While it is not uncommon for insurance carriers to require completion of a six-month medically supervised weight loss program as a condition of approval for weight loss surgery, it may be time for them to reconsider the waiting period requirement.
A medical weight management program typically combines diet, exercise, behavioral therapy, and pharmacotherapy. The rationale given for this requirement is the necessity of qualifying and preparing individuals for bariatric surgery. While this may be true, the six-month requirement is arbitrary.
According to a study conducted by researchers at Carolinas Medical Center in Charlotte, North Carolina, the mandated medical weight loss programs unnecessarily delayed bariatric surgery and did not provide any additional clinical benefits to patients.
For the study, researchers followed 440 consecutive bariatric surgery patients who had either laparoscopic gastric bypass (327 patients) or laparoscopic adjustable gastric banding (113 patients) from 2006 to 2010. Of these patients, 116 were required by their health insurance plan to complete a six-month “mandated medical program” (MMP) before bariatric surgery and 324 did not have this requirement.
While the patients in the MMP group had to wait nearly four months longer to have surgery than the patients in the non-MMP group, there was no significant difference in pre- or long-term post-operative weight loss between the two groups of patients when they were evaluated one year after surgery.
According to Timothy Kuwada, MD, the study’s lead investigator and the bariatric surgeon who performed all the surgeries in the study, “Our study shows that insurance mandated medical weight loss programs demonstrate no clinical benefit over what we normally do to prepare our patients for bariatric surgery. The most significant thing they seemingly do is unnecessarily delay surgery, which could be potentially harmful to patients.”
Dr. Kuwada patients typically receive about two-months of doctor supervised nutritional and psychological counseling to prepare them for surgery, regardless of insurance requirements. He hopes that “insurance companies revisit their policies on mandated medical weight loss programs so patients can have bariatric surgery when they are ready physically and mentally, not at an arbitrary time point like six months.”
Source: ASMBS Press Release
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