Patients who were medically eligible for bariatric surgery but denied coverage by their health insurance were highly likely to develop obesity comorbidities within a few years even though their body mass index (BMI) remained relatively unchanged, according to a study recently presented at the 27th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).
While it is well-known that bariatric surgery can resolve and improve many obesity-related comorbidities that are already present, researchers at Gundersen Lutheran Health System in La Crosse, Wisconsin evaluated medical records of patients and found that bariatric surgery can also prevent new diseases from developing.
For this study, researchers compared the medical records of patients who had laparoscopic gastric bypass with patients who were medically eligible but did not get bariatric surgery due to insurance problems during the period 2001 to 2007. Study results showed that approximately 30% of the individuals who meet patient criteria for bariatric surgery do not proceed with surgical treatment for insurance reasons, including denials or unattainable prerequisites.
At the initial evaluation, both groups of patients had an average body mass index (BMI) of about 48. The rates of comorbidities for the surgical group and denial group were, respectively: diabetes, 24% and 20%; hypertension, 43% and 51%; sleep apnea, 22% and 20%; lipid disorders, 24% and 34%; gastroesophageal reflux disease, 49% and 62%.
After three years, the patients in the surgical group reduced their average BMI to 30.5% and less than 1% developed new obesity-related health conditions. A large number of patients in the denial group, however, developed new obesity-related diseases even though their BMI remained relatively unchanged.
The difference in disease development between the two groups was significant. In the surgical group of patients compared to the surgery-denied group of patients, respectively: 0.3% vs 9.2% developed diabetes; 0.9% vs 41.9% developed hypertension; 0.4% vs 34.2% developed sleep apnea; 3% vs 11.2% developed lipid disorders; and 0.6% vs 19.4% developed gastroesophageal reflux disease.
As study results show, bariatric surgery can prevent the development of obesity-related comorbidities and that denied coverage for bariatric surgery can negatively impact the health condition of obese patients within a relatively short amount of time. It would do well for health insurers to consider the future health of medically eligible patients and not just the current health status before they deny bariatric surgery.
Source: ASMBS Press Release
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