Orbera: Cost, weight loss expectations, insurance coverage?

Question

I recently found out about the this "smart stomach balloon" and am considering it as option to aid in my weight loss journey. I know that diet and exercise are key at maximizing results. Assuming that one commits to exercise of at least 45 minutes 5-6 days per week and makes a change in diet, at a BMI of about 40 (give or take), would a 60 lb loss be an attainable goal in 6 months? Lastly, what insurances would cover such a procedure, or would this always be a self-paced procedure?

Reza Keshavarzi, MD, FACS, FASMBS · Answer

We charge $8000 for our Orbera Balloon program. $4000 for the hospital portion (done at a bariatric center of excellence - highest stamp of approval for bariatric sites) and $4000 for the surgeons professional fees which includes both in and out as well as follow-ups. You can expect to loose between 20-50/60 pounds. On average our female patients loose about 30-40 pounds and our male patients are loosing 40-50 pounds. Insurance will not cover this procedure at all but we do offer financing and can be as low as $190/month.

Christopher E. McGowan, MD · Answer

Your goal of 60lbs is ambitious, but certainly attainable. I typically counsel patients that the amount you will lose depends on your starting weight (not just BMI) and your motivation. Your plan for exercise is an excellent one. We know that the Orbera system will restrict how much you eat. This is a great opportunity to simultaneously attack the exercise component, which will really maximize your weight loss. In the US pivotal trial of Orbera, patients lost an average of 10.2% of their total weight, which was 3 times more than diet and exercise alone. In the "real world" we find that people will typically lose more than that, as they are more motivated than those enrolled in a clinical trial. We generally advise that an average of 20-50 lbs should be expected. Insurance does not cover Orbera, but many financing options are available. Keep in mind that the cost of the balloon includes a full 12-month comprehensive program, with monthly dietician visits.

Isaac Raijman, MD · Answer

Thank you for your question. Orbera balloon is an effective non-surgical endoscopic procedure with the added benefits of being reversible and safe. The combination of a diet and the balloon as well as exercise will help you reach your goals, and then "resetting" your mind set in terms of diet and how you see yourself will help maintining the weight loss. The cost of the procedure is $6700 but the price varies in different markets. Best of luck to you

Darrien Gaston, MD, FACP, FACG · Answer

In my experience with the Orbera balloon, I have had patients lose 40, 50, 60, and 70 pounds in 6 months. . The most successful patients are the ones who follow a proper diet, exercise at least 5 days per week (cardio, not strength training).
Insurance does not cover the procedure at this time. No knows if or when insurance companies will cover these nonsurgical procedures

Angelo G. Coppola Jr., MD · Answer

The Orbera balloon, like all bariatric procedures, is a tool in attaining your weight loss goals.  You have made the best first step, that is understanding the importance of exercise and diet in achieving any weight loss goal.
With a medically supervised weight loss program, exercise to include strength training and aerobic activity and gastric balloon, we see between 45-65 pound loss on average in a six month period.  This is variable depending on the basal metabolic rate, other medical conditions and motivation.
Most insurance programs do not cover gastric balloons, though some allow payment through a health savings account.  You would need to check with your plan administrator.

Orbera: Cost, weight loss expectations, insurance coverage?

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Answers (5)

More Orbera Gastric Balloon Questions

I am curious to know if insurance covers Orbera?

Is ORBERA covered by insurance?

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