Bariatric Surgery Program

CHI Health Immanuel's Bariatric Program is a Comprehensive program. That means our weight loss surgery program is:

• Conducted by Board-Certified surgeons
• A fully Accredited MBSAQIP Bariatric Surgery Program  
• A multidisciplinary team
• Medically monitored to ensure safe and effective weight loss
• Your one point of contact from insurance approvals, to pre- and post-surgery appointments, to long-term maintenance support

• Minimally invasive laparoscopic procedures for all surgeries 
• Collaborations with other specialties
• Bi-monthly educational seminars for program candidates
• Monthly post-operative patient support groups
• Long-term patient follow-up with educational and nutritional support
• Opportunities for virtual visits

New to the CHI Health bariatric program is our program app which allows patients easy access benefits like:

• Tracking Nutrition
• Seminar to Surgery Checklist
• Tracking Exercise 
• Tracking Weight Loss
• Vitamin & Supplement Reminders
• Bariatric Surgery Education
• Diet Guidelines
• Food/Water Timer

How to get the app:

Download the Baritastic app from Google Play or the Apple App Store.

Please Note: You will need a program code which will be given at one of your patient appointments.

Roux-en-Y Gastric Bypass

• Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine.
• You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed.
• Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss.
• The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum).

Endoscopic Sleeve Gastroplasty (ESG) 

• Advanced endoscopic procedure that requires no incisions, leaves no scars and reduces stomach size by 70-80%.
• Weight loss is expected to be 20% of total body weight 12 months after the procedure, in combination with dietary and lifestyle changes. 
• CHI Health is the only program in Omaha offering this new procedure. Learn more about this program.

Adjustable Gastric Band

• A gastric band procedure is a restrictive laparoscopic surgical procedure in which a band is placed around the upper most part of the stomach. This band divides the stomach into two portions, one small and one large portion. Because food is regulated, most patients feel full faster.
• Food digestion occurs through the normal digestive and absorption process.
• Laparoscopic adjustable gastric banding leads to loss of about 40% of excess weight, on average.
• Gastric banding is considered the least invasive weight loss surgery; it is also the safest.
• Unlike gastric bypass surgery, gastric banding does not interfere with food absorption. For this reason, vitamin deficiencies are rare after gastric banding.

The Surgical Management of Obesity

Michael Hovey, MD

Is Bariatric Surgery Right for Me? 

Consider these items before beginning your weight loss surgery journey. If you feel that you are ready, continue on to the bariatric surgery checklist.

Can you comply with the follow up that is required after surgery?

You have to follow the directions of your surgeon and bariatric team, especially diet, exercise, labs and office follow up. Surgery alone will not take care of your weight or health issues. We have an extensive follow-up routine for all our bariatric surgery patients in order to successfully maintain

Does insurance cover weight loss surgery?

Check with your insurance company and see if bariatric surgery or weight loss surgery is a covered benefit under your policy. If your insurance policy includes a specific exclusion for the surgical treatment of obesity you will not be covered for surgery, no matter your current health issues.

Are you looking to surgery for the right reasons?

Bariatric surgery is NOT done for cosmetic reasons. It is done to improve failing health. If you meet the medical criteria, you are doing it for health reasons.

Do you have the emotional support you need?

It is crucial that you have a strong support network of family and friends that will be there to help you through the decision making process, and especially as you recover after surgery. We suggest that not only the patient, but also their close friends and family become educated about the risks and benefits of weight loss surgery.

Bariatric Surgery Checklist

Use this checklist to guide you through the process toward bariatric surgery. Note: Items 1-3 should be done before your appointment with our weight management team.

1.) Check to see whether you have the benefit for bariatric surgery.

2.) Surgeon education video (webinars) online. This 1 hour video must be done before your appointment.

3.) Appointment with the bariatric surgery weight management team (Bariatric Nurse Practitioner and Dietitian)

4.) Begin medical weight management visits.

5.) Psychiatric Evaluation - Must be completed by qualified provider before surgery and within the same year that surgery is done 

6.) At least one attendance to a bariatric surgery support group is required. 

Additional requirements will be discussed at your appointment. All required documents will not be submitted to your insurance for approval until the program and insurance documents have been completed. Contact our Weight Management office for any questions at (402) 572-3684, option 1. 

Our monthly support groups provide a secure, warm setting for patients undergoing the process of lifetime diet and lifestyle changes that can improve surgery outcomes and are necessary to achieve enduring weight loss.

Support sessions have been shown to directly increase the chances of short- and long-term patient success following bariatric surgery. Regardless of where a person is in relation to the bariatric surgery process, he or she is welcome to attend the sessions.

The support group meets twice a month via zoom with a new topic for education. *Registration is not required however there will be a sign in sheet upon arrival. If you should have any questions please contact the CHI Health Weight Management team at (402) 572-3684.

Am I a candidate for weight loss surgery?

