Patient Care

Insurers should cover all treatments for severe obesity, AOA House says.

“If we’re going to treat the whole person, surgery is an important component of obesity treatment,” delegate says.

Weight loss surgeon Adam B. Smith, DO, found that about 40% of patients at his Texas practice, Fort Worth Lap-Band, had no insurance coverage for bariatric surgery, so he decided to do something about it. He co-wrote a House resolution on behalf of the American College of Osteopathic Surgeons (ACOS) urging federal and state policymakers and third-party payers to cover the costs of treatment—both surgical and nonsurgical—of severe obesity.

The AOA House of Delegates voted today to approve that resolution, which notes there is no universal coverage for all treatments of severe obesity.

“If we’re going to treat the whole person, surgery is an important component of obesity treatment,” says Dr. Smith, an ACOS delegate, which proposed the policy. “Statistically speaking, bariatric surgery is the most effective long-term treatment for the significantly obese population—those who body mass index is over 35.”

He cites more than 15 years of clinical research data on gastric bypass surgery and some 10 years of data on laparoscopic gastric banding that show weight loss surgery often leads to significant improvements in obesity-related morbidities, especially type 2 diabetes mellitus, hypertension and obstructive sleep apnea. In addition, he says bariatric surgery is effective along with nonsurgical weight loss approaches at helping obese people maintain their weight loss.

“We’re not making these people look like Barbie. We’re treating a disease surgically,” Dr. Smith says.

Although the cost of bariatric surgery ranges from $12,000 to $35,000, according to 2010 estimates from the National Institutes of Health, Dr. Smith says it can be less expensive over time than other medical treatments for obesity-related complications.

The new policy, which passed without debate as part of a consent agenda, also recommends that the AOA support the efforts of the Obesity Action Coalition to secure coverage for all recognized treatment modalities for the treatment of severe obesity. The OCA is a Tampa, Fla.-based nonprofit organization offering obesity education, advocacy and support. Dr. Smith advocates on behalf of the coalition for support of obesity prevention, treatment and research.