Mandated Pre-Op Weight Loss: ASMBS SAYS NO!
PRE-OPS: YOU CAN FIGHT YOUR INSURANCE COMPANY'S REQUIREMENTS FOR PRE-OP WEIGHT LOSS PROGRAMS!
Summary and Recommendations
1. There are no Class I studies or evidence-based reports that document the benefits of, or the need for, a 6 to 12 month pre-operative dietary weight loss program before bariatric surgery. The current evidence supporting preoperative weight loss involves physician-mandated weight loss to improve surgical risk or to evaluate patient adherence. Although many believe there may be benefits to acute preoperative weight loss in the weeks before bariatric surgery, the available Class II-IV data regarding acute weight loss prior to bariatric surgery are indeterminate and provide conflicting results leading to no clear consensus at this time. Preoperative weight loss that is recommended by the surgeon and/or the multi-disciplinary bariatric treatment team due to an individual patient’s needs may have value for the purposes of improving surgical risk or evaluating patient adherence, but is supported only by low-level evidence in the literature at the present time.
2. One effect of mandated preoperative weight management prior to bariatric surgery is attrition of patients from bariatric surgery programs. This barrier to care is likely related to patient inconvenience, frustration, healthcare costs and lost income due to the requirement for repeated physician visits that are not covered by health insurance.
It is the position of the ASMBS that the requirement for documentation of prolonged preoperative diet efforts before health insurance carrier approval of bariatric surgery services is inappropriate, capricious, and counter-productive given the complete absence of a reasonable level of medical evidence to support this practice. Policies such as these that delay, impede or otherwise interfere with life-saving and cost-effective treatment, as have been proven to be true for bariatric surgery to treat morbid obesity, are unacceptable without supporting evidence. Individual surgeons and programs should be free to recommend preoperative weight loss based on the specific needs and cir****tances of the patient.
HW-244, SW-234, CW-207
4/8/04 Lap-band-Goal weight for 5 yrs, Tummy Tuck 6/23/08
Lap-band Leak 4/2011, Revision to Gastric Bypass 4/5/12
It will only make you healthier for the actual surgery, improve your recovery, and give you less weight needed to lose after the surgery.
I don't see any negatives to it - other than people just being used to getting what they want NOW.
Here, let me spell it out for you, in words I hope you understand:
THERE IS NOTHING WRONG WITH LOSING WEIGHT BEFORE WLS. WHAT IS WRONG IS THE INSURANCE COMPANY AND DOCTORS REQUIRING WEIGHT LOSS AS A CONDITION TO BE ALLOWED TO HAVE SURGERY, WHEN THERE IS NO MEDICAL EVIDENCE TO SUPPORT THIS PRACTICE. IN FACT, IT IS MOSTLY AN UNDERHANDED MEANS OF PREVENTING PEOPLE FROM GETTING SURGERY.
PEOPLE DIE WAITING UNNECESSARILY FOR SURGERY. THEY GIVE UP, BECAUSE THEY CAN'T MEET THE REQUIREMENT. THEY LOSE THEIR INSURANCE. THEY GET IRREVERSIBLE DAMAGE TO THEIR JOINTS, ORGANS AND OPPORTUNITIES IN LIFE.
Do you understand now?
The problem is that studies don't really support that it improves surgical outcomes. In fact, there is a school of thought that the sort of extreme dieting that a lot of programs put them on, such as 2-4 weeks on a liquid diet, can actually cause harm because it puts a lot of stress on the body and puts it in a malnourished state which makes recovery from surgery harder.
But it does give you less weight to lose post-op. The question is: is that a good enough reason to put people through hell and sometimes even postpone their surgery, and possible endanger their health?
HW - 225 SW - 191 GW - 132 CW - 122
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I personally think surgeons *****quire it are fatty-haters who think their patients deserve to be punished.
We KNOW the insurance companies think that way.
It will only make you healthier for the actual surgery, improve your recovery, and give you less weight needed to lose after the surgery.
I don't see any negatives to it - other than people just being used to getting what they want NOW.
Yep I understand. I think your surgeon screwed up though. You're not supposed to have **** for brains after a DS.
I guess you won't be needing insurance help in CA getting a DS. Good.