Those who are candidates for bariatric surgery typically fall into the below categories:

• Adults who have a BMI over 40
• Adults with a BMI between 35 and 40, who have obesity-related medical complications, such as diabetes, heart disease, or sleep apnea.
• Those who have failed to lose weight by non-surgical means (weight loss programs, diets, etc). Some insurance companies may require documentation of participation in at least one weight loss program.
• Those willing to commit to a lifelong change of proper diet, exercise, and medical follow up.

For patients in Kearney, NE we do offer initial steps of the program to be completed with Dr. Moeller. Learn more about this opportunity.

To receive more information and be contacted by our staff, sign up here.

Is bariatric surgery the right choice for me?

If you are someone who has tried multiple diets and has tried to lose weight over and over again without success, then bariatric surgery is something you should take into consideration as an option.

How do I know if I am eligible for weight loss surgery?

You will need to check your insurance benefits first and foremost. Ask if you have the "bariatric surgery benefit."

How am I able to lose weight from surgery?

After surgery, food travels down the esophagus and enters your new pouch. Depending on what surgery you may have, weight loss is determined by decreasing portion size and how well the body absorbs calories/nutrients. Adherence to a food plan, exercise, and support after surgery will promote success. 

How many days in the hospital and how much down time from work is necessary?

Most patients require 1-3 days in the hospital. Many patients return to work in approximately 2 weeks. Heavy lifting and taxing physical activity is discouraged for up to 4 weeks. 

How bad is the pain after surgery?

Pending your pain tolerance, this is individualized.  We do everything in our power to treat pain via all avenues. We use the multi-modal pain management intervention model that utilizes different types of medications to decrease pain in different ways. 

Will I be sick a lot after the operation?

During the healing process you may have occasional episodes of nausea with retching and or vomiting. This is usually associated with the surgical procedure itself and will gradually subside. Once you begin to introduce soft foods back into your eating plan, you may have an occasional episode where a particular food does not digest well and may make you sick. Patients that overeat and overfill their pouch experience stomach/chest pain & pressure, and often vomiting. Frequent episodes of nausea and vomiting are a red flag that you may not be following the rules. In this case, notify the nurse or dietitian to discuss.

Will I be able to maintain my goal weight for many years or for the rest of my life?

Yes. Many patients lose up to 50-75% of their excess weight 3 years after surgery. It is important to stay connected with your bariatric support team for long term support. Remember, medically complicated obesity is a chronic disease process and you must maintain good healthcare practices, following doctor’s guidelines for the rest of your life.

When can I start exercising again after surgery?

Depends on the type of exercise. You should begin walking while still in the hospital, unless instructed otherwise. As you heal, begin to increase your exercise time and intensity. Your surgeon will allow you to increase your activity based on your progress. After surgery, exercises such as weights, sit-ups, pull-ups, or any abdominal straining should wait until you get the go-ahead from your doctor.

What will my new weight be?

Weight loss is not necessarily the goal...body fat loss is the goal!  Our program focuses on body composition for overall health. So each individual going through the program has the opportunity to have their body composition analyzed by our "InBody" machine.  This will calculate the amount of body fat that is realistic and attainable if a patient chooses the lifestyle interventions to meet their specific goal.

Do most patients need to have plastic surgery after weight loss?

Not necessarily, this is very individualized based on patient preference and/or potential skin rash complications.

Will I lose hair after bariatric surgery?

Some hair loss is common between 3 and 6 months following surgery.  Even if you take all recommended supplements, hair loss will be noticed until the follicles come back. Hair loss is almost always temporary. Adequate intake of protein, vitamins and minerals will help to ensure hair re-growth and avoid longer term thinning.

Do I need to take vitamins and minerals after surgery?

YES, you will need to take a bariatric specific vitamin the rest of your life post-operative to prevent acute and chronic vitamin deficiencies

Will I have to diet after the surgery for the rest of my life?

Not necessarily diet, but you will be expected to make permanent lifestyle changes in your dietary intake and physical activity regimen.  These expected lifestyle changes will prevent acute and chronic post- operative bariatric surgery complications and re-hospitalizations. 

Are there certain foods that I can’t eat ever again?

In the end each individual going through this process has "choices". We tell patients "you do what you need to do to be where you want to be.” It is essential for long term safety that every post-op patient needs to eat at least 60-90 Grams of protein daily and eat foods in this order: protein first, vegetables second, fruits third. Additionally, just know that not everyone will tolerate all foods the same they did pre-operatively.

Will I ever be able to eat sweets again?

Some patients have a severe reaction to sweets caused by the high sugar content. Other patients are able to tolerate without difficulty. The important thing to focus on is that you will limit sweets as they are not in the protein family and add empty calories. Often, sweets are a trigger food for many. Once you have a sweet treat it triggers the craving to have more. This can sabotage your meal plan and weight loss.