If you are currently suffering from obesity and weight-related health issues and are seeking help with weight loss, chances are you have considered gastric sleeve surgery. This is a good first step because research has shown that individuals who suffer from obesity have a very slim chance of reaching a healthy weight on their own and without some type of medical intervention.

Did you know that you can’t just decide to have gastric sleeve surgery and call to schedule it? There are a series of gastric sleeve requirements that you must meet that are set by both the surgeon who will be doing the procedure and the insurance company if you are counting on them to pay for some or all of your surgery.

Today we are going to talk about these gastric sleeve requirements and we will also highlight the much less invasive alternative of Suture Sculpt ESG and the qualifications needed for this procedure.

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What Are The Basic Gastric Sleeve Requirements?

Qualifying for gastric sleeve surgery may be more involved than you realize, especially if you are working within the confines of the requirements outlined by your medical insurance company. First, a patient must meet the standards set forth by their bariatric surgeon, followed by the specific ones outlined by their insurance carrier.

Standard Prerequisites For Gastric Sleeve Procedure

1. A body mass index (BMI) of 40 or higher, or being at least 100 pounds overweight;
2. A BMI of 35 or higher, along with at least one comorbidity such as hypertension or type 2 diabetes;
3. Proven efforts to lose weight through other methods without success.

Typical Medical Insurance Gastric Sleeve Requirements

Typically, an insurance company's list of gastric sleeve requirements might include:

1. The patient must be an adult who is at least 18 years old;
2. The individual must fulfill all the standard criteria for gastric sleeve surgery;
3. They must provide documented evidence of attempting to lose weight through a structured program lasting at least 6 months or two separate programs lasting 3 months each. This effort must have occurred within the last year or two. (An example of a structured weight loss plan is Weight Watchers.) The insurance company may have its own mandated weight loss program that must be followed before approval for surgery is granted;
4. They may require the patient to quit smoking;
5. They may require drug testing to ensure the patient is free from substance abuse issues;
6. The patient must be willing to undergo a psychological evaluation to ensure they understand and are prepared to make the necessary lifestyle changes, including a lifelong commitment to a healthy, low-calorie diet and regular exercise, to achieve and maintain weight loss long-term.

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Qualifying For Gastric Sleeve Surgery Goes Beyond The Basics

Meeting the basic gastric sleeve requirements doesn't guarantee approval from an insurance company or surgeon. Conditions such as eating disorders, a history of blood clots, heart issues, or other health problems can disqualify an individual. Even if initially approved, the surgery might be postponed or canceled if the patient fails to follow the pre-surgery guidelines and diet. This could be a sign to the surgeon that they are not ready to make and stick to the critical lifestyle changes necessary.

A Major Pitfall Of The Gastric Sleeve Requirements For Surgery

One of the most significant challenges in undergoing weight loss surgery is that a patient's weight problem often needs to be extremely serious before they can qualify to get assistance. This prevents many who want help before their situation declines further from getting the help they need because they do not meet the gastric sleeve requirements.

In other words, their weight and health would have to get worse before they would qualify for the surgery that would help them get better. Kind of crazy, right? The good news is that there is an alternative to surgery that most overweight and obese patients qualify for called Suture Sculpt endoscopic sleeve gastroplasty.

What Is Suture Sculpt ESG And What Are The Qualifications?

This non-surgical procedure makes your stomach smaller by placing strategically spaced sutures inside your stomach to change its shape and size. It is done using a special medical instrument called an endoscope that is lowered down your throat and into your stomach without requiring any incisions. A special suturing device and other thin tools are sent down through the endoscope, and the doctor performs the entire procedure from inside the patient's stomach. This reduces the usable capacity of their stomach by about 75% and prevents them from eating more than a tiny amount of food at each meal.

Patients who are not in stellar health and would not qualify for surgery may be good candidates for Suture Sculpt ESG because the procedure is quick and offers a fast recovery. The qualifications for Suture Sculpt ESG are much less restrictive than the gastric sleeve requirements and include:

• The patient has a BMI (body mass index) of 30 or above;
• They have been unsuccessful in previous weight loss attempts;
• They are committed to making the necessary lifestyle changes to maintain a healthy weight.

For patients who do not meet the gastric sleeve requirements or do not wish to undergo invasive surgery, there are non-surgical options for medical intervention, like gastric balloons or the Suture Sculpt (ESG) procedure. Both options are non-surgical, do not require a hospital stay, and offer a much faster recovery than that of surgery.

Suture Sculpt ESG offers the potential for substantial weight loss, and we have witnessed amazing results from many of our patients. At Batash Endoscopic Weight Loss Center, our team is committed to assisting you in achieving your weight loss goals to help you improve your health. Make your appointment today to hear more about surgery-free weight loss options like Suture Sculpt ESG and how they could benefit you.

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