Because weight loss surgery is still “considered” cosmetic surgery, it can be excluded from insurance plans that are self-funded by the employer. Tell an insulin-dependent diabetic that now takes no diabetic medication after bariatric surgery that it is cosmetic surgery and see your response! I tell patients in my seminar that we do not do surgery so you look better and feel better. We do weight loss surgery so you live longer and live better. In keeping with the ASMBS position statement for low BMI patients, we believe the 1991 NIH criteria that insurance companies use to determine who qualifies for weight loss surgery is out-dated. We also agree that obesity is a chronic disease and that earlier intervention is associated with greater long term success. Therefore, we will provide the appropriate self-funding candidate a surgical option for BMI >30 with co-morbidities, especially with a strong family history of diabetes or metabolic syndrome. All of our insurance candidates must have a BMI of 35.
Gastric bypass surgery refers to a surgical process in which the stomach is divided into a small upper pouch and a much larger lower "remnant" pouch and then the small intestine is rearranged to connect to both. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different gastric bypass procedures (GBP). Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and physical response to food.
Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The result is a sleeve or tube like structure. The procedure permanently reduces the size of the stomach, although there could be some dilatation of the stomach later on in life.
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