What happens after I have been referred?

First appointment

On arrival at the clinic, a nurse will take some measurements including your weight, height, neck circumference and blood pressure. You will also fill in an eating habits questionnaire which will be discussed at your next appointment.

At your initial assessment you will meet one of our members of the staff, this could be a surgeon, a registrar a specialist nurse or a dietitian.
At your initial appointment, you will be asked a great number of questions regarding your past medical, surgical history, weight management history, psychological wellbeing, eating behaviour and social circumstances.
Your clinician will order tests and investigations to help determine your suitability for surgery.  Who you get referred to depends on your individual clinical needs and past medical and mental health history.
Most commonly ordered investigations are:
- Blood Test
- Oesophago-gastro-duodenoscopy (OGD)
- Eating Disorder Assessment
- Cognitive Behaviour Therapy (CBT)
- Echocardiogram (ECHO) Electrocardiograph (ECG)
- Sleep Study
- Attend a virtual education session
- Other necessary investigations or treatment – based on previous medical history

Having undergone your first assessment does not guarantee that you are a suitable candidate for bariatric surgery.  Suitability will be determined at your second appointment – based on the results of investigation, recommendations of clinicians, such as a psychologist, anaesthesiologist, cardiologist, and your ability to fulfil your assigned weight loss target. 

Please Note: If you do not attend your appointments, you may be discharged back to your GP to avoid disappointing other patients who would like to avail the opportunity.

Pre-surgery review appointment

After the initial assessment you will be invited to see your surgeon,  approximately 4 – 6 moths after your initial assessment to review the result of the above investigation, which will determine if you are a suitable candidate for bariatric surgery and to ensure that you have reached your weight target assigned to you at your first assessment.
After your second appointment the surgeon will do one of three things:
1. List you for surgery
2. Request further investigations
3. Discharge you – if you are found to be unsuitable for surgery at this time.

The purpose of this appointment is also to verify your funding status. Please note: If you do not attend your appointments, you may be discharged back to your GP to avoid disappointing other patients who would like to avail the opportunity

Other Appointments

If you don’t attend for you appointments, you may be discharged back to your GP to avoid disappointing other patients who would like to avail the opportunity.

Group Education

You will receive a letter inviting you to Group Education on two occasions.

Currently for your safety and convenience, these sessions are virtual.  In both instances, you will be sent or given a link to the video sessions and will be asked to complete a quiz at the end of the virtual session, to check your understanding of the topics covered.  After you have emailed us with your answers to the quiz questions and we have acknowledged the receipt of your answers you will move on to the next step of the pathway. 

These video sessions should take approximately 45minutes to complete, but you should take as long as you need to understand the content.
You cannot progress to the next stage of the pathway without attending both of the Group Education sessions.

Psychology/Eating disorder appointment

After you have been assessed in full, the team may wish to refer you to a psychiatrist or a psychologist for assessment and treatment of:
• Disordered eating habits, which may prevent you from reaching your full weight loss potential.
• Depression – which may be linked to comfort eating.
• Psychiatric illness for which you may need support prior to being able to undergo surgery.

Other specialist appointments to assess fitness

Some patients are at a higher risk of developing complications during or after surgery due to pre-existing illness. You may be referred to:

Respiratory physicians for:
• Sleep studies – if you are at risk of obstructive sleep apnoea
• Respiratory function – if you have breathing difficulty from lung diseases
• Smoking cessation clinic for smokers – you need to be at least 6 weeks smoke free to proceed with the surgery, this includes vaping.

ECHO, ECG, exercise bike test
If you are at risk or have a history of heart problems.

If you have a history of significant acid reflux or any other symptoms without a known cause

High Risk Anaesthesia Clinic
You may be sent to see an anaesthetist to assess your fitness for an anaesthetic.

Physiotherapy led Exercise

Some patients who have been found to be high risk due to their cardiac status may be asked to attend an exercise programme. This is usually for 6 weeks and your fitness levels and cardiac function will usually be measured before and after to observe improvements.
Page last updated: 12 May 2016
Working on it!