ASMBS: Study Questions Mandated 6-Month Wait Time for Bariatric Surgery
On average, bariatric surgery recipients lose more than 25% of their body weight regardless of preoperative wait time, according to a recent study. These findings contradict current insurance mandates that require patients to lose weight in the 6 months prior to bariatric surgery before the procedure is approved.
Results of the study were presented at the American Society for Metabolic & Bariatric Surgery (ASMBS) Obesity Week 2017, which is taking place from October 29 to November 1, 2017, in Washington, DC.
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Previous studies have indicated that metabolic and bariatric surgery are the most effective and long-lasting treatment options for severe obesity and various related conditions, and are associated with significant weight loss.
For their study, John M. Morton, MD, of the Stanford School of Medicine in California, and colleagues evaluated the waiting periods of 427 patients receiving Roux-en-Y gastric bypass (n = 263), sleeve gastrectomy (n = 152), or adjustable gastric banding (n = 12) at the Stanford University Medical Center from 2014 to 2015.
Results indicated that the average wait time from the initial surgical consult to the actual procedure was approximately 7 months, with an overall range of 7 days to 5 years. About two-thirds of patients had to wait 6 months to receive surgery due to insurance requirements for preoperative weight loss. However, these patients lost little weight during this period of time, with body mass index (BMI) dropping only from 47 kg/m2 to 46 kg/m2, on average.
Once patients had undergone surgery, however, the average BMI dropped by 25% to about 35 kg/m2, regardless of the duration of pre-surgery wait time.
“The majority of patients seeking bariatric surgery are delayed or deterred from having surgery because of an arbitrary insurance requirement,” said Dr Morton. “Based on the evidence, these policies are not helping patients. In fact, it could be hurting them as medical problems may become worse and patients suffer unnecessarily. Mandated preoperative wait times should be re-evaluated with a greater emphasis given to goal directed, and not time-mandated preoperative weight loss.”
In 2016, the ASMBS released a position statement indicating that no medical evidence supports insurance-mandated preoperative weight loss requirements, that preoperative weight loss is not effective for preoperative weight loss, and that preoperative weight loss is not associated with any benefit for bariatric outcomes.
Researchers question value of making patients with severe obesity wait six months or more to have weight loss surgery [press release]. Washington, DC. American Society for Metabolic & Bariatric Surgery. Accessed November 1, 2017.