Gastric bypass surgery candidates are those who are unable to achieve or maintain a healthy weight through diet and exercise, are severely overweight, and who have health problems as a result. Gastric bypass surgery may be an option if:
- Your body mass index (BMI) is 40 or higher (extreme obesity).
- Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problems such as diabetes or high blood pressure.
Gastric bypass surgery doesn't replace the need for following a healthy diet and regular physical activity program. In fact, the success of the surgery depends in part on your commitment to following the guidelines given to you about diet and exercise. As you consider weight-loss surgery, make sure that you make every effort to exercise, change your eating habits and adjust any other lifestyle factors that have contributed to your excess weight.
Will my insurance pay for gastric bypass surgery?
Depending on the type of major medical insurance policy you have, most insurance companies will pay for gastric bypass surgery if you meet certain conditions. However, some insurance companies have exclusion clauses for treating obesity. These companies refuse to cover any treatment related to "losing weight." They will, however, treat the diseases caused by excessive body weight.
To qualify for coverage, gastric bypass surgery must be considered a medical necessity. The insurance company will make the final determination. They may rely on the information your doctor sends to them or they may require you to be seen by a doctor that they specify.
What are the benefits of gastric bypass surgery?
There are many benefits to gastric bypass surgery besides dramatic weight loss. Gastric bypass surgery can improve or resolve the following conditions associated with obesity:
- Type 2 diabetes
- High blood cholesterol
- High blood pressure
- Obstructive sleep apnea
- Gastroesophageal reflux disease (GERD)
What are the risks of gastric bypass surgery?
- Death. A risk of death has been associated with gastric bypass surgery. The risk varies depending on age, general health and other medical conditions. Talk to your doctor about the exact level of risk gastric bypass surgery may pose for you.
- Blood clots in the legs. Blood clots in the legs are more likely to occur in very overweight people. Blood clots can be dangerous. In some cases, they travel to the lungs and lodge in the lungs' arteries causing a pulmonary embolism — a serious condition that damages lung tissue and can lead to death. Walking and using leg wraps that apply intermittent pressure to the leg can help reduce this risk of blood clots in the legs.
- Leaking at one of the staple lines in the stomach. This severe postoperative problem would be treated with antibiotics. Most cases heal with time. Sometimes, the leak can be serious enough to require emergency surgery.
- Pneumonia. Excess weight places extra stress on the chest cavity and lungs. This means a higher risk of developing pneumonia after the surgery.
- Narrowing of the opening between the stomach and small intestine. This rare complication may require either an outpatient procedure to pass a tube through your mouth to widen (dilate) the narrowed opening or corrective surgery.
How do you prepare for gastric bypass surgery?
Surgical candidates must go through an extensive screening process. Not everyone who meets the criteria for gastric bypass is psychologically or medically ready for the surgical procedure. A team of professionals, including a physician, dietitian, psychologist and surgeon, evaluate whether the surgery is appropriate for you. This involves identifying which aspects of your health would be expected to improve after surgery and what aspects of your health may increase the risks of surgery. Surgery is recommended when the perceived benefits of surgery outweigh the recognized risks.
It's important to follow your doctor's directions in preparing for gastric bypass surgery. This includes restrictions on eating, drinking, starting a program of physical activity, and limiting or stopping the use nicotine products.
