What If My Insurance Doesn’t Cover Bariatric Surgery
When patients think of surgery, the first thought that pops into their minds is the cost, and rightly so. Surgery is, by any measure, an expensive proposition. When it comes to semi-elective procedures like bariatric surgery, there may not be the immediate desire to pay out of pocket, unlike more urgent surgical needs where there’s simply no choice. As such, patients quickly look to their insurance company to see if bariatric surgery is covered. The sad truth is that many insurance companies have bariatric surgery exclusions in their policies, which may vary between policies, despite being under the same parent company. The result is often frustration when patients hear that friends or family members with the same insurance company have coverage while they may not.
However, the insurance landscape is very different today than even a decade ago. Patients have more options if their insurance does not cover bariatric surgery.
Addiction Substitution After Bariatric Surgery
We know that food, particularly sugary foods, can be addictive. Some studies suggest that the addictive properties of sugar are as powerful, if not greater than some illicit drugs. It is, therefore, no wonder that it is so difficult to “just lose weight.” While many of us start a new diet with great enthusiasm and success, a few weeks or months later, this focus tends to fall by the wayside, and we eventually regain the weight, sometimes adding even more weight afterward. Of course, there are several reasons for this weight regain, not least of which are the stresses and anxieties in everyday life and a concept known as metabolic adaptation. Still, it would be fair to say that some patients suffering from obesity are also addicted to food.
Can Hormone Levels Be the Key to Maintaining Your Weight Later in Life?
The endocrine system of the human body is a finely tuned machine. Hormones secreted throughout the body regulate everything from our mood to heart rate and even how much fat we accumulate (and where). When we gain weight and add visceral or bad fat (typically around our waist), we can often throw our bodies out of balance and cause hormonal changes that affect our metabolic system significantly.
Both men and women are affected by hormonal imbalances. For example, some of the newest research on obesity and its hormonal consequences revolve around sexual function. In men, obesity can cause erectile dysfunction and infertility. In women, obesity can increase the risk of miscarriage, polycystic ovarian syndrome, and infertility. In fact, one of the most satisfying parts of our jobs is seeing couples that could not conceive before surgery do so afterward. But it doesn’t end there. Dysregulated hormones can promote the development or increase the severity of certain forms of cancer, including breast and colon. Inflammatory secretions from visceral fat can cause our joints to degrade more quickly. The list goes on…
New Bariatric Surgery Guidance Released by ASMBS and IFSO
While excess weight and obesity are some of the most researched topics in modern-day society, mainly due to the incredible rise in weight-related comorbidities, we do not often get the exciting news of new surgical guidance or suggestions from influential organizations. When they happen, it’s a big deal and something we should consider carefully. Just that happened last month when the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) released joint guidance intended to update federal guidelines since 1991. In your research of bariatric surgery, you’ve likely come across these older guidelines, which essentially state that patients with a BMI of 35 or over with one or more obesity-related comorbidities or patients with a BMI of 40 or over regardless of comorbidities may be eligible for bariatric surgery. While these guidelines have been in place for the best of three decades, they have also limited access to bariatric surgery for millions of patients suffering from excess weight-related conditions but with no qualifying BMI. How is this possible?
Ultimately, the reason for this is the inherent inaccuracy of the BMI calculation. The BMI was never intended to be used as a measure of obesity. The larger question is, what exactly is obesity? Arbitrary BMI levels very loosely define obesity – there’s little empirical evidence behind it.
No Exercise, No Diet Weight Loss. Does It Exist?
If you’re considering bariatric surgery, you have likely tried many diet and exercise programs to get back into shape over the years. If you haven’t been successful, don’t beat yourself up. Unfortunately, for most, these programs are not effective. Many patients regain their weight, and often put on even more, after some time. Despite a lifetime of being bombarded with diet plans that claim to work, we continue to be lured into the promise of weight loss and fat-busting with little or no work. And it’s no surprise it often ends in frustration.
So, to get right to the point, fat loss and weight loss do not happen without work; no matter what road you take to get there. To lose weight, proper diet and exercise are essential. And this is also true after bariatric surgery.
Breaking Down Metabolic Adaptability to Understand Weight Loss
You may be coming off a failed diet and feeling frustration and despair as you read this. You may feel very alone now, but you should also know that millions of people are in the same position. Losing weight is not easy and doing so without help is even more challenging. We are often taught that the key to weight loss is a deficit of 3500 calories at a time (equal to the loss of a single pound). However, sometimes it feels like you’ve restricted so many more calories than that, yet the number of pounds lost has not kept up. Well, there is a reason for that, and it is called metabolic adaptability.
Recent studies have shown that your metabolism may not slow until about 60. However, just like it does each day, as you eat and exercise, it adapts. And this is one of the reasons why losing weight without a catalyst like bariatric surgery is so difficult.
Diet or Exercise: Which Is Better for Weight Loss?
Whether you are a bariatric patient or not, diet and exercise are vital components of any weight loss program. But while the concept of simple calories in versus more calories out for weight loss is true, it does not tell the whole story. Diet and exercise contribute to weight loss and improved health in different ways.
Eliminating “Forever Chemicals” as Part of Your Post-op Weight Loss Plan
You have undoubtedly received plenty of advice on diet and exercise. You have a post-operative manual from your practice, giving you the blueprint for how to lose weight consistently and safely over time. You are also motivated, partly by your decision to have weight loss surgery, but also because you’ve seen the dramatic results early on. However, calories in and out may not always be the end of the story, and we must look at the weight loss process overall to give ourselves the best chance to lose weight quickly and maintain that weight loss over the long term.
Who Needs to Know You Are Considering Bariatric Surgery?
Let’s cut right to the chase. The decision to have bariatric surgery is a very personal one. Many factors come into play when you make that decision, and whom you tell is, frankly, entirely up to you. We have some patients that wish to tell everyone they know about their decision, while others don’t say a word to anyone but their medical team. Either way is acceptable, but there are a few considerations:
If you keep your decision about bariatric surgery close to your chest, be sure you have some kind of support system available to you. This can include your bariatric practice, but it’s also important to have a support system outside your surgeon’s office. The support can come online or in person, or you may have a small group of trusted friends that also had bariatric surgery and are willing and able to keep your decision between you.
What Decisions Go Into Having Bariatric Surgery?
You’ve probably agonized over decisions far smaller than having a life-altering surgery. No one can question that this decision is one of the biggest you’ll ever make. But what factors should go into deciding to have bariatric surgery or continue with the status quo? While we are bariatric surgeons, we do not, by any means, believe that bariatric surgery is suitable for everyone. Hopefully, considering the following will help you make the right decision.
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