Your Visit

The Surgical Weight Loss Program for Teens at Cincinnati Children’s has the resources to conduct a complete evaluation of your condition in a single day. Once the required clinical documentation has been received by our office from the family and referring medical doctor, and the insurance verification has been confirmed, we will contact the family to schedule an initial evaluation.

At the initial evaluation, we will perform a full range of tests to evaluate your child’s overall health and the effect weight has had on  health and quality of life. At the end of the week – after the medical team has thoroughly reviewed all evaluation consultations, tests and lab results – we will share our findings with you and your child.

Transportation, Lodging, Directions and Interpreter Services

Families traveling to Cincinnati from more than 35 miles outside of city limits can receive assistance with lodging, transportation, translation and other needs. Contact Guest Services and Interpreter Services for more information, or call toll-free at 1-800-344-2462 from 8:30 am to 5 pm, Monday through Friday.

 

What to Expect During Your Initial Evaluation

If our medical team in the Surgical Weight Loss Program for Teens determines that your child is a candidate for bariatric surgery, and insurance verification has been confirmed, we will schedule you and your child for an evaluation. During this visit, you’ll meet with one of our pediatric surgeons, our medical doctor, psychologist, dietitian and nurses. This visit can last up to four hours, but it allows us to get to know you better and learn what has brought you to this point.

At the evaluation, we like to get a sense of your child’s overall health as well as the effect weight has had. We will also discuss various options that are now available for weight management, including weight loss surgery, and answer your questions.

Several diagnostic tests may be needed during your evaluation, including:

  • Blood work
  • Glucose (sugar) tolerance test  
  • Consultation and study for sleep apnea
  • Other tests, as needed

Once the evaluation and diagnostic tests are completed, a case summary is prepared. Our medical team once again reviews the case summary and a determination is made regarding whether surgical weight loss is a good option for your child.

 

From Treatment Plan to Surgery

As your family prepares for this surgery, it is our intent to provide you and your parents with lifelong tools and strategies for long-term weight loss and weight maintenance. This is exactly what occurs during your “Treatment Plan” appointments.

You will spend approximately two hours at this monthly appointment developing and implementing a personalized diet and exercise plan. You will meet with a dietitian, exercise physiologist, nurse, and occasionally, a surgeon. Once the diet and exercise plan is in place, we anticipate you will begin losing weight and becoming healthier as you prepare for your surgery. If surgery is recommended after the patient has successfully completed the medically supervised weight loss requirement, a “letter of medical necessity” is prepared using information from the evaluation and treatment plan visits. The letter is sent to your insurance company to obtain authorization for the surgery and postoperative care.

Once we have authorization from your insurance company, someone from the Surgical Weight Loss Program for Teens medical team will contact you to schedule a date for the surgery and preoperative education session. Included in this second visit will be a consultation with a cardiologist and an anesthesiologist in preparation for the surgery.

During the preoperative education session, you will be advised of out-of-pocket costs for additional items that are needed following surgery:

  • Nutritional supplements, such as liquid protein, vitamins and minerals, not covered by insurance.  Vitamin and mineral supplements, protein shakes, powders and products, protein and low sugar healthy drink options.
  • Equipment, blender, hand mixer or Magic Bullet Blender, needed for post-surgery dietary preparation

We will provide you with measuring cups, (both liquid and dry measure), measuring spoons and a water bottle.

These items need to be purchased and brought with you to the preoperative education session. It is important to have all of the necessary items  to rehearse the postoperative dietary regimen at the  preoperative visit.

At the preoperative nutritional education session, the patient and family will receive a binder with the post-operative dietary staging (eating plan), resource lists and tracking forms.  The patient and family will have the opportunity to taste a variety of protein shakes.  The dietitian will answer questions and provide several examples of post-op daily eating plans.

Once the day of your child’s surgery arrives, you are well on your way. Adherence to the postoperative medical and dietary regimen is vitally important to your child’s speedy recovery and the overall success of the surgery. Once released from the hospital, you and your child will need to return for regular follow-up appointments with the Surgical Weight Loss Program for Teens team. Typically, all patients are required to return post-operatively at two weeks, six weeks,  three months,  six months,  nine months,  12 months, 18  months, and then on an annual basis. Your child will also need several tests done at regular intervals to measure progress.

Our program offers a support group that meets every other month to discuss topics and share information that will assist patients in making long-term lifestyle changes.

Timeline Process

The Surgical Weight Loss Program for Teens at Cincinnati Children’s provides a timeline for our program. Each patient, each situation and each insurance policy is unique. Information is subject to change.

 

A Typical Patient Timeline

Average time:  One to three weeks.

Additional information: The patient and family are responsible for returning all paperwork in a timely manner. Once paperwork from your child's doctor is received and the patient insurance coverage has been verified, an appointment will be arranged.

Insurance verification is critical in the initial steps to our program.  Our office staff works closely with the Cincinnati Children’s family financial advocate to verify that each patient’s policy coverage is active and determines the policy’s clinical requirements for bariatric surgery before the initial evaluation.

 

Average  time:  Three hours on one day (a Tuesday) with the team. ALL patients must meet with the entire team before proceeding with the next step.

Additional information: Your family will meet with the surgeon, medical physician, psychologist, nurse and the dietitian during this visit.

Average  time: The nurse will contact you – one to two weeks after your initial evaluation -- to notify you of the team’s decision to pursue surgery authorization OR explore other weight management options.

The pre-op diet and exercise phase of the program is a critical component.

Missed appointments, cancellations or no-shows will delay your process through the program, and delay surgery. 

Average  time:  Appointments are on Tuesday afternoons or Thursday mornings. Patients are expected to return every   four to six weeks for  three to six  months until a surgery decision is made.

The following criteria must be met at these visits:

  • The patient and caregiver must come to each visit as planned.
  • You must complete any additional testing based on health needs.
  • You must demonstrate that you can use weight management tools to achieve short-term weight loss.

Additional information: The purpose of treatment plans is for patient and family members to learn about calories and eating habits and to receive a personalized diet and exercise plan. The patient is responsible for monitoring daily intake. This is also an opportunity for our team to teach a large amount of information over several appointments. Patients who can achieve preoperative weight loss are healthier at the time of surgery.

Average time: In weeks or months, depending on your specific insurance benefits, the insurance process of approval for surgery authorization will be complete.

Additional information: This can occur simultaneously with Step 4 above. In this process, the program’s doctors write to your insurance company to request prior-authorization for surgery. Many times, more information is requested by the insurance companies to demonstrate that the surgery is medically necessary.  We seek to most efficiently work toward this goal on your behalf.

Average time: Typically four to six weeks after receiving the insurance approval.

Average time: Most of the obesity research studies can be accomplished in one to two days.

Additional information: Cincinnati Children’s is not only a world-class clinical facility, but also a highly respected research hospital. There are numerous ongoing research studies in our program that have been funded by the National Institutes of Health and other organizations. This is an excellent opportunity for patients and families to help us better understand obesity and outcomes of weight-loss surgery. Many of the studies provide compensation for the patient’s time.

We complete our patient evaluations in one day.
We complete our patient evaluations in one day.