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Insurance-mandated weight management program completion before bariatric surgery provides no long-term clinical benefit.
Hutcheon, Deborah A; Ewing, Joseph A; St Ville, Madeleine; Miller, Megan; Kirkland, Lindsay; Kothari, Shanu N; Scott, John D.
Afiliación
  • Hutcheon DA; Department of Surgery, Prisma Health, Greenville, South Carolina. Electronic address: deborah.hutcheon@prismahealth.org.
  • Ewing JA; Data Support Core, Prisma Health, Greenville, South Carolina.
  • St Ville M; Data Support Core, Prisma Health, Greenville, South Carolina; School of Mathematical and Statistical Sciences, Clemson University, Clemson, South Carolina.
  • Miller M; Department of Surgery, Prisma Health, Greenville, South Carolina.
  • Kirkland L; Department of Surgery, Prisma Health, Greenville, South Carolina.
  • Kothari SN; Department of Surgery, Prisma Health, Greenville, South Carolina.
  • Scott JD; Department of Surgery, Prisma Health, Greenville, South Carolina.
Surg Obes Relat Dis ; 19(4): 290-300, 2023 04.
Article en En | MEDLINE | ID: mdl-36424327
BACKGROUND: There is no evidence that insurance-mandated weight loss before bariatric surgery affects outcomes. OBJECTIVE: This retrospective study evaluated the relationship between insurance-mandated weight management program (WMP) completion before primary bariatric surgery and postoperative outcomes. SETTING: Suburban academic medical center. METHODS: Patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB, n = 572) or sleeve gastrectomy (SG, n = 484) from 2014 to 2019 were dichotomized to presence (LRYGB n = 431, SG n = 348) or absence (LRYGB n = 141, SG n = 136) of insurance-mandated WMP completion. Primary endpoints included follow-up rate, percent total weight loss (%TWL), and percent excess weight loss (%EWL) through 60 months after surgery. The Mann-Whitney U test compared between-group means with significance at P < .05. RESULTS: Follow-up rate, %TWL, and %EWL were not different (P = NS) up to 60 months postoperation between groups for either surgery. Both LRYGB and SG patients without WMP completion maintained greater %TWL (LRYGB: 34.4 ± 11.1% versus 29.8 ± 11.0%, P = .159; SG: 21.4 ± 10.0% versus 18.2 ± 10.5%, P = .456) and %EWL (LRYGB: 71.3 ± 26.3% versus 67.6 ± 26.5%, P = .618; SG: 49.2 ± 18.8% versus 47.5 ± 28.8%, P = .753) at 36 months after surgery. Secondarily, duration of time to get to surgery was significantly greater among yes-WMP patients (LRYGB: 178 days versus 121 days, P < .001; SG: 169 days versus 95 days, P < .001). CONCLUSION: Insurance-mandated WMP completion before bariatric surgery delays patient access to surgery without improving postoperative weight loss potential and must be abandoned.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Derivación Gástrica / Laparoscopía / Cirugía Bariátrica / Programas de Reducción de Peso / Seguro Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Surg Obes Relat Dis Asunto de la revista: METABOLISMO Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Derivación Gástrica / Laparoscopía / Cirugía Bariátrica / Programas de Reducción de Peso / Seguro Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Surg Obes Relat Dis Asunto de la revista: METABOLISMO Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos