Weight management program requirement for bariatric surgery ‘should be abandoned’

According to researchers, the weight management program required by pre-obesity surgery insurance is ineffective and “should be abandoned.”

Deborah Hatchon, DCN, RD, CSOWM, LD, Prisma Health’s clinical nutrition experts in Greenville, South Carolina, reported that the controversial requirements do not provide clinical benefit at the Annual Meeting of the American Society for Metabolic Obesity Surgery (ASMBS).

Many insurance companies require patients to undergo a weight management program because they believe that weight management programs will have better results for patients before obesity surgery is approved. According to the ASMBS press release, each insurer has its own requirements. Some only require the patient to complete the program, others require the patient to maintain weight loss, and others refuse surgery if their weight fluctuates.

Hutcheon et al. 2014-2019. Of these, 779 completed the insurance-required WMP.

The researchers compared the total and excess weight loss rates of participants who completed WMP and those who did not complete it during the 60-month postoperative period. They also analyzed secondary outcomes such as surgery time, surgical site infections, ED visits, length of stay, and readmissions.

Total weight loss and excess weight loss were not significantly different between the groups after the follow-up period. In fact, researchers who underwent laparoscopic gastric bypass but did not complete WMP maintained significant and excessive weight loss up to 60 months postoperatively than those who completed WMP. Reported. In addition, patients who underwent sleeve gastrectomy but did not complete WMP maintained greater and excessive weight loss until 13 months postoperatively. According to the release, on average, patients who did not complete WMP lost 1% to 5% more weight.

There was no difference in secondary outcomes, and researchers concluded that WMP requirements did not provide short-term or long-term clinical benefits.

“Believe is one thing, and proof is another. Patients with insured weight management programs do not achieve significant weight loss before and after obesity surgery and have fewer postoperative complications. There was no better solution to obesity-related illness when compared to patients who did not have such insurance requirements, Hatchon said in a release: “Data will reduce outcomes and lead to life-saving medical interventions. Shows requirements that only serve to unnecessarily delay patient access. “

reference:

• Hutcheon D, et al. Abstract A002. Place of presentation: Annual Meeting of the American Society of Metabolism and Obesity Surgery. June 5-9, 2022. Dallas.
• Weight management programs mandated by pre-weight loss insurance do not provide clinical benefits. https://www.eurekalert.org/news-releases/954732. Published June 7, 2022. Accessed June 9, 2022.