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CNN REPORTS THE MOST COMPREHENSIVE PROOF THAT Gastric Bypass Lowers Risk of Death TIME MAGAZINE AUGUST 22, 2007 By Sora Song Whether one regards bariatric surgery — last-resort weight-loss operations such as gastric bypass and stomach stapling — as an essential treatment for obesity or as a failure of the fat person's will, the fact is, it works. Studies have shown that after surgery, patients often lose 50% or more of their excess weight — and keep it off — and symptoms of obesity-related conditions like diabetes, high blood pressure, high cholesterol and sleep apnea are improved or eliminated altogether. Now, two new studies in the New England Journal of Medicine (NEJM) show another long-term benefit: a lower risk of death. The larger of the two studies — the largest of its kind — led by researchers at the University of Utah School of Medicine, looked specifically at gastric bypass surgery, also known as Roux-en-Y gastric bypass, which accounts for 80% of all bariatric surgeries in the U.S. The operation involves creating a small walnut-size pouch at the top of the stomach, which is then stapled off and connected to the small intestine lower down than usual; the result is that patients can eat only an ounce of food at a time, and the food bypasses most of the stomach and the top part of the intestine, limiting the number of calories the body absorbs. In the Utah study, researchers compiled data on 15,850 severely obese people, half of whom had undergone gastric bypass surgery between 1984 and 2002, and half who were from the general population and had had no surgical intervention for obesity. Overall, researchers found, the surgery patients were 40% less likely to die from any cause during a mean 7 years of follow-up, compared with the obese controls. What's more, the mortality rate attributable to obesity-related disease was 52% lower on the whole in the surgery group: after gastric bypass, patients were 92% less likely to die from diabetes, 59% less likely to die from coronary artery disease, and 60% less likely to be killed by cancer. Results like these have got some doctors intrigued enough to start thinking about bariatric surgery as a treatment for conditions other than obesity —especially diabetes. A growing body of research suggests that the surgery may reverse the disease, a potential solution that could help some 20 million American diabetics. Though the current NEJM study did not specifically study the impact of bariatric surgery on diabetes, it did reveal a 92% reduced risk of death from the disease in surgery patients —findings that support what has been emerging in other experiments. "In more than 80% of patients who are severely obese and have diabetes and then have gastric bypass surgery, the diabetes is cured," says Ted Adams, professor of cardiovascular genetics at the University of Utah School of Medicine and lead author of the new study. "The interesting thing is that the resolution of diabetes happens within a few weeks following surgery, long before patients have lost their weight." Like some other researchers in the field, Adams believes that the surgery triggers other biological mechanisms, separate from weight loss — perhaps an interruption of a crucial biochemical pathway or a change in the release of certain hormones in the stomach or small intestine — that may have powerful effects on diabetes. "The gastric-bypass patient is really providing a source of intriguing research related to all kinds of disease treatment as well as weight gain and weight loss," says Adams. The second study, led by researchers at Gothenburg University in Sweden, involved 4,047 obese volunteers, 2,010 who underwent some form of bariatric surgery and 2,037 who received conventional obesity treatment, including lifestyle intervention, behavior modification or no treatment at all. Ten years after surgery, researchers report, the bariatric surgery patients had lost more weight and had a 24% lower risk of death than the comparison group. Though the overall number of subjects in this study is much smaller than the first, the results confirm general benefits of bariatric surgery, and gastric bypass in particular: after 10 years, bypass patients had maintained a 25% weight loss, compared to a 16% loss in patients who had stomach stapling, and 14% in those who underwent a banding procedure. In both studies, surgery patients had an overall lowered risk of death, but an interesting finding in the Utah study shows that these patients were 58% more likely to die from other causes, such as suicide and accidents. The authors speculate that as people lose weight and become more active, they also become more prone to accidents, which may up their risk of death. Surgery patients may also have pre-existing psychological problems — a history of abuse, perhaps — that can't be resolved by losing weight. "There have been some studies reporting that following bariatric surgery, some individuals may be more prone to chemical dependency, such as increased alcohol use," says Adams. "There's some speculation that certain addictive behaviors that are in place before the surgery — with food, for example — are transferred to alcohol or another addictive behavior." "Hopefully this research will stimulate additional evaluation of what the optimal approach is for evaluating candidates for this surgery," says Adams. "I think we should never lose track of the importance of individual evaluation of benefits and risks." Last year, an estimated 177,600 patients underwent bariatric surgery, a figure that's likely to grow as Americans get fatter and fatter. Though modern surgery techniques have become more sophisticated, less invasive and safer than in the past, the bariatric procedure still carries all the risks of any other operation. Patients have a .5% to 1% chance of death. The risk of gallstones goes up. Sometimes a second surgery is necessary. And all patients must be careful to make up for Vitamin and mineral deficiencies. The surgery isn't for everyone; current guidelines recommend it as a last resort, only for the morbidly obese who have a BMI of 40 and higher, or for the obese with a BMI of 35 and higher plus a serious weight-related illness like diabetes or hypertension. This should help. Gary Viscio Viscio Law and The Obesity Law Center - Welcome

