Your first gastric sleeve consultation: what happens and what to bring

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Your first gastric sleeve consultation: what happens and what to bring

A first gastric sleeve consultation is a conversation about your weight history, your health, and whether a sleeve or a different treatment fits you. At the Rancho Cucamonga practice of Dr. David G. Davtyan, MD, FACS, FICS, FASMBS, the first consultation is complimentary. You do not have to decide anything that day. This page explains what such a visit usually covers and what to bring.

Booking the visit

Call the office at 909-355-2525 or send a request through the contact page. Spanish is spoken. When you book, say which situation is closest to yours:

You are thinking about weight-loss surgery for the first time.
You have settled on a sleeve and want to know whether you qualify.
You are comparing a sleeve with other treatments, such as a gastric bypass, a balloon or medication.

The practice works with PPO and HMO plans that allow care with Dr. Davtyan. Have your insurance card in hand when you call, and ask us whether we can see patients on your plan. It also helps to ask how long to set aside, whether forms can be filled out ahead of time, and whether records can be sent before the visit.

What the conversation usually covers

Much of a first visit is talking. Expect questions about:

How your weight has changed over the years, and what you have tried, including diets, programs and medications.
Health conditions linked to weight, such as type 2 diabetes, high blood pressure, sleep apnea (pauses in breathing during sleep), joint pain and heartburn.
Past operations, especially on the stomach, gallbladder or a hernia.
Smoking, alcohol, and the medicines and supplements you take.
Whether you plan a pregnancy in the next couple of years.
What you hope will be different a year from now.

Heartburn deserves a clear answer. Reflux can begin or get worse after a sleeve, so if you already have it, raise it early and ask whether a different operation, such as a gastric bypass, should be part of the discussion. Our pages on acid reflux after a sleeve and gastric bypass versus gastric sleeve explain why.

It is also a time to hear what a sleeve is. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) describes it as removing about 80 percent of the stomach, leaving a long, banana-shaped pouch, and states that it cannot be reversed because part of the stomach is permanently removed. That permanence is a main thing to weigh before you decide.

How candidacy is judged

Body mass index (BMI) is a number calculated from your height and weight. The 2022 guidelines from the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) recommend metabolic and bariatric surgery for people with a BMI of 35 or more, whether or not they have related health conditions. They say surgery should be considered at a BMI of 30 to 34.9 when metabolic disease, such as type 2 diabetes, is present.

Insurance plans do not always follow those guidelines. Some still apply older thresholds, such as the BMI of 40, or 35 with a serious related condition, that the NIDDK lists on its candidates page, and some ask for a documented period of supervised weight management. Meeting the medical guideline and meeting your plan's rules are two separate questions. See insurance requirements for a gastric sleeve and, for a lower BMI, a sleeve at BMI 30 to 35.

BMI is not the whole picture. The same guidelines describe a team assessment that looks at risk factors you can change before surgery, and they say the decision about readiness should be determined by the surgeon.

What to bring

Photo ID and your insurance card.
A list of every medicine and supplement with doses, including any GLP-1 medication such as Wegovy, Zepbound, Ozempic or Mounjaro, and how long you have taken it.
Your diagnoses and past operations, with dates if you know them.
Recent lab results, a sleep study report, or an endoscopy report, if you have any.
Any record of past weight-loss attempts that a doctor supervised. Some insurers ask for it.
Your primary care doctor's name and phone number.
Your questions, written down. Our list of questions to ask a sleeve surgeon is a starting point.

What to ask before you leave

Try to leave knowing whether a sleeve looks reasonable for you, what else could be considered, and what would have to happen before a date could be set. If you want to compare other treatments, such as a gastric bypass, a balloon or medical weight loss with GLP-1 medications, ask the office whether each is currently available.

If you go ahead, the next stage is a work-up. A 2019 guideline from several American medical societies, including ASMBS, lists what it usually includes: a history and physical, blood tests, heart and lung checks with sleep apnea screening, a nutrition evaluation, and a psychosocial evaluation. Our guide to the steps from consultation to surgery walks through them. The Rancho Cucamonga gastric sleeve guide covers the operation itself.

Frequently asked questions

How long does a first sleeve consultation take?

It varies from one practice to another, so ask when you book. A first visit generally includes check-in, being weighed, the conversation, an examination and time for your questions. Arriving a little early with your medication list and records already gathered keeps more of the time for the discussion itself.

Can I bring my spouse or a family member?

Many people find that it helps, and you can mention it when you book. A sleeve changes how a household shops, cooks and eats, and a second listener catches details you may miss. The person who will drive you home from the hospital and help in the first week is a good choice. If you would rather discuss some topics privately, say so.

Do I need a referral from my primary care doctor to book?

That usually depends on your insurance. Many HMO plans require a referral or authorization before a specialist visit, while PPO plans often do not. Call your plan or the number on your card to find out what it needs, and ask us whether we can see patients on your plan. Either way, your primary care doctor's notes are useful to bring.

Will I be told to lose weight before a sleeve can be approved?

Possibly, by your insurer. The 2022 ASMBS and IFSO guidelines state that there are no data to support insurance-mandated weight loss before surgery, yet some plans still require a supervised program. That is different from the short pre-surgery diet a surgeon may prescribe in the weeks before the operation, which has a medical purpose.

Is this the right place to start if my sleeve was done elsewhere?

Call first and say so. Ask whether Dr. Davtyan can see you and whether the complimentary consultation applies when you already have a sleeve, since this page is written for people considering a first operation. Our guide for transfer patients lists the records worth requesting from your first surgeon.

Book a consultation in Rancho Cucamonga

Dr. Davtyan is a bariatric surgeon who earned his MD at the UCLA School of Medicine. The Rancho Cucamonga office of Davtyan Medical Weight Loss & Wellness is at 8330 Red Oak Street, Suite 201, Rancho Cucamonga, CA 91730. Call 909-355-2525 or toll free 877-9-BE-SLIM (877-923-7546), or use the contact page.

Your first gastric sleeve consultation: what happens and what to bring

Your first gastric sleeve consultation: what happens and what to bring

Booking the visit

What the conversation usually covers

How candidacy is judged

What to bring

What to ask before you leave

Frequently asked questions

How long does a first sleeve consultation take?

Can I bring my spouse or a family member?

Do I need a referral from my primary care doctor to book?

Will I be told to lose weight before a sleeve can be approved?

Is this the right place to start if my sleeve was done elsewhere?

Book a consultation in Rancho Cucamonga

Sources

More in the Gastric Sleeve in Rancho Cucamonga guide

Understanding the sleeve

Weighing your options

Getting care in Rancho Cucamonga

Adult BMI Calculator

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