What is the main reason that some insurance companies specify as a requirement for weight loss surgery, that a patient have been under at least one six-month physician supervised weight loss program? I have heard/read various theories: to show that the patient is able to stick with a diet; to show that dieting has been unsuccessful in the past; to show that the patient is serious about losing weight; to demonstrate that the patient will comply with a program; etc.I meet all other criteria to qualify for bariatric surgery (i.e. BMI over 35 with co-morbidities, over age 18) am currently doing the six-months but don't know if I actually lose many pounds will I then be denied the surgery? It would be helpful to know the purpose behind this insurance requirement.Thank you for your help.
(I tried replying two days ago but this screen kept freezing.)
First, thank you for your reply. Second, based on what you have said, would you think it reasonable that I not lose too much so that insurance cannot say I lost weight so don't need surgery? Seems to be a catch-22.
Medical Doctor, Surgeon
Many times we are faced with this dilemma. Of course if you can loose the weight by diet and exercise this is the best option. That being said it is not uncommon for some patients to add some weight to make the insurance cover a procedure. Of course that's not the healthy thing to do.
I guess insurance companies don't stop to realize that if the patient could lose the weight by diet and exercise AND keep it off, they would not be seeking bariatric surgery. I have lost almost 20 lbs as I go thru the 6-month program and now run the risk of falling below the minimum BMI. This will necessitate me putting on weight intentionally....as you said, not a healthy thing to do, but insurance forces the hand. Thanks.