By Mark Colquitt, MD, FACS, FASMBS
There’s good news and bad news when it comes to the number of weight loss surgeries performed in the United States. The good news: more Americans than ever are having bariatric surgery. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), over half a million people in the United States under went a weight loss procedure between 2011 and 2013. That’s a 15 percent increase. It means more people are taking steps to overcome obesity and the many comorbidities associated with it such diabetes, heart disease, sleep apnea, and acid reflux.
The disappointing news is that only 1 percent of the estimated 18-million morbidly obese Americans who could benefit from bariatric surgery are actually undergoing procedures. That’s a huge number of patients who are going untreated.
There are numerous barriers that continue to roadblock obese patients from receiving the bariatric procedure that can transform their life and health. One of the biggest struggles is getting insurance companies and employers to cover all aspects of weight loss surgery. Nearly two-thirds of health plans sponsored by employers don’t cover bariatric surgery. And only 24 states require the new state-run insurance exchanges to cover weight loss surgery. The insurance plans that do allow coverage have strict requirements for patients who do qualify.
Another issue is that insurance companies limit patients to one bariatric procedure per lifetime. If someone has hip or knee surgery and needs another procedure, there’s no problem with insurance coverage. And it’s ridiculous to think of people only being allowed one cardiac procedure in their life. Insurance companies and society are still not fully accepting that bariatric surgery is not a cosmetic procedure, it’s treating a disease.
The fact that weight loss surgery helps resolve so many other health problems such as diabetes, high blood pressure and sleep apnea is why we do bariatric surgery. Even some primary care physicians don’t always see that the bigger picture is about making patients healthier overall.
Things are slowly getting better, but there is still a lot of discrimination against people who are obese, something I experienced as a child. It continues to be an uphill battle to educate the public, physicians, employers and local policy makers about the crippling effects of the disease of obesity. All of us should be on the same team, working to make availability and coverage of obesity treatments accessible to more than just a fraction of Americans.