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ASMBS Agrees: Low BMI Patients Find Improvement with Early Bariatric Surgery

January 01, 2024

The surgical team at Orlando Health Weight Loss and Bariatric Surgery Institute has developed a multi-modality protocol to help patients with a lower body mass index (BMI) of 30-34.9 and weight-related comorbidities. This comprehensive program includes non-surgical weight loss plans, endoscopic approaches and advanced bariatric and metabolic surgical intervention.

Andre Teixeira, MD
Andre Teixeira, MD

The National Institutes of Health cites a BMI of 40+ or a BMI of 35-40 with at least one comorbidity as the standard qualification for bariatric surgery. However, studies show earlier intervention at a lower BMI directly correlates to better patient results.

“Surgery provides a viable option for obese patients with lower BMI who fail to achieve significant, lasting weight loss with nonsurgical methods,” says Dr. Andre Teixeira, a nationally recognized, board-certified surgeon at Orlando Health Weight Loss and Bariatric Surgery Institute. “We are one of a few centers in Florida offering endoscopic and surgical intervention for low BMI patients.”

NIH guidelines, established by a consensus panel in 1991 and used by insurers as a baseline, have never been updated to account for surgical advancements and technological improvements. As such, low BMI patients, even with obesity-related comorbidities, are usually denied insurance coverage.

That may be changing. In October, the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders updated their guidelines. According to those, anyone with a BMI over 35 need not have a qualifying comorbidity to be eligible for weight loss surgery. Those with a BMI over 30 also would be eligible if they have been unable to achieve substantial or long-term weight loss. 

“It is frustrating to think insurance wants our patients to gain more weight and put their lives at greater risk to qualify for coverage,” says Dr. Teixeira. “We believe we have created a surgical protocol that best benefits patients.”

Orlando Health offers bariatric surgery to low BMI patients suffering type 2 diabetes. “Bariatric surgery significantly improves these patients’ outcomes,” says Dr. Teixeira, who notes many pay cash or seek medical loans for the surgery. “Surgery often puts them into remission, eliminating the need for medication to control blood sugar. We reviewed our low BMI surgical patients and learned 73 percent were off all of their medications five years post-surgery.”

Board-certified surgeons at Orlando Health Weight Loss and Bariatric Surgery Institute are the most experienced in Florida, having performed thousands of successful laparoscopic bariatric surgeries since 2000.

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