So I am preparing for my appt with my bariatric surgeon Jan 8th and trying to get all my records together to shorten the approval process for my ins. I am only 28 years old so the extent of my medical visits for the last 8 years have been ob/gyn visits for my 3 kids. Last year I did go to a "wellness" clinic for fatigue, exhaustion and just general well being, thinking that if I was not so tired all the time I might have energy to excercise, cook healthier meals, etc. I thought I might try a different approach since the dieting I have done since 1990 (10 years old) has not worked so far. I have been seeing this wellness doctor for 10 months about every 2-3 months and she has found a thyroid problem and been treating me for that as well as my fatigue, stress, etc. Bottom line... she won't write my a letter stating that I have seen her for " weight related issues".......WHAT!!! And no where in her notes does it say anything about our discussion regarding my claoric intake, daily excercise, weight history, etc!!! And we discussed that at EVERY visit!!!! HELLO..... IT IS A WELLNESS CLINIC, me walking in at 230 lbs, you would think she would have noted somewhere that she asked about my weight problem...how else would I have gotten to 230 lbs. I am a nurse and I know that docs don't have time to note EVERY word, but is she not treating my "wellness" which to me includes my nutritional state. As we all know the "damper" obesity is on "wellness" What a joke, I am so irritated. Anyone have a similar situation? Thanks for reading, I am not one for long posts. :rain::clap2:my sone wanted to put the smiley in.

I looked into my insurance requirements for the sleeve. I have been seeing my pcp for the 6 month supervised diet. I made the appointment to see the nut doctor. And I been goin to the gym. I feel like I'm missing something. This is what they want. Patient selection criteria for bariatric surgery include (NHLBI, 1998): Documentation of a motivated attempt of weight loss through a structured diet program, prior to bariatric surgery, which includes physician or other health care provider notes and/or diet or weight loss logs from a structured weight loss program for a minimum of 6 months. Active participation in an integrated clinical program that involves guidance on diet, physical activity and behavioral and social support prior to and after the surgery. Psychological evaluation to rule out major mental health disorders which would contraindicate surgery and determine patient compliance with post-operative follow-up care and dietary guidelines.

It's only been a few days since my sleeve but all is going well. I am self pay so I understand your concerns. Be sure you have a very experienced surgeon; mine only does bariatric surgery in a center of excellence. He overstitched the staples and says this all but eliminates the risk of leaks. I thought I would be out of work for one week, but my doc says not to drive for 2 weeks. I plan on doing about a half days work from home next week just so I don;t fall so far behind. I also find that I am not rebounding as quickly as I did when I was younger (I'll be 60 next month). Good luck on your journey.

