How do I get LAP-BAND surgery?

Question

And make my insurance company pay for it?

I am overweight and I've tried everything to lose weight. I have done a lifestyle change i.e. exercise, diet, etc. BUT I STILL CANNOT LOSE THE WEIGHT.

I am at my wits end.

Answer 1

That's a cop out. It not physically or humanely impossible to lose weight by adopting a lifestyle change. Before you take the easy way out maybe you'd want to speak with your dr. about what the possible underlying causes could be to your so called not being able to lose weight. I don't truly believe your insurance will may for a LAP-BAND.  

Answer 2

First of all, you can't MAKE your insurance company pay for anything that they are not contractually obligated to cover.  You'll need to review your specific contract to see what is and is not covered.

Consult a bariatric surgeon.  They know what is required for insurance to cover the procedure, and can tell you if you are a candidate.

Any bariatric surgery is only a tool to help you lose weight through lifestyle modification.  You will still have to eat less and exercise more.

Answer 3

pay me $12,500

or go to india and have it done for $2,500

Answer 4

Medicare now covers bariatric surgery in cases where a series of reasonable criteria are met.  Because of this, many other insurance carriers do as well.  There are several aspects to the pre-operative evaluation prior to bariatric surgery that you might want to know about.

First, there is a BMI criterion.  BMI stands for "body mass index" and is defined as the weight in kilograms divided by the height in meters, squared.  A BMI of 40 or more is generally considered "morbidly obese" and suggests that bariatric surgery may be required.  

Additionally, the surgeon will want to document what are called "obesity related co-morbidities".  These are health problems that can be blamed on the overweight.  Some of the most common issues include things like type 2 diabetes, hypertension, obstructive sleep apnea and osteoarthritis of the hips and knees.  There are many others.  The surgeon considering a patient for surgery does a thorough screen.

Next, there are typically some psychological screens.  In point of fact, there are quite a few people who would be better candidates for surgical weight loss if they had better psycho-social support networks, but the most important aspect is to help the patient develop a realistic picture of what to expect, not only in terms of the medical outcome but the radical change in mode of living that happens after surgery.

There are often one or two medical issues to iron out, in terms of optimizing pre-op safety, but these pieces of the puzzle fall right in line with everything else.

Bariatric surgery is relatively high risk.  Obesity makes it more difficult to detect complications and it makes those complications worse.  I agree with you that the LapBand is a good choice, and the reason that I say that is that it has a great safety record.  The average weight loss isn't as good, but the best outcomes with the LapBand are still in the ballpark with other surgical procedures.

Most obesity operations are designed to help the patient feel "full" with a very small amount of food so that they are abiding by a caloric restriction plan just like dieting, only without the constant gnawing hunger that is part of the typical failure pattern.  This is called a "restrictive" operation, to be contrasted with a "malabsorptive" operation in which something is done to defeat the bowel's ability to absorb energy rich compounds.  Malabsorptive operations have generally fallen out of favor.

On the forefront of this field, new data is suggesting that something called a "sleeve gastrectomy" will have excellent safety and efficacy, and the practice is spreading.  As much as I like the concept of the LapBand, I suggest waiting to see if a bit more data shows this to be actually a superior result with equal safety.

I, myself, do not perform bariatric surgery, although I was trained to do so.  Part of the reason is that my hospital and the health system it supports is currently ill-equipped to tackle all the needs of these patients and the situations that can arise surrounding this type of procedure.  Another part of the reason is that if I were to set up the infrastructure necessary to support obesity surgery, I'd have to keep the system "in practice" for the operation to be as safe and effective as it can be.  Basically, I'd have to do a lot of these cases and it would quickly come to dominate my practice.  I do a lot of other kinds of surgery and I'd lose some of that in the balance.

You, too, should be looking at surgery in terms of volume.  You don't want to have this operation performed by someone who just occassionally dabbles.  You want a surgeon that is strongly dedicated to this operation and it's nuances.  You want it to occur at a facility for which the care surrounding these operations is a routine.  It's your right to know.  You can ask the surgeon and you can check the facility.

Don't go rushing into this.  Do your homework.

... and good luck!