Written By: Pavitra Sampath | Updated : August 6, 2013 11:42 AM IST
Is bariatric surgery a cosmetic procedure or a medical one? That is the big question. The Indian Regulatory and Development Authority (IRDA) which regulates the industry have ruled that bariatric or weight loss surgery was a cosmetic procedure and would therefore not be covered by insurance. This is strange considering obesity-related diseases are rapidly increasing in India. A Lancet study in 2008, found that eight million women and 4.4 million Indian men are obese while another one found that an average Indian women's blood pressure shot up from 120.9 mm to 123.1 mm in the last 28 years.
With Indians on the brink of an obesity endemic we are forced to wonder if the IRDA's denial to provide insurance cover to patients opting for Bariatric surgery, on the grounds that it was merely a cosmetic procedure, was justified.
Here is why bariatric surgery is not purely a cosmetic procedure:
According to Dr Goel, a renowned bariatric surgeon, 'Bariatric surgery is a sort of a 'last resort' surgery. I get patients who are well into their 60's, who undergo bariatric surgery so that they can regain their quality of life. A person, who is obese or morbidly obese, finds it difficult to perform even the simplest of tasks. He/she is unable to walk on their own to the bathroom because of severe knee pain, they may be unable to drive a car, or cook. There are patients who cannot sleep due to severe sleep apnoea (a condition that leads to suffocation and loud snoring). I find it laughable that the IRDA would say that such people would undergo this surgery for the cosmetic factor. Almost 80% of my patients are beyond the age where looks would matter, it is their functionality that matters to them.'
Obesity is one of the biggest causes of the majority of non-communicable diseases we have today. The sedentary lifestyle and fat rich foods available at our finger tips have only added to the cases of obesity and the number of morbidly obese people. Obesity leads to several other diseases such as high blood pressure, heart disease, hypertension, diabetes, cholesterol, progression of arthritis, osteoporosis or simply put, leg and back pain. Bariatric surgery is usually advised to a patient whose BMI is over 30, when he/she would be classified as morbidly obese. When asked, Dr Goel said'when a patient comes in we evaluate, if they really need the surgery and if they have exhausted all other options of weight loss. If we feel that they can achieve effective weight loss with good diet and exercise, we hand them over to our team who counsels them appropriately. Adjusting to this kind of surgery is a lifelong process and the patient's nutrition levels have to be checked regularly. Thinking that bariatric surgery is a shortcut to becoming thin is a myth.'
According to a number of physicians, if a person loses even 10% of their body fat, they will be able to see a remarkable change in the severity of conditions such as diabetes, heart function, infertility, menopausal symptoms due to hormonal imbalances etc.
Health.india.com view:
The blanket ban on non- payment of insurance for this surgery is not the best way to solve the problem. The sheer number of people suffering from obesity and obesity related disorders is staggering. While there are a small percentage of people who might opt for the procedure for the cosmetic benefits, a majority of them need it to better their life. As a solution, insurance companies should ask the treating physician weather the procedure is medically necessary for the patient. If they do find that the reasons for the surgery are insufficient, it is well within their rights to deny the claim. Reaching a middle ground on this potentially life altering (in some cases) procedure is the need of the hour.