@@meantforsunshine Hi There, Congratulations on having your surgery. So sorry that you now have this crappy diagnosis. I have Psoriatic Arthritis and my mother had Rheumatoid arthritis. Recently I started showing signs of Rheumatoid as well and I was tested for it when I was tested for Psoriatic and the tests were negative. Not sure what the Paddison program is but I will tell you this. I have to limit my Protein because of kidney issues caused by years of medications for my arthritis and being overweight. I have a strict no more than 65 grams of protein per day or it taxes my kidneys. I eat a diet mainly of meat, veggies and fruit. I have noticed that my Psoriatic Arthritis has improved so much since my 152lb weight loss. My disease has been in remission and the only time it seems to kick up now is when they put me on oral or IV steroids so I avoid them unless it is life threatening which has not happened since 9 months post op. In fact, I spoke with my doctor on tuesday and we have been weaning me off of cyclosporine which is a immuno suppressant and are even lowering my dose of Stelar which i get every 10 weeks now. It used to be 8 weeks and double the dose. There is even talk of removing me from it completely at some point. So, I tell you all this because both my rheumatologist and my dermatologist are amazed at the transformation this surgery has done for my health. I suffered with Psoriatic Arthritis which is auto immune my whole adult life. I remember the onset began when the weight started piling in in my mid 20's. Obviously with RA, the goal is always to get you on a biologic that stops the progression and the same is true of Psoriatic arthritis so i am nervous about taking me off of the thing that gave me my life back. Anyway.....the diet you are speaking of meats, veggies and fruits are exactly what got me to the point that I am at. I did not have to pay for a special diet as this really is what the bariatric diet is centered around. Not sure if this helps but it has been my personal experience and I could not be happier.

It's good you had this discussion with your doc. Lots of people don't, and then are super surprised and upset when the scale stops moving when they are 40lbs above a normal BMI. Here's an article that talks about it: http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/dear-doctor-ive-had-bariatric-surgery-will-i-ever-get-to-normal-weight

I completely agree with you , but at some point when you can’t eat any cleaner or reduce your calories, your body is done. I’ve been through all this as I was once 135 lbs. my diet was strict, but I did put in lots of hours at the gym to maintain this. Most of us don’t burn enough calories in the gym anyhow compared to how much we eat. Now that’s the average person. Maybe not how little bariatric patients consume now. But yes, weight loss is 80% diet. This is true. Plus there are so many other factors like hormones , stress levels and cortisol, health issues , sleep , antiquate water intake, and more.

I was told by my psych doc that most ins. will cover part of the consult but not all, meaning they will cover the consult itself but not the report that the psych has to type up to be submitted by your bariatric surgeon to ins. He said the key to getting them to cover the small part of the consult is when you call for precert you HAVE TO SAY that you need a consult for "weight related issues" ie. depression, not a consult in preparation for bariatric surgery. He told me that this would get the precert but I would have to pay out of pocket for the report, which was $150 plus my copay for the small part that they would bill ins for. so I basically would just be paying for the whole thing anyways. Hope this helps, you know it is all in how you word it with ins.

I had my open enrollment meeting at work today. They are no longer covering bariatric surgery under our health insurance plan effective January 1. I was going to wait until next year for my sleeve, I am so thankful I didn't!!! I am loving my new tummy!!

Thank you for telling us, I,for one, feel honored you shared this secret with us. I am waiting for my surgery, maybe May, after curves and a threatened derailment of my journey on the weight loss road , I am fighting what seems an uphill battle to secure a RnY . Started my battle in August 2015, now ready to proceed with program # 2 at bariatric center#2 for hopefully not a 3rd set of requirements, I should have clairification after April 25th 2 hour meeting with OSU psychologist Dr Kramer in Columbus Ohio. There are days I toy with the idea of novacaine, a box cutter and 30 wt fishing line and doing my own . I have begged, pleaded ,jumped through hoops, crawled through minefields of quasi regulations, slithered across broken glass, had various portions of my anatomy scanned, prodded ultrasounded and groped to no avail. Every portion of my gastrointestinal system is there except the appendix and gall bladder I gave up 30+ years ago.[emoji10] I have answered questions, allowed my psyche to be probed, and presented myself in abject humiliation to have surgery and it still has not happened. If this is truly a journey I have gone around enough hairpin turns to last me until infinity.But I have resolved not to let it triump over me, I will subdue the Bariatric dragons in my path with my Rightness sword. And surgery will be mine![emoji7][emoji626] Sent from my VS880PP using BariatricPal mobile app

