Roux-en-Y prior to scheduling an appointment at the Center. You will be asked to provide this information at your appointment.

Diet History

Most insurance companies require you to provide a history of prior diet attempts for at least a consecutive six-month period before they will cover the cost of surgery. This can often be proven with receipts from weight-loss groups, nutritionists and physicians. If you don't have this information, start working on documentation now.

For more information, please refer to our insurance approval guide.

Step 3: Make an appointment

Call 781-744-3044 to make your first appointment. This will be an all-day, multi-departmental consult. Please plan to spend the entire day at Lahey Clinic on the day of your appointment.

Please complete all of the paperwork given to you at the information session. For printable copies of the required forms, select the links below.

Required Forms

Patient questionnaire

Eating questionnaire

Step 4: Attend your all-day consult

When you come for your preliminary appointment, please bring your completed patient questionnaire, eating questionnaire and insurance questionnaire and be prepared to spend the entire day meeting with specialists.

During this consultation, you will meet with a nurse practitioner or physician assistant from the Center for Surgical Weight Loss who will be your primary caregiver during this process. You will also meet with a psychologist and a dietitian.

Following a consultation, a staff meeting is held among all of the clinicians who met with you, where they determine your candidacy for surgical weight loss. If you are a good candidate for surgery, you will receive a follow-up appointment in the mail. If you are not, you will receive a letter in the mail explaining why.

Patient Assessment

You will be required to complete a detailed patient assessment with information about your family medical history, insurance coverage and general health.

Step 5: Nutritional and Diagnostic Testing

Once it is determined that you are a good candidate for surgical weight loss, you will undergo a series of diagnostic and nutritional tests to screen for any underlying comorbid conditions.

Together, you and a dietitian will draft a pre-surgical nutritional plan with set goals that must be met before surgery. These include maintaining a healthy, nutritious eating plan and losing 10 percent of excess weight through diet and exercise. This weight loss makes for an easier and less risky surgery.

If you are found to need treatment for any medical conditions, such as diabetes, depression or high blood pressure, you will have separate scheduled appointments with specialists in these areas to address the conditions. Once these are under control, you will continue on your path to surgery.

Step 6: Post-Consultation Nutrition Follow-up

You will meet with the dietitian to assess progress on your goals. An appointment with a surgeon will be scheduled based on your readiness at your nutrition follow-up.

Step 7: Support Group Meetings

Prior to your surgery, you must attend a minimum of two support group meetings specific to the procedure you will undergo.

The support group for the Roux-en-Y gastric bypass is on the second Monday of each month from 6 to 7:30 pm in the 6 Central waiting room at Lahey Clinic Medical Center, Burlington.

The support group for the laparoscopic adjustable gastric band is on the last Tuesday of each month from 6 to 7:30 pm in the 6 Central waiting room at Lahey Clinic Medical Center, Burlington.

Step 8: Final Pre-Surgical Appointments

Before your surgery, you will attend a number of appointments with your surgeon and other members of the team for education and assessment. These appointments will include blood work and an EKG (a diagnostic test of your heart) and will include your final meeting with your surgeon before your surgery takes place.

During this visit you will also schedule your postoperative appointments with your surgeon, dietitian and other members of the team.

Step 9: Surgery

Depending on the procedure you and your surgeon have selected, and whether there are any circumstances that affect the speed of your operation, your surgery should last from one to three hours.

Adjustable laparoscopic band surgery takes approximately two hours, laparoscopic Roux-en-Y about two to three hours and open Roux-en-Y approximately two hours. You will most likely stay in the hospital for one to four nights, depending on your procedure and overall health.

Step 10: Post-Surgical Care

Weight-loss surgery requires a lifetime commitment. Following your surgery, you will continue to see members of the Center for Surgical Weight Loss team for virtually the rest of your life.

The follow-up protocol for each procedure is as follows:

Roux-en-Y Gastric Bypass

1 week post-op: meet with physician assistant or nurse practitioner
2 weeks post-op: meet with dietitian
3 weeks post-op: meet with physician assistant or nurse practitioner
4 weeks post-op: meet with dietitian
6 weeks post-op: meet with surgeon
3 months post-op: meet with physician assistant or nurse practitioner; meet with dietitian
6 months post-op: meet with surgeon; meet with physician assistant or nurse practitioner; meet with dietitian
12 months post-op: meet with surgeon; meet with physician assistant or nurse practitioner; meet with dietitian
18 months post-op: meet with surgeon; meet with physician assistant or nurse practitioner; meet with dietitian
Yearly: meet with physician assistant or nurse practitioner; meet with dietitian
As needed: meet with psychologist

Laparoscopic Adjustable Gastric Band

1 week post-op: meet with surgeon
2 weeks post-op: meet with dietitian; continue to meet one to two weeks after each fill (the procedure used to control weight-loss) until weight loss plateaus.
6 weeks post-op: meet with physician assistant or nurse practitioner; continue to meet every six to eight weeks thereafter until weight loss plateaus.
6 months post-op: meet with surgeon
As needed: meet with psychologist

Step-by-Step Guide to Weight-Loss Surgery