Those who are interested in weight-loss surgery inevitably have questions, and one relates to potential disqualifications. What disqualifies you from getting bariatric surgery? There are a few things that means someone isn’t a candidate, including active drug abuse, untreated high risk health conditions like heart problems, and in most centers, failing to quit smoking tobacco. But the main reason most people seem to be “disqualified” is really because they did not persevere in jumping through the hoops required for insurance approval.
Can Medical Conditions Be A Barrier To Bariatric Surgery?
It’s a common misconception that medical conditions are likely to disqualify a person from bariatric surgery. For example, mental illness is often brought up as a reason to deny people access to care. This is ridiculous if you think about it because most of us would recoil in horror if we decided to stop providing cancer care for people with mental illness. In practice, many millions of people with some form of mental illness receive treatment for mental illness and it is well managed. It’s certainly not at all a reason to avoid medically necessary bariatric surgery. The same is true for health issues like heart, disease, lung disease, kidney problems, and all the litany of health conditions that we could list. Generally, once we get them addressed and treated, the person can and should proceed safely with bariatric surgery. In most cases, bariatric surgery reduces the risks of worsening heart, lung, kidney, and other diseases, so it is important to undergo the sleeve gastrectomy expeditiously to become healthier and reduce risks.
The Biggest Hurdle To Bariatric Surgery
Unfortunately, we live in an era in which the care you receive is often highly controlled or limited by the obstacles placed in front of you by the health insurance companies and committees. These barriers to care are especially severe for bariatric surgery, one of the most well-proven, life-changing treatments out there. Health plans require that people spend months attending appointments and undergoing additional evaluations prior to the approval to proceed with surgery. These hoops are usually months long and require people to meet with a whole variety of medical practitioners from psychologists to nutritionists to physicians and nurse practitioners until they get the stamp of approval. Many studies have examined this process and found that the delays result in severe negative outcomes for some people who seriously need to proceed with bariatric surgery sooner rather than later. The studies also show no added health benefits from these delay tactics.
The barriers do “save” money in the short term for the insurance company by reducing the number of people who undergo the procedure. I cannot tell you how many patients I have seen who started the process but just had a hard time completing all of the hoops, taking time from work, driving in and attending all of the appointments, dealing with all the red tape while balancing all the other challenges in life. Often, I see those same people again a year or two or three later, and we must double down on our efforts to jump through those same hoops to get approval and receive the much-needed healthcare in the form of bariatric surgery.
Lifestyle Choices That Disqualify Candidates From Bariatric Surgery
We surgeons do rightfully draw a few lines in the sand, however, for things like active drug abuse, active alcohol abuse, and in many centers, ongoing smoking. I will address smoking first, since it has been shown that the effects of smoking are bad, and they do affect the complication rate of surgery in a negative way. We of course want all our patients to succeed and not have any complications, so we insist upon smoking cessation to avoid tissue leaks, infections, ulcers, and respiratory complications. Active drug and alcohol abuse are somewhat different matters but as you can imagine, they need to be addressed prior to proceeding with surgery so that the person can be focused and compliant with the postoperative guidelines. Past substance or alcohol abuse is certainly not a reason to deny someone any medical care, including bariatric surgery.
The Bottom Line
Bariatric surgery is sometimes referred to as a miracle, and many of my patients have used that term for the effect it has had on their lives. But it is just a specific and effective treatment for a very difficult set of conditions, including type two diabetes and obesity. And it is not perfect. It does not take away the need for us to also address all the other physical and mental health issues that we may encounter in life. We must keep addressing all of them and stay active, stay positive, and move forward in life. If you or a loved one has a body mass index over 30, don’t wait to investigate reasons you might be disqualified; speak to an expert and learn the truth, evaluate the pros and cons for your individual case, and choose the path that will provide the greatest safety and best health outcome for you.
In Reno and Sparks, contact the team at Nevada Surgical today to learn more.
