I am 26 years old, 5’2" and weigh 220 lbs. Do I qualify for VGS surgery to be covered by insurance?

Question

I am 26 years old and 5’2 and weight 220 I’ve always been up and down with my weight I lost weight 2 years ago and gained it right back I have really bad back pain and my knees always hurt right at the joints so I qualify for the vgs surgery to be covered by my insurance?

Babak Moeinolmolki, MD, FACS · Answer

Hello,
Congratulations on being proactive in seeking solutions to improving your health! I have had many patients find relief for back and joint pain through weight loss.
As Dr. Garcia pointed out, to qualify for gastric bypass surgery (aka weight loss surgery), the American Society for Metabolic and Bariatric Surgery recommends you meet one of the following:
BMI ≥ 40, or more than 100 pounds overweight.BMI ≥35 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.
Insurance often covers surgery for patients who meet #1 or #2. With a BMI of 40, you meet both. Obesity puts you at risk for obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, and heart disease. Thus you are wise to be concerned about your weight, its impact on your health, and the increased difficulty to lose weight or undergo surgery as you grow older.
Meeting with a bariatric surgeon in your area will allow you to further discuss the pros and cons of surgery as well as the cost for the surgery in your geographic area. You can also check with the Patient Learning Center of the American Society of Metabolic and Bariatric Surgery to educate yourself on surgical options.
Best regards,
Dr. Moein

Pablo Garcia, MD · Answer

Hello
Thank you so much for your question. According with your BMI you are a great candidate for bariatric surgery; The sleeve gastrectomy, witch reduces the size of the stomach is probably an excellent option because  the 70% to 80% of the stomach is removed and the part that produce Ghrelin witch is a hormone that makes you feel hungry.
To qualify for weight loss surgery, the American Society for Metabolic and Bariatric Surgery recommends you meet one of the following:
1- BMI ≥ 40, or more than 100 pounds overweight.
2- BMI ≥35 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
3- Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.
Have a consultation with a bariatric surgeon this will allow you to discuss about the different procedures in details. Many factors should be considered when deciding for a bariatric surgery, is needed to check your current health status with lab work and in a consultation you can accomplish this.  Don't be discourage and continue searching the best option to improve your health.
My Best Wishes,

I am 26 years old, 5’2" and weigh 220 lbs. Do I qualify for VGS surgery to be covered by insurance?

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I am 26 years old, 5’2" and weigh 220 lbs. Do I qualify for VGS surgery to be covered by insurance?

Answers (2)

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Everything you need to know about Gastric Sleeve Surgery

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