Bariatric surgery is a serious surgery that has many requirements you need to be pre-approved for before your surgery can be scheduled.  Many of these requirements are put in place by your insurance plan.  Your insurance plan has these requirements to make sure your health is in actual need of this surgery as a last resort.

There are other reasons for specific mental and physical tests and examinations due to your current health state, age, and previous surgery history.   All of these factors affect whether or not your health care team can approve and schedule you for surgery.

These requirements may appear daunting and excessive, but they are in place to prepare you mentally and physically for the lifetime commitment you make with bariatric surgery.  You must be ready for the lifestyle changes you need to have for surgery to have long term success.

What is Gastric Lap Band?

Gastric Lap Band, more commonly known as Lab Band, is a weight loss surgery where an object is placed around the upper portion of your stomach.  This object, the band, creates a pouch that significantly your stomach size.  With a smaller stomach size, your food portions are reduced considerably.

Some technical aspects of the procedure include, the band is made of silicone and is tightened around your stomach by adding saline to fill your band.  This band is connected to a port that is placed under your abdominal skin.

By having a reduced stomach size, your brain feels full quicker and will eat less food than before your surgery.

What is a Lap Band Fill?

A lap band fill occurs when you require an adjustment to your band.  This means your band may have loosened over time and is not as tight. Most insurance companies cover your adjustment.   This procedure includes injecting saline into your port just under your skin that is connected to your band. Most fills are virtually painless and can enhance your weight loss.

Insurance Coverage Requirements?

There are many common requirements insurance plans have for you to qualify for weight loss surgery and specifically LAP BAND.

The insurance coverage that is required for pre-approval for surgery is typically a Body Mass Index (BMI) of 40 or greater. Patients with BMI 35 or greater with at least one comorbidity may qualify as well. A comorbidity is a serious illness that is directly related to your obesity.  This can include having sleep apnea, high blood pressure, type II diabetes, joint issues, polycystic ovarian syndrome, and depression. In 2011, the FDA approved Lap-Band surgery for patients with a body mass index (BMI) of 30 or higher who have at least one obesity-related condition.

Other requirements needed for pre-approval is proof of your obesity for the last five years and participation in a weight loss program that has failed. You are also required to have a letter from your primary care physician, recommending or supporting you for weight loss surgery.

Another common requirement is passing a psychological exam to show you are mentally strong enough to handle the pressure and dedication needed for disciplined eating and exercising before and after surgery.

Lastly, you have had routine tests of your adrenal, pituitary, or thyroid that are proven healthy and not the cause of your obesity.

When all of these routine benchmark tests have been passed and accepted by your insurance provider, you will be able to schedule your surgery.

The weight-loss surgeries most commonly accepted by insurance companies include gastric bypass surgery, sleeve gastrectomy, duodenal switch and gastric lap band.

Reasons You Might Not Qualify

You may not qualify for bariatric surgery if you are proven to use steroids.  You will also not qualify for malignant cancer, noncompliance with medical treatment, chronic pancreatitis, pregnancy, or inflammatory bowel disease.

All of these conditions will hinder your health from progressing positively.  Because weight loss surgery is a drastic, permanent change to your body and mind, you must be in relatively safe health.

Another primary reason you may not qualify for weight loss surgery is due to a psychological treatment plan that interferes with the diet and lifestyle recommended by your bariatric health care team.

Because mental health plays a pivotal role in weight loss surgery, you will need to readjust your weight loss plan.

Price of Lap Band Surgery?

Because the Lap Band surgery is a surgery that requires a hospital stay due to the placement of a foreign object in your body, the procedure is delicate. It must be done with precision and competence.  Due to all of these factors, the price of surgery ranges from $9,000 and $18,000.  The prices vary due to the weight loss clinic, demand, insurance coverage, and location.

Today many insurance companies cover most and, in some cases, all costs of lap band surgery. If you do not have insurance, some weight loss programs will offer financing options for weight loss surgery. Discuss your options with your surgeon’s office about your financing options.

My Thoughts and Experiences:

I had my gastric sleeve surgery at a bariatric hospital.

The only options available to me were the gastric bypass and gastric sleeve.  I asked about the lap band procedure, and my surgeon did not offer this service, and it was not performed at my hospital.

Based on the research I have performed on the Lap Band, I do find it a risky procedure, patients often have to remove their lap band due to common complications.  Having a foreign object in your body long term creates potential health risks.

Because of all of the hard work bariatric patients do to increase their mortality by having their health move in a more positive direction, I would recommend a different procedure.  I would recommend the gastric bypass or gastric sleeve.  I would never recommend the gastric lap band due to the high failure rate of the long term significant weight loss.  When you have struggled for years with the weight, you deserve a surgery that will improve your life, not drastically alter and reduce your health to worse than before surgery.