Predictions for the Future of Bariatric Surgery

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The Consumer Guide to Bariatric Surgery, a publication of the Ceatus Media Group LLC, has issued its prediction of trends for the future of bariatric (weight loss) surgery for 2010. Among the top ten trends is the forecast that the number of bariatric surgeries performed in the US will increase, particularly among adolescents and diabetic patients.

The number of bariatric surgeries in the United States has already doubled in the last six years. 220,000 people had surgery in 2008, according to the American Society for Metabolic and Bariatric Surgery. Technical improvements, improved outcomes, and greater education will likely lead to more patients investigating their weight loss surgery options.

Although the economic downturn has caused a drop in insurance coverage for many patients due to a loss of job or through restricted coverage, the group still foresees an increase in bariatric surgeries. Acquiring insurance coverage for weight loss surgery can be a huge obstacle in the pre-surgical process. Due to an increase in the number of procedures and the cost (average is approximately $25,000 per surgery), insurance carriers require strict preauthorization requirements before it will approve coverage.

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Surgery may also be recommended for patients with uncontrolled diabetes. Currently, the minimum BMI for surgical qualification is 35. Research has been introduced to the Centers for Medicare and Medicaid Services to decrease the minimum for patients who are unable to control their diabetes through other measures to a BMI of 30. CMS has currently rejected the proposal, but with continued research on the long-term benefits and cost savings, there may be reconsideration in the future.

The number of surgeons performing single incision or incision free bariatric surgeries will increase. Single incision Laparoscopic Surgery (SILS) is being performed at a few bariatric centers for adjustable gastric banding surgery, where a silicone band is placed around the upper portion of the stomach. Transoral gastroplasty, also called the TOGA procedure, and Primary Obesity Surgery Endolumenal (POSE) are two incisionless surgeries that are being studied for weight loss. These create a stapled restrictive pouch that work by restricting the amount of food a person can eat, thereby reducing the number of calories.

Other new procedures are also on the horizon that do not involve invasive surgery. One is called the EndoBarrier Gastrointestinal Liner, by GI Dynamics. A “lining” is placed in the small intestine, which restricts the amount of food that is absorbed in that portion, thus reducing the number of calories that is taken into the body cells. The addition of an adjustable device, called a Flow Restrictor, that is placed at the outlet of the stomach at the small intestine can increase weight loss by delaying gastric emptying, allowing a person to feel full longer and reducing calorie intake.

Post-surgical cosmetic procedures will likely increase, as significant weight loss can result in loose skin around the abdomen, in the arms and thighs. Common procedures include abdominoplasty, brachioplasty (arm lift), mastopexy (breast lift), and medial thigh lift. Most insurance plans will not cover the cost of cosmetic surgery.

For more information about Bariatric Surgery options, visit the Consumer Guide for Bariatric Surgery at www.yourbariatricsurgeryguide.com or Obesity Action Coalition, at www.obesityaction.org

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