Qualification for bariatric surgery is based upon strict medical guidelines; however, insurance companies may impose additional medical requirements before they will approve and cover the procedures. One common requirement is the patient attending a mandatory preoperative medical weight loss management (MWM) program. This insurance issue remains one of the major hurdles for bariatric surgical patients.
Advanced Laparoscopic Associates surgeons are experts in the field of bariatric surgery. ALA surgeons Toghrul Talishinskiy, Sebastian R. Eid, Douglas R. Ewing and Hans J. Schmidt, were part of a group that performed a study to assess the effect of MWM programs on weight loss outcomes. The group recently published their results in the peer-reviewed journal Obesity Surgery.*
The group reviewed all sleeve gastrectomies performed between 2012 and 2016 at Advanced Laparoscopic Associates. Patients were divided into two groups: those who were required to complete a preoperative MWM program and those who did not. In order to compare results:
- The group used an algorithm to review 3059 sleeve gastrectomies and match the patients into pairs based on similar characteristics.
- The characteristics used for matching pairs were based on age, body mass index (BMI), smoking, gender, race, sleep apnea and diabetes.
- The algorithm chose a member from one group and paired that participant with their closest match in the other group.
- This step was repeated until all participants from both groups were matched, resulting in 530 total participants (265 in each group).
- At the end of one year, the total weight loss and percent excess weight loss for each group were compared.
The study concluded that insurance-mandated medical weight management programs in sleeve gastrectomy patients did not improve their weight loss outcomes one year after surgery. There was no significant difference in weight loss after one year in patients required by insurance to participate in MWM programs compared to those who were not required to do so. Therefore, the necessity of these preoperative-mandated programs should be questioned.
If you are considering bariatric surgery, request an appointment at Advanced Laparoscopic Associates. Our world-class surgeons will take the time to understand your needs, detail your options and help you choose a surgery or treatment plan that’s right for you.
*Talishinskiy, T., Blatt, M., Nyirenda, T. et al. Insurance-Mandated Medical Weight Management Programs in Sleeve Gastrectomy Patients Do Not Improve Postoperative Weight Loss Outcomes at 1 Year. OBES SURG (2020). https://doi.org/10.1007/s11695-020-04692-0