The avoidable delay in weight loss surgery for those with BMI over 50.

Area of Science:

• Bariatric Surgery
• Obesity Medicine
• Health Services Research

Background:

• Insurance companies often require medically supervised weight loss programs (MSWLPs) before approving bariatric surgery.
• This study investigates the effectiveness of a 6-month MSWLP in reducing BMI for patients with a BMI ≥ 50.

Purpose of the Study:

• To determine if the mandatory 6-month preoperative medical management period effectively decreases BMI in patients with a BMI ≥ 50.
• To assess the percentage of weight loss achieved during this mandated period.

Main Methods:

• Retrospective analysis of electronic medical records from New York University Langone Health (2015-2021).
• Included adult patients with BMI ≥ 50, no prior bariatric surgery, and a 6-month insurance-mandated medical visit history.
• Paired t-test used to compare BMI and percent weight loss at least 6 months pre-surgery versus the day of surgery.

Main Results:

• A total of 130 patients met the inclusion criteria.
• The mean BMI reduction was 1.51 points (P < 0.01).
• Mean total body weight loss was 4.8% (P < 0.01), with no intraoperative or 30-day complications or mortality.

Conclusions:

• The 6-month medically supervised weight loss period resulted in statistically significant weight loss.
• However, the average weight loss of 4.8% did not meet the typical 10% target.
• The study suggests reconsidering the prolonged delay for bariatric surgery given the modest weight loss and absence of complications.