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Type of Insurance Matters in Bariatric Surgery Success Rates

US researchers announced Monday that patients with private health insurance lose more weight after having gastric bypass surgery than those covered by Medicare do. The study which surveyed data on 750 gastric bypass patients showed Medicare patients tend to weigh more before the surgery than those one private insurance, and that they are most likely to be depressed, have high blood pressure, heart disease, diabetes, and sleep apnea. Gastric bypass has risen in popularity in the past few years as a treatment option for severe obesity. This type of bariatric surgery works by reconstructing the digestive tract to reduce the amount of food that can be eaten by a patient. It is most frequently used to treat

patients whose BMI (body mass index) is over 30. Patients with BMIs of 40 to 49 are considered morbidly obese, while those with a score of 50 or above fall in the category of the super obese. The researchers in this study say that morbid obesity is the leading public health crisis in the US and that bariatric surgery is often the only effective treatment option for these people. Both large private insurers and Medicare (covering 44 million elderly and disabled Americans) cover the surgery in severely obese people. The surgery usually costs between $15000 and $35000.

The researchers showed that a year after surgery, though all patients studied had significant weight loss, the private insurance patients lost more weight. Those on Medicare lost 57% of their excess weight while those with private insurance lost about 82% of their excess weight. Although the Medicare group had the biggest reductions in bad cholesterol (low-density lipoprotein, which causes heart disease) and showed bigger improvements in fasting insulin (a measure of diabetes severity), the Medicare group also had slightly higher complication rates post-surgery, though none of the study subjects died. Researchers argue that these results are because patients in the Medicare group started out much heavier than those in the private insurance group. Those in Medicare’s average BMI was nearly 50, making them super obese. Researchers argue that if this study can be extrapolated to represent the entire population of bariatric surgery patients, it shows that many Medicare patients are going into bariatric surgery with more profound disadvantages, and that they may need additional support in exercise and nutrition to succeed.

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