What weight loss is best for a person's with POTS?

Question

I Am considering a weight loss surgery. Mainly the Gastric sleeve. I have POTS (Postural Orthostatic Tachycardia Syndrome). Will this make it worse? Are there other recommendations? Is it covered by insurance?

Ariel Ortiz, MD, FACS · Answer

POTS has been described as new onset or worsening in both gastric bypass and sleeve gastrectomy as a transitory event manageable with  none pharmacological measures in most patients and  pharmacological in a few cases. we would suggest sleeve gastrectomy since it is typically not associated with dumping syndrome which could add anxiety and confuse symptoms for some patients. The import thing to remember  is that if there is any worsening of symptoms  they tend to be transitory. AMG

Ali Solmaz, MD · Answer

POTS can make gastric sleeve surgery more challenging because it affects blood pressure, heart rate, and hydration levels. Since the surgery reduces stomach size, it can make it harder to stay hydrated, which is a major concern for POTS patients. Many people with POTS already struggle with dizziness and fatigue, and these symptoms can worsen after surgery, especially in the early recovery period. IV fluids after surgery and careful electrolyte management are often necessary to prevent complications.
Gastric sleeve surgery does not cause malabsorption like gastric bypass, but it can still lead to nutritional deficiencies. This is important for POTS patients because maintaining proper salt and electrolyte levels is crucial for blood volume regulation. Rapid weight loss can also impact autonomic function, potentially making POTS symptoms worse. If you’re seriously considering surgery, it would be a good idea to work with a cardiologist who understands POTS to help manage any complications that might arise.
Gastric bypass is another option, but it comes with additional risks. Since bypass affects nutrient absorption and can lead to dumping syndrome, it might cause more blood sugar fluctuations, which could worsen POTS symptoms. If surgery seems too risky, medical weight loss programs that include medications or structured nutrition plans might be worth considering.
As for insurance coverage, it depends on your provider and whether they recognize POTS as a qualifying condition. Most insurance companies cover weight loss surgery if your BMI is at least 40 or 35 with significant comorbidities. Because POTS isn’t always classified as a weight-related comorbidity, approval may depend on other factors, like whether you have conditions such as high blood pressure, sleep apnea, or diabetes. Checking directly with your insurance company and getting a letter of medical necessity from your doctor would be the best way to confirm your coverage.

Pablo Garcia, MD - Account Suspended · Answer

Hello, I hope you are well. There are several factors that determine what type of bariatric procedure would be best for you, if you qualify. Besided your medical history and pre-existing conditions, your BMI needs to be taken into account. It is possible you are eligile for  gastric sleeve, however you would need to be evaluated by a certified briatric surgeon in order to be sure. Please dont hesitate to contact us if any other inquiries arise.

What weight loss is best for a person's with POTS?

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Answers (3)

More Gastric Sleeve Surgery Questions

I want to lose 50 pounds. Is a gastric sleeve procedure a good option for me?

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