As a bariatric surgeon, I have seen firsthand the life-changing effects of weight loss surgery. But when is weight loss medically necessary? The answer lies in your body mass index (BMI) and the potential health risks associated with it. If your BMI is high and you're at risk of developing serious health problems, then weight loss surgery may be necessary. But how much weight loss is considered significant? As a general rule, losing more than 5% of your weight over a period of 6 to 12 months can indicate a problem. This is especially true for older adults with other health conditions.
When traditional methods like diet and exercise have failed, bariatric surgery becomes a viable option. There are different types of weight-loss procedures, some of which limit the amount you can eat while others reduce the body's ability to absorb fat and calories. The specific details of the surgery will depend on your individual situation and the practices of the hospital or doctor. Some surgeries are performed with traditional large incisions in the abdomen, known as open surgery. Others involve creating a small pouch around the small intestine or placing a band around the top of the stomach to limit food intake. So who is eligible for weight-loss surgery? Generally, individuals with a BMI of 35 or higher may benefit from medical weight loss.
This includes people who are overweight and have associated medical conditions like sleep apnea or diabetes. However, many insurance companies require patients to complete a doctor-supervised weight management program before approving bariatric surgery. These programs typically last 4 to 6 months and require monthly documentation of weight and diet counseling. While preoperative weight loss can lead to better outcomes, it's unclear if insurance-mandated programs actually result in significant weight loss. In fact, some studies suggest that these programs may increase the dropout rate before surgery. It's important to remember that weight-loss surgery is not a quick fix.
It's a tool that helps you lose weight, but maintaining that weight will depend on making long-term changes to your eating and exercise habits. The effectiveness of an insurance-mandated weight-loss regimen before bariatric surgery and its relationship to weight loss after surgery is still being studied. The “gold standard” for surgical weight loss is gastric bypass surgery, which limits the amount of food the stomach can hold and helps patients feel full faster. However, for those who do not want or qualify for surgery, there is another option: medical weight loss. This involves working with a doctor or advanced provider to lose weight without surgery. Fortunately, most insurance plans cover bariatric surgery when used to correct serious medical conditions like diabetes and high blood pressure.
As a bariatric surgeon, I have seen firsthand how this lifesaving tool can help patients make real and lasting changes to their health and weight. To learn more about weight-loss surgery and when it may be necessary, I spoke with Alexander Abkin, MD, FACS, FASMBS, director of JFK For Life, the bariatric surgery program at JFK University Medical Center. He emphasized the importance of a thorough physical exam and evaluation of medical history to determine if someone is a candidate for surgery. Ultimately, surgery is only offered to those who have been unable to lose weight through traditional methods, are healthy enough for surgery, and are committed to improving their overall health. Weight loss after bariatric surgery varies depending on the type of procedure and individual factors like health and weight before surgery. It's also possible for some patients to not lose enough weight or regain weight after the procedure.
That's why it's crucial to make long-term lifestyle changes to maintain weight loss and improve overall health.
