Bariatric Surgeries Delayed Due to Medical Weight Loss Programs

Before they will approve coverage for a patient’s weight loss procedure, some insurance carriers require potential bariatric surgery patients to complete a six-month weight loss program that is supervised by healthcare providers. However, it may be time to rethink the length of this waiting period.

The typical weight management program that is medically supervised is a balanced combination of diet and exercise, pharmacotherapy and behavioral therapy. It is believed that this widely inclusive program will give patients the best preparation for bariatric surgery, and will help to weed out any individuals that aren’t suited for the procedure. This approach makes sense, but the specification of six months is purely arbitrary and may well be unnecessary. A recent study on mandated medical weight loss programs found that they forced a needless delay on bariatric surgeries, and did not serve to prepare the patients for their surgery in any useful way.

The study, which ran from 2006 to 2010, involved 440 bariatric patients whose procedures were either laparoscopic gastric bypass (327 patients) or laparoscopic adjustable gastric banding (113 patients). Some 116 of the patients had to go through a mandated medical program (MMP), as required by their health insurance carriers. The other 324 patients were not asked to meet this requirement.

Ultimately, the wait time for surgery for the MMP patients was about four months longer than for those patients in the non-MMO group. And when the two groups were evaluated 1 year after their surgery, it was learned that they had nearly the same pre- or long-term post-operative weight loss.

The bariatric surgeon who performed all of the surgeries for patients in the study believes that there is no clinical benefit to mandated medical weight loss programs required by insurance carriers, and in fact, the same method of preparation that he has always used to get his patients ready for surgery works just as well as the MMP. The only thing that these programs accomplish, according to the surgeon, is to successfully cause the delay of a surgery that may be medically urgent for some patients.

The patients treated by the surgeon leading the study generally have a two-month period of doctor-supervised nutritional and psychological counseling prior to their surgery – no matter what their insurance companies require. In time, he hopes, insurance companies will realize that the arbitrarily chosen six-month waiting period has no bearing on whether or not patients are physically and mentally ready for weight loss surgery. And maybe sometime in the future, the insurance companies will revise their policies on this matter.