Question:
Does anyone know what the National Institute of Health surgery is?

My husband is needing the LapBand and we have Kaiser in Northern CA (Napa) and his doctor said that he would have to have issues like high blood pressure and sleep apnea etc. It turns out that he does have high blood pressure(on meds), possible GERD and sleep apnea. His doctor said that he sent a referral to the Bariatric Center and they denied him because his BMI is not +35. His doctor said he didn't meet the guidelines of the NIH. What are the NIH guidelines for surgery and are they the same for Kaiser? Although he didn't say the NIH guidelines for Bariatric he said NIH guidelines for Surgery. Please, any comments would be very helpful. It seems to me like his dr controdicted himself and just doesn't want him to have the surgery. But we aren't giving up. thank you in advance. Kristy    — Kristy (posted on December 17, 2007)

December 17, 2007
The National Institutes of Health published a set of guidelines for when bariatric surgery would be appropriate. If you go the NIH site and search for "bariatric surgery", you will be taken to the specific page. The guidelines basically state that bariatric surgery should only be considered if a patient has a BMI of over 40 or if a patient has a BMI of at least 35 in addition to have co-morbidities related to the weight. Insurance companies can have rules that are more restrictive than NIH guidelines. This is how many insurance companies deny coverage for bariatric procedures.
   — SteveColarossi

December 17, 2007
I have Kaiser insurance in southern California. I and RNY surgery 17 months ago. My BMI was 39.5, and I was required to have at least 2 co-morbid conidtions. I qualified for RNY surgery because I had hypertension, took cholestorol medications, and had sleep apnea. My general practitioner doctor within Kaiser told me of all of the conditions that Kaiser said I must meet for surgery. I weighed about 340 pounds, and was 6 ftpt 3 inches in height at that time. I'm now down to 202. I don't believe Kaiser approves the lap band in southern CA, only the RNY.
   — Dave Chambers