Hi there, I'm a health reporter at VICE News and MedPage Today working on a story about a JAMA study that found bariatric surgery patients are more likely to self-harm after surgery than they were before surgery. I'm hoping to report beyond the study numbers and talk to a few patients about the mental challenges that can arise after surgery and how they got past them. Would anyone in this forum be interested in doing a brief phone interview with me? What would YOU want to share in a story on this topic? What experiences would YOU have found useful to read about that you can share? How do support groups, blogs and forums like those at BariatricPal help after surgery? My deadline is end of day tomorrow, but I'd like to do interviews this afternoon and early tomorrow morning. Please send me an email so we can set up a time to talk. Thank you so much! And thank you, Alex, for granting me permission to post here. I'm really looking forward to hearing your stories. -- SYDNEY LUPKIN Health Reporter VICE News/MedPage Today sydney.lupkin@vice.com s.lupkin@medpagetoday.com

Hi all!!! I am Cyndi in (near) Atlanta, if you live in Atlanta, you know what I mean. I am just starting to look into the possibility of this. I have been up and down all my life. Highest weight with my last pregnancy was 300 5 1/2 years ago. Lowest adult weight 163, 3 years ago. Lost 112 lbs on WW, had lower body lift, ran the Disney half marathon and then proceeded to gain all but about 15 lbs back. Have tried to get back into WW but it just isn't happening. BCBS this year for me states covers "bariatric services", whether this means GB or LapBand or just help with dieting remains to be seen. I am here to find out what I can, good and bad.:help:

Thanks for your advice. I am actually seeing my PCP this coming Tuesday to talk about lapband and get her recommendation for a surgeon. But, I also made a reservation to attend a seminar w/Scottsdale Bariatric Center next Sunday already as well. Even if its not the surgeon my PCP ends up recommending, I figure it doesn't hurt to get as much info as possible. Anyway, I will definitely ask my doctor about testing for additional comorbidities. I had full bloodwork done in late November, though, and was a little surprised I don't show as pre-diabetic. I feel just awful when I eat high glycemic index type foods. But, I wonder if I don't test as pre-diabetic because I just avoid those foods now.

Shorty At least in some states Medicaid will pay if the program has earned a designation of Bariatric Center of Excellence. These are typically hospital-based programs. Be aware that many programs require an upfront, non-refundable program fee to cover the costs of evaluation, which no insurance will pay. My program charged $500, which covered the mental health eval, and meetings with the dietician and the nurse. Good luck to you!

you go to the main site, aetna.com, then in the "search" field you type in "bariatric surgery" - otherwise it wont come up or you have to search through pages of crap.

Aetna only counts high blood pressure if it's not controlled by medicine. I don't know about cholesterol but I vaguely remember it's the same. Their bariatric policy is here: Obesity Surgery It's got all the details.

Wow, it sounds like you have been dealing with a lot of life. As far as your post-op food plan, can you get another copy from your surgeon? Try googling "Bariatric Center of Excellence manual" and you should be able to find some examples. I would suggest you make an appointment with your surgeon and/or NUT to discuss your health issues (especially your use of steroids). A good bariatric NUT should be able to help you get back on track. It's never too late.

I work for an insurance copany, but am not directly involved in the insurance part of the business, so I can only go on my understanding... but when a company excludes part of a plan (e.g. bariatrics), there's nothing to be done through the actual insurance company (outside of purchasing your own something or other through them). It has nothing to do with them, and at that point is all in the hands of your employer. Considering that your employer is now the one you have to work with, your HR rep should ne the first stop, but the most you can do is request that they release the exclusion. Considering what the cost is, it's not *likely* that they'll do it based on one request, but the worst that could happen is they say no, right?

