Welcome to the first step in your consideration of weight loss surgery with Dr. Belsley at Mt. Sinai Morningside. Our office practice is based in the Department of Surgery at Mt. Sinai West and we understand that you have a choice in your medical care. We will do our best to answer your questions and ensure you a safe, personalized and individual experience throughout your weight loss.

Puree food for bariatric surgery — The weight loss journey never ends. You must continue on your new path as it is one that you must walk for the rest of your life. Please keep in mind that bariatric surgery requires continuing positive lifestyle change and is best described as an invitation for life-long dieting.

The entire process typically takes six months due to monthly visits with your primary care physician mandated by most insurance carriers. Dr. Belsley and his team will typically see you three times during this six month period. The spacing of these vists helps ensure that there will be plenty of time for asking questions, learning and speakign with us while determining whether you might be appropriate for bariatric surgery.

Initial Orientation Visit and Information Session with Dr. Belsley

You will meet our entire team during your initial visit in our office and typically takes a couple of hours. Bring your insurance card, co-payment and referral (if required). You are also welcome to bring a friend or an adult family member.

You will have a private consultation with Dr. Belsley and his entire team. At this visit, your medical history will be reviewed; the risk and benefits of surgery will be discussed. You will be examined and Dr. Belsley will give his initial opinions on whether you are an appropriate candidate for surgery.

We will explain the typical operations that are performed including the laparoscopic gastric bypass and the laparoscopic gastric sleeve.

We will make recommendations for you but ultimately remember that it is your body and you need to make an informed decision based on your expectations and lifestyle preferences.

Our registered dietician is available at this initial visit and you will have a formal nutrition assessment at this point. During your initial visit with the Dietitian you will begin to discuss some realistic goals as well as lifestyle changes that will help you develop good habits that allow weight loss and eventually weight maintenance.

During this initial visit, we will perform a vitamin level blood check and refer you for a sonogram which helps evaluate liver size, fatty infiltration of your liver and the presence of gallstones. Many times the sonogram and blood tests can be performed the same day as your visit in other offices in the same building.

Fresh herbs demonstrated by a chef — An important part of losing weight is to control the amount of calories that you consume. The best way to control your own nutrition is to prepare you own foods. You need to identify bad habits and stop convenience foods and snacking.

Monthly Visits and Supervised Diet with Primary Care Doctor

There is almost no way around the mandated monthly weigh-in visits with your primary care provider. You should therefore embrace the opportinuity to optimally address your other medical problems. Work with you primary care physician to control both blood-pressure and diabetes

Start making positive lifestyle changes. Ask friends or relatives who have had bariatric surgery explain to you what their experience has been like. Use the internet. Although some information can be misleading in general it is a very good source of research.

Follow through with any recommendations provided by your primary care physician, dietician and Dr. Belsley. This includes improving food choices, improving your exercise regime and quitting smoking. Avoid weight gain.

Gym work out — Exercise is an important part of your weight-loss plan. While seeing your primary care doctor in the months prior to your operation, it is very important that you try to get into shape and maximize your cardiovascular condition. Make sure that you speak to your regular doctor about your exercise plans and try to lose as much weight as possible before you have your procedure.

Mid-Point Visit with our Team

We typically see you at a midway point in your six-month process. We typically judge this as the time when you have completed three consecutive monthly visits with your primary care physician. At this visit we will review with you the results of your blood tests and ultrasound that you had performed at your initial visit or shortly thereafter. We will have given you a laboratory requisiton so that you can bring in a stool sample prior to your mid-point visit with our team. We would like to have the result of that test so that we can decide whether you will need to be given a course of antibiotics prior to surgery. We will also give you a prescription for vitamins if it turns out during your initial evaluation that you are vitamin deficient.

You will be weighed at this mid-point visit and we will discuss your progress with weight-loss and lifestyle change. You will meet with our entire team again where we will tailor goals and expectations for the ensuing months prior to your operation.

Tests and visits that are typically required

Our practice offers the orientation and initial visit with Dr. Belsley, nutrition consultation, vitamin level blood work, abdominal ultrasound all at our initial visit.

You will require a psychological evaluation prior to your operative date. We do not have a psychiatrist in our office but can offer suggestions to psychiatrists that commonly work with our practice. We also do not mandate a large battery of tests that include things such as an exercise stress test, cardiology clearance, pulmonary function tests, pulmonary clearance, endoscopy or an Upper GI Series in all our patients. We will obtain these tests only if we think they are clearly indicated. We typically defer to the judgement of your primary care provider with regards to necessary testing for pre-operative clearance.

Speak with your primary-care physician through the process and schedule appointments for any needed test or consultations with specialists during these monthly visits. It is up to you to make these appointments and have the results sent to Dr Belsley’s office before coming in for your pre-operative appointment. You are welcome to have your tests performed close to your home or with the specialists that are typically used by your primary care physician. You are responsible however for ensuring that our office has these results. Our fax number is 212-523-8857.

Pre-operative Visit with Dr. Belsley and Bariatric Quiz

Once you have completed the six consecutive months of weigh-ins along with your other testing discussed here, you will be given a pre-operative visit with Dr. Belsley and his team. You are encouraged to bring an adult member of your family or a close friend. Dr. Belsley will review your laboratory and radiology test results and offer further suggestions as to a choice of operation. A surgery date will only be given if work-up is complete and the office is in receipt of all results and reports. The Bariatric Quiz will be given at this point to provide another opportunity to discuss the risks and benefits of your decision. You do not get graded on this quiz as it meant to represent a time for Dr. Belsley to reinforce important parts of your surgery and recovery.

You will sign consent forms at this visit. We will then give you a list of standard pre-operative testing that your primary care physician should perform to provide a letter of medical clearance. Although we will give you a date of surgery, your date of operation may change because of difficulties obtaining insurance approval for your operation.

Physician examining table and blood pressure machine — Deciding to have surgery is an important process. You will be expected to commit your time to making all of the appointments, nutrition sessions and fulfilling the requirements outlined here. Your commitment will help ensure successful weight-loss and a healthier you!

Your Day of Surgery

Relax and congratulate yourself. This has been a long process in preparation and this day marks another important milestone in your new weight-loss journey. You will be on a clear liquid diet for the days leading to your operation. Please refrain from having anything to eat or drink from midnight before you operation.

If you normally take blood pressure medication in the morning then please take your usual dose with a sip of water. Do not take your usual diabetic medications. If you usually inject insulin then please only use half of your usual dose prior to coming in to the hospital. If you take blood thinners regularly than these need to be specifically discussed with Dr. Belsley and your primary care physician.

You must arrive at the Hospital two hours prior to your scheduled operation time. You are welcome to bring a family member or friend to wait with you. You will register on the first floor at Mt. Sinai Morningside Hospital and then they will send you up to the third floor of the Babcock Building at Mt. Sinai Morningside.

Congratulations and Dr. Belsley will see you to confirm the consent forms prior to going into the operating room.

Follow-Up

Dr. Belsley typically sees you in his office one week and then three weeks after your operation. Frequent follow-up visits during the first year are important and you will see Dr. Belsley and his team typically six times in the first year after your operation. It is your responsibility to schedule these appointments with our office and attend. These help us ensure that everything is on track and going the correct direction with the changes that happen after bariatric surgery both in your body and in your life.