Weight-loss surgery rarely covered by health insurance, UAE doctors say

Insurers rarely cover bariatric surgery as they see it as a short-term fix, rather than encouraging patients to make long-term lifestyle choices through diet and exercise.

Dr Maria LoTempio, a US plastic surgeon at Dubai’s American British Surgical and Medical Centre. Reem Mohammed / The National
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DUBAI // Millions of dirhams could be cut from healthcare costs if weight-loss surgery and follow-up cosmetic procedures were covered by health insurance, doctors say.

They say the operations can cut the risk of diabetes, heart attacks and strokes.

But insurers will not cover it because they see it as a short-term cure, and say patients should be urged to commit to weight loss through diet and exercise.

But Dr Abdulla Alhassani, gastroenterologist at Zayed Military Hospital in Abu Dhabi, said bariatric surgery was the best treatment for obesity, of which the country has a high rate.

“Obesity is one of the main problems the world is facing and the UAE is considered one of the countries with high prevalence,” Dr Alhassani said. “Although surgery is considered the most expensive obesity treatment, it is also the most effective.”

Surgery costs up to Dh50,000, with further costs for cosmetic operations to remove excess skin.

Operations on morbidly obese patients is increasing by more than 5,000 cases a year, says the Bariatric and Metabolic Institute Abu Dhabi at the public Sheikh Khalifa Medical City.

Dr Abdelrahman Nimeri, division chief at the SKMC’s institute, agreed surgery was the best option, especially for diabetics.

“If you are morbidly obese with a Body Mass Index over 40 and a diabetic, then the recommended treatment is bariatric surgery,” he told the 2017 Arab Health Congress.

In 2010, US insurer United Healthcare added gastric sleeve, which reduces the volume of the stomach, to its list of covered operations for weight loss. After two years almost every other major insurance company followed.

From 2010 to 2015, gastric sleeves became the fastest-growing bariatric procedure in the US.

“It is very unhealthy to be that overweight,” said Dr Maria LoTempio, a US plastic surgeon at Dubai’s American British Surgical and Medical Centre.

“In the long-term these people will cost healthcare dollars and have related health problems.

“This kind of surgery is very common in America as it is covered by health insurance.

“That is a good thing as it gives patients access to procedures they would not have.”

Between 2009 and 2015, the SKMC’s institute received 940 bariatric surgery cases.

But there are drawbacks to the surgery. Not all obese patients are prepared to have the operations that may be required to return to their desired weight and appearance.

Post-bariatric surgery patients often require excess skin to be removed from their thighs, abdomen, back, breasts and arms, which can take several operations over the course of a year.

And obese patients are more at risk from complication during surgery.

Dr Nimeri also referred to a study of diabetic patients five years after they had received a sleeve gastrectomy, a weight-loss procedure reducing the patient’s stomach volume.

While initial weight loss was maintained in 134 patients, they regained weight between two and six years later, and had a good chance of regaining their diabetes.