Evaluating the Necessity of a Weight Loss Surgery
Author: tiger Published Under: Health
When deciding whether or not a patient qualifies for weight loss surgery and most notably gastric bypass surgery, the first order of business is usually to determine whether the person is obese and whether they are at risk of developing obesity related illnesses.
How BMI is Used
BMI or the Body-Mass-Index, is a way of using a persons height and weight to determine if they are at a healthy weight, overweight, or obesity. While BMI is a common and popular tool, it should always be taken with a grain of salt, as BMI does not take into account how much of the weight is muscle and how much fat. To this end, most professional athletes, who are arguably in the top tier of health, are classified as obese when you calculate their Body-Mass-Index.
To calculate BMI, simply take your weight in pounds and divide it by your height in inches. Then, divide this number again by your height in inches to determine BMI. Generally, those with a BMI of between 18 and 25 are classified as normal, while those with a BMI over 30 are classified as Obese.
There are three levels of Obesity, with Class I Obesity being a BMI of 30 – 34.9, Class II Obesity being a BMI of 35-39.9, and Class III Obesity being a BMI of more than 40.
Generally, in order for a weight loss surgery to be preformed, the patient must have Class II or Class III Obesity.
Obesity Related Illnesses
Most doctors also consider whether the patient is at risk for developing obesity related illnesses or whether these are already present when deciding whether a weight loss surgery is warranted. There are a number of weight related illnesses, like heart disease, diabetes, hypertension, blood clots, sleep apnea, and arthritis. The doctor will also look for a history of strokes, blood clots, infertility, and cataracts, as well as a number of other disease that can be caused by being overweight.
However, the doctor should not only consider physical conditions, but also emotional ones that could be caused by being overweight, such a depression, anorexia, or schizophrenia. Often, these conditions will lead a doctor to not recommend a surgery like gastric-bypass.
Is Gastric Bypass Surgery Covered By Insurance?
Gastric bypass surgery can be covered by insurance providing that several requirements are met.
- Class II or Class III Obesity, with at least one major obesity related medical condition.
- Other treatments have been attempted, such as diet and exercise, but were not effective.
- The Patient does not have a history of drug or alcohol addiction
- The surgery can be preformed with a realistic expectation that it will be successful.
Of course, these can vary by insurance company, but most adhere to these recommendations, which are put forth by the National Institute of Health.
Sometimes, however, Gastric Bypass surgery may not be the first choice of your physician, so it may be necessary to suggest it to the doctor and let them know that you have fully researched the procedure and are comfortable with it.