Gastric Bypass

If you're very overweight and can't lose pounds with a healthy diet and exercise, weight loss surgery might be an option for you. The surgery is usually for those with a body mass index (BMI) above 40 or those with a BMI of 35 or greater with serious co-morbidities. In general, this means men who are more than 100 pounds overweight and women who are more than 80 pounds overweight. If you are somewhat less overweight, surgery still might be an option if you suffer from life-threatening pulmonary problems like diabetes, heart disease or sleep apnea.

Weight loss, or bariatric, surgery can promote weight loss by limiting the amount of food your stomach can hold, limiting calorie and nutrient absorption, or both. Some operations also restrict the amount of food you can digest. Restriction operations, such as gastric banding and vertical banded gastroplasty, are the surgeries most often used for producing weight loss. These operations restrict food intake by making the stomach smaller and delaying the emptying of food from the stomach, causing the person to feel fuller faster. These restrictive operations lead to weight loss in almost all patients, but some weight regain occurs because individuals are unable to adjust their eating habits.

Gastric bypass surgeries are restrictive operations that construct a pathway from the stomach to the small intestine to avoid nutrient and caloric absorption. These operations produce more weight loss than restriction operations. In fact, patients who have bypass operations generally lose two-thirds of their excess weight within two years of the surgery. Gastric bypass is the favored bariatric surgery in the United States because it’s safer and has fewer complications than other weight loss surgeries.

Most people who have any type of weight loss surgery lose at least 50 percent to 60 percent of excess weight in the first 18 to 24 months after the procedure. Plus, many of the patients’ obesity-related conditions, such as diabetes or sleep apnea, improved after the surgery. Bariatric surgery also can provide long-term, consistent weight loss when accompanied with a few lifestyle changes.

As with any surgery, there are possible risks with weight loss surgery. A common risk of restrictive operations is vomiting when food is not chewed well and stretches the stomach size. Gastric bypass surgeries may cause “dumping syndrome,” whereby stomach contents move too quickly through the small intestine producing symptoms like nausea, weakness, sweating or diarrhea. There is often the potential for small, treatable complications such as abdominal hernias, gallstones and nutritional deficiencies after weight loss surgery.

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Steps for Making Weight Loss Surgery Affordable

Have you delayed the idea of weight loss surgery because you’re worried about the cost? The good news is that insurance may cover more than you think. While navigating the world of deductibles and copays can seem complicated, our easy-to-follow steps can be a helpful tool. 

Here’s how to make weight loss surgery affordable with—and without—insurance. 

Step 1 

Find out if you are covered for weight loss procedures under your insurance policies. 

Look for policy information on the insurance company’s website or ask your human resources department for details. Many employers cover weight loss surgery in their insurance plans. 

Step 2

Your weight loss surgery program can help with insurance pre-authorization by sending information about your health showing that your surgery is medically necessary. 

For example, if you have a condition that’s caused or worsened by obesity, such as diabetes or heart disease, billing codes for those conditions (or others that apply) will be included in the application. 

Step 3

Get approval. 

Your responsibility will be to understand your insurance benefits, copays and deductible information. Your surgery program can help with the approval process. 

Step 4

If you can’t get insurance coverage for your procedure, you still have options. 

Many weight loss surgery programs offer a cash pay rate. Financing options, such as a flexible payment plan, can also make your procedure affordable. 

So now that you have a good understanding of how to cover the cost of weight loss surgery, why weight?

Weight loss surgery is generally designed for those with a body mass index (BMI) equal to or greater than 40, or equal to or greater than 35 with serious co-morbidities. Laparoscopic adjustable gastric banding with the Lap Band® is also FDA-approved for weight loss surgery in people with a BMI of 30 to 35 who have at least one obesity-related condition. Weight loss surgery is considered safe, but like many types of surgery, it does have risks. Consult with your physician about the risks and benefits of weight loss surgery.

How to Know if You’re Ready for Surgery

See questions to ask your doctor that may help inform your decision about weight loss surgery.
Read Questions To Ask Yourself

Know What to Expect 

Prepare in advance and understand the journey of weight loss surgery. 
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Better Health with Weight Loss Surgery

After weight loss surgery, medical conditions such as type 2 diabetes or sleep apnea may get better or go away completely.
Read Six Ways Your Health May Improve