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Getting Authorization

Obesity is the second leading cause of unnecessary deaths. It is a disease that affects more than one-third of the adult American population (approximately 60 million), with an estimated 5 to 10 million considered morbidly obese. Morbid obesity is defined as being 100 lbs or more over the ideal body weight or having a Body Mass Index (BMI) of 40 or greater. According to the American Society for Bariatric Surgery, morbid obesity is a serious disease and must be treated as such.

Obesity results from the excessive accumulation of fat that exceeds the body’s skeletal and physical standards. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your "ideal body weight" is the point at which excess weight becomes a health risk.

But authorization for bariatric surgery is not a quick and easy process. Generally, people who have attempted weight loss with exercise, and commercially and medically approved diet plans, but have not achieved lasting weight loss may be candidates for bariatric surgery.

Bariatric surgery offers loss of excess weight by modifying the stomach and/or intestines to reduce the amount of food that can be eaten. It reduces life-threatening conditions such as heart disease and diabetes. Important factors contributing to the success of keeping weight off after surgery include motivation and commitment to making and adhering to lifestyle changes.

At most hospitals, Patients interested in bariatric surgery must attend informational seminars prior to a visit with surgeons. Following the consultation, if the patient desires to proceed with surgery, authorization for surgery is often requested from insurance providers.

Once the authorization is approved, tests such as pulmonary function test, stress test, radiology test, and blood work are usually scheduled. In most instances, a psychiatric evaluation is also necessary. The psychiatric assessments are used to identify patients at higher risk for postoperative psychological problems that may arise due to such a life altering surgery.

The formal evaluation process for consideration of bariatric surgery is extensive and comprehensive. It provides surgeons a chance to fully understand a patient’s specific health problems. This evaluation may take two or more visits to the patients’ clinic to allow for gathering of all pertinent medical data, laboratory tests, x-rays, as well as evaluation by subspecialty consultants and counseling by the dietary/nutrition services.

It may take several weeks for a full evaluation to be complete before surgical plans are made.