12-MONTH MEDICAL WEIGHT LOSS PROGRAM FOR ORBERA™

Once you have attended a seminar and have elected to have the procedure, you will be enrolled in our 12-month program Medical Weight Loss (MWL) program. This entails monthly visits with our Physician Assistant or Bariatrician (Internal Medicine doctor). You will also attend weekly classes with our Behaviorist, Dietitian, and Exercise Physiologist for the best results and weight loss outcome. A glimpse into our year long program is below.

PRE-PLACEMENT STEPS

Step 1: Attend an Seminar

Step 2: History and Physical Exam/Surgical Risk Assessment by the Bariatrician.
• An EKG and noninvasive history and physical exam will be done.
• If you are required to have additional tests prior to surgery those will be ordered at this visit.
• Lab order will be given for fasting blood work to be done at your earliest convenience.
• Behavior Evaluation will be arranged if determined necessary.

Step 3: Consult with Bariatric Surgeon
• Medications: You will receive prescriptions for medications to use at home pre and post balloon placement.

Step 4: Pre-Procedure Appointment
• This appointment takes place two weeks prior to balloon placement.
• This appointment is designed to prepare you for what to expect before and after your procedure.
• Appointment time can vary from one to two hours.
You must bring in an updated medication list including dosage.
• You will be given a binder outlining the pre-procedure presentation. This binder will also be a tool for you to reference after your procedure.
• During this appointment you will meet with the Dietitian and Exercise Physiologist.
• You will purchase the required food product to start your pre-procedure diet.

Step 5: Day of Balloon Placement
• Report to The Bariatric Clinic 90 minutes prior to your scheduled procedure time for a weigh in.
• Surgical Coordinator will escort you to Endoscopy Dept.

POST-PLACEMENT STEPS

 First two weeks:
• Liquids only for the first five to seven days after balloon placement. You will follow the Very Low Calorie Diet (VLCD) protocol for the remainder of the two weeks.
• Daily phone calls by staff/surgeon for the first seven days will be made to assess for dehydration and/or other complications and provide support.

2-4 Weeks:
• Follow up visit at week two with Bariatric Surgeon and Dietitian.
• Back to food class with Dietitian for a transition to 1200kcal high protein diet. This is approximately a four week long transition.

Month 1-4:
• You will participate in weekly classes through the NOCH Medically Supervised Weight Loss Program for 16 weeks.
• You will have monthly follow-up appointments with either the Bariatrician or Bariatric PA.

Month 5:
• 30 minute visit with the Bariatric PA to prep for, and schedule removal of balloon. (Updated H&P). An EKG and a lab order will be given at this time. Lab draw to be done within five days from the visit.
• Start VLCD two weeks prior to balloon removal, the last four days of which will be liquids only.
• Intake of diet soda is encouraged at this time to assist in “cleaning” of the balloon.

Month 6:
• Balloon removal in the Operating Room under general anesthesia.
• First 24 hours, follow clear liquid diet. Dietitian to advise on specific details.
• Continue on VLCD 2 weeks post balloon removal.
• Back to food class with Dietitian for a transition to 1200kcal high protein diet.
• You are encouraged to attend MWL classes during transitional period for support.
• You may discuss adding weight loss/appetite suppressant meds with Bariatrician.

Month 7-12
• Continue MWL class weekly.
• Continue with monthly Bariatrician or Bariatric PA visits.
• Utilize two complimentary one-on-one visits with either Dietitian, Exercise Physiologist, or Behaviorist for continued support.