Doctors recommending weight loss surgery for children, but insurance won’t pay for it

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INDIANAPOLIS (WISH) — A new recommendation says weight loss surgery for children overweight may be the best solution. But most insurance companies are not willing to cover the procedure yet.

Some adults have had the gastric bypass procedure. The surgery for children is similar and some doctors suggest it for children as young as 12-years-old. Most doctors recommend it if a patient has fatty liver disease.

The new guideline from the American Academy of Pediatrics suggests that a person have a BMI above 35. The patient has to have several health consequences of obesity, like Type 2 diabetes, sleep apnea or fatty liver disease.

Although doctors may suggest the surgery, IU Health Dr. William Bennett said there is no comprehensive weight loss surgery for children in the entire state of Indiana. He said the problem isn’t doctors willing to perform the surgery, but that nobody will pay for it.

Dr. Bennett said insurance will pay for the surgery about 80 to 90% of the time if the person is over the age of 18. Insurance only pays for less than a third of the surgeries for children younger than 18.

“Unfortunately, a lot of people think about obesity as being just like a will power thing,” Dr. Bennett said. “Like just stop eating or go run around the block a few times, it’s just not that simple. We’re talking about something that has really deep roots in how the brain works and behavior and then how our metabolism works. So, once somebody becomes obese it’s very difficult to reverse that.”

IU Health is taking matters into their own hands by working to create a center that can accomplish these surgeries. Doctors hope the new AAP guidelines will push state and federal governments to get the surgery paid for in children.

The surgery alone is tens of thousands of dollars, which most people can’t afford.

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