Hi, I have been lurking around for a while and I finally have a date.:clap2::clap2: This Wednesday at 12:30. I am self pay so I was able to get in really quick. I am soooooo excited. I never thought I would say that about having surgery. My doctor is Dr. Brady with Southwest Bariatric Surgeons in Austin, TX. Tammy

Has anyone on this website heard of Texas True Choice, it will be my new ins. carrier effective in the fall. Do they cover bariatric surgery? If you know anything about this carrier, please let me know. My surgery is already covered, I would need aftercare for fills, or complications. I will try to call the 1*800 number, but I'm not sure they will give me info, since technically, I am not an official member on their plan.

My brother's girlfriend works as a nutritionist for a bariatric surgeon. She has said that she sees people that can't get health insurance now because they had weight-loss surgery. If your current insurance covers your surgery, but you have to change insurance afterwards for some reason, can you get insurance? I have also heard people say that as long as you get insurance within 60 days of your old coverage ending, the new company can't consider it a pre-existing condition and therefore deny you. I need to know because I will be dropped from my parents' insurance plan when I turn 24 next August, but I am hoping to have surgery before the end of this year, or at least before my classes start again at the end of January. I don't want to be uninsurable at the age of 24.

wow. i gotta say looking for a job based only on if they cover lapband is a new one to me. as a small business owner with 9 employees can i give a different viewpoint on this? sorry if it seems crass. i provide pretty decent healthcare insurance for our folks here< at real reasonable rates, but i do not have bariatric coverage included in our pkg. i had lapband by the way in august of this year. i was a self pay. i excluded bariatric coverage because i have 2 employees and 1 of their spouses that would probably utilize it. sounds like a typical "cheap" employers huh? look at it from an employers side. 2 years ago we had 2 gallbladder surgeries and a pregnancy. our renewal rate was initially +24% the following year. my agent got it down to only a 16% increase. we had very few claims last year and no serious ones. latest renewal was less than 1% for 09. good for all of us. if only 1 of these folks had a bariatric operation here in the states it would run minimum of $20k and up to $45k. for 2 folks, double that. here in lies the problem...i know these folks need help but if we have those surgeries go on our insurance our renewal rates would approach 40% to 60% next year IF they choose to renew at all. then what do i do when i can't afford to provide any insurance to ANY of my other empoyees. everyone thinks employers are just greedy and don't want people to be healthy if it costs them money. not true. most small business owners i know want to provide good coverage for their employees but the insurance companies have us by the balls! small companies can't get insurance if there are too many claims on the history so we are forced to be selective where necessary to be able to maintain any coverage. sorry, i'll get off my soapbox now. my advise to you is DO NOT advirtise to potential employers that you want bariatric surgery as soon as you qualify. no one will hire you. trust me on this one. good luck.

Just wondering if anyone has Lumenos insurance and how fast/slow they were with the process of approving you. The bariatric coordinator says that they usually gove approval but wasn't really sure on the time frame...I'm just so ready and waiting is very hard(you all know this though:rolleyes:!!).

Hi Pookie, I have Kaiser in California and I'm just starting the process as well. I asked my PCP about the Lap-Band and she referred me to the bariatric department. I received a letter from the bariatric dept. within 2 weeks stating that I'm scheduled for an orientation on May 22. It also said that I'd need to go to my PCP beforehand for some blood work, a urine sample, chest xray and an ekg. I had all of that done last friday, so now I'm waiting to attend orientation. I can't wait! I'm not sure what to expect with any of this, but I want to get the ball rolling as soon as possible! I'll let you know how orientation goes after next tuesday...

Some folks in chat have asked me about the vitamins, shakes and suppliments I take. I wanted to post the website. Bariatric Advantage - Nutritional Supplements, Vitamins, Proteins, and Help for Gastric Bypass, Distal, Lap Band, Realize, Stomaphyx and Duodenal Switch Surgery Patients