Why should bariatric surgery be covered by insurance? Explains Dr. Harsh Sheth

Obesity is a health issue faced by all sections of society globally. India is in the third position globally, behind the United States and China, regarding the number of obese people. Also, the Asian population is prone to developing visceral obesity and diabetes, that too, at a younger age, comparatively. With advancements in medical research, especially bariatric surgery, obese people can renew their hopes of reducing their weight and enjoying a healthier and better lifestyle.

The first bariatric surgery was performed in India in 1999 and was considered an expensive medical treatment that only a few could afford. But in 2019, the IRDAI (Insurance Regulatory and Development Authority of India) included bariatric surgery in the medical conditions eligible for insurance coverage. This is a good move, especially for obese people who have had to bear the expense of the surgery, provided the policyholders prove that surgery is medically necessary and not performed for aesthetic purposes.

Bariatric surgery helps obese people to lose weight and improve their health. It is typically recommended for individuals with a body mass index (BMI) of 40 or higher or those with a BMI of 35 or higher who are experiencing obesity-related health problems. These individuals have made multiple attempts to lose weight but could not succeed.

The IRDAI’s (Insurance Regulatory and Development Authority of India) guidelines state that the candidate should be above 18 years of age, has a BMI of more than 40, have a BMI equal to 35 with severe co-morbidities, and a doctor has recommended bariatric surgery after thorough medical examination. 

There is a waiting period of 2 to 4 years which means to claim the bariatric surgery expenses, the policyholder needs to wait for the completion of the waiting period after the commencement of the policy.

Justifying the inclusion in medical insurance, Dr. Harsh Sheth explains when it is necessary to perform bariatric surgery, he states that this surgery can help to resolve several obesity-related conditions, such as type 2 diabetes, high blood pressure, arthritis, non-alcoholic fatty liver disease, infertility, and sleep apnea. In addition, it reduces the risk of certain obesity-related complications, such as heart disease, stroke, and certain types of cancer that affect these patients, improving their quality of life.

He states that it is wrong to consider bariatric surgery as cosmetic surgery. Cosmetic surgery improves the appearance of a person’s body or face; some popular cosmetic surgeries include breast augmentation, liposuction, and facelifts. On the other hand, the main aim of bariatric surgery is to reduce the complications or risks arising due to the excess body weight of the patient.

Bariatric surgery helps ease the patient from experiencing health disorders and complications from obesity, such as high blood pressure, cardiac issues, stroke, type 2  diabetes, and so on. Hence, rather hand considering it as a life-saving procedure, but a life-changing procedure. After bariatric surgery, the patient has to undergo a tremendous change in their lifestyle and follow it in a disciplined manner to attain the desired weight and BMI.

He concedes the inclusion of bariatric surgery in health insurance policies will resolve the health issues of lakhs of people who are suffering from obesity and its co-morbidities to turn a new leaf and become healthy and active.

About Dr. Harsh Sheth

Dr. Harsh Sheth is a laparoscopy and bariatric surgery specialist with more than a decade of expertise. His proficiency includes minimally invasive surgical techniques, endoscopic surgeries, obesity surgery, laparoscopic adjustable gastric band, single port procedures, mini-port operations, and laparoscopic surgery.

He is available for consultation across Mumbai at Saifee Hospital, Bhatia Hospital, ACI Cumballa Hill Hospital, Apollo Spectra Hospital (Tardeo), Wockhardt Hospital, Mumbai Central, and Conwest & Manjula S Badani Jain Charitable Hospital.

Patients can reach him at Saifee hospital and Bhatia Hospital, Mumbai. For an appointment, call +91-9819388836.

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