The Duke Metabolic and Weight Loss Surgery Program offers a comprehensive approach to weight loss for eligible individuals who have struggled to maintain weight loss through traditional methods such as diet, exercise, and medication. As a Bariatric Center of Excellence, Duke provides safe, effective, high-quality bariatric care. Weight loss surgery is just the beginning of your journey.
Is Weight Loss Surgery Right for You?
If you have been unable to maintain weight loss through lifestyle changes with or without medication, you may be considering weight loss surgery, also known as bariatric surgery or metabolic surgery. You are not alone in this journey.
Comprehensive Support System
The Duke Metabolic and Weight Loss Surgery Center provides a multidisciplinary team to support patients throughout their weight loss journey:
- Bariatric Surgeons: Evaluate your overall health and help recommend a weight loss procedure that's right for you.
- Nutritionist and Behavioral Health Providers: Meet with you individually and in group settings to address your concerns and recommend ways to overcome challenges.
- Nurses and Financial Counselors: Navigate you through your insurance benefits and requirements, evaluation, and testing.
Eligibility and Coverage
Bariatric surgery is available for benefits-eligible Duke employees with at least two continuous years of service, or their covered spouse, on Duke Select, Blue Care or Duke Options plans. Bariatric surgery is not covered if you have the Duke Basic plan. The benefit will be available after the employee has two years of continuous service (as verified by the most recent continuous service date on file) with Duke University or Duke University Health System.
For members who reside in the state of North Carolina, the surgery will only be available at Duke Regional Hospital. If you permanently reside in the state of North Carolina, the surgery is covered only if performed at Duke Regional Hospital by a Duke Metabolic and Weight Loss Surgery Center surgeon and you meet the requirements of the Duke Metabolic and Weight Loss Surgery Center.
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Eligible individuals may receive one procedure per lifetime. The benefit provides for one bariatric surgery procedure per lifetime. It does provide for lap band adjustments, even if the surgery was performed elsewhere. A revision of a previous bariatric surgical procedure will be covered if you meet the required medical criteria for the revision.
Costs
You are responsible for the $2,500 copay, which must be paid-in-full at the time of the surgical procedure. This copayment applies to the surgery only. Payment will be requested once you meet the precertification requirements and your surgery has been approved by your health plan.
Prior to and after surgery, your responsibility for copays, coinsurance, etc. varies. In general, any services you have as a component of your evaluation and post-operative visits will not count toward your limits listed in your Schedule of Benefits. However, nutritional visits received at the Duke Metabolic and Weight Loss Surgery Center will count toward your benefit limits.
The Bariatric Surgery Process
The process is composed of two components. The first is the "Evaluation" component which is designed to provide education for you and information for the Duke Metabolic and Weight Loss Surgery Center surgeon and will result in a decision by you and your surgeon about the appropriateness of a surgical weight loss procedure for you. Subsequently, when it is determined that you are an appropriate candidate for a bariatric surgical procedure and you decide to proceed with obtaining the service, there is a "package" of services included in the definition of "bariatric surgery" which include the surgery itself, and the additional attention of the surgeons during the defined post-operative period.
Precertification
Once the health vendor has received the precertification request from the Duke Metabolic and Weight Loss Surgery Center, they will render a decision within 3 business days, provided they have all the necessary information.
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If your request for Bariatric surgery is denied, the health vendor will notify you in writing and provide the reason for the denial.
LIVE FOR LIFE’s Pathways to Change Program
Because LIVE FOR LIFE’s pre-bariatric health coaching program is tailored to those planning an upcoming procedure, you must identify that you wish to enroll in the Pathways to Change health coaching program. Completion of LIVE FOR LIFE’s lifestyle management health coaching program will not meet the surgery requirements.
If you are a benefits eligible employee or dependent with a Duke insurance plan, you may choose to enroll in Pathways to Change, our pre-bariatric procedure health coaching program. We will work with you for at least 3 months prior to your procedure and will continue to support you with lifestyle changes throughout the following year. Program start is typically initiated after your first visit to the Duke Center for Metabolic and Weight Loss Surgery but is available for enrollment at any time. The program requirements must be completed no more than 6 months prior to the date of surgery. For enrollment instructions, please contact Sally Neve, RD, at 681-0525.
Duke Center for Metabolic and Weight Loss Surgery, Durham Clinic
Insurance coverage for Duke Center for Metabolic and Weight Loss Surgery, Durham Clinic varies based on your plan. Before scheduling your appointment, we strongly recommend you contact your insurance company to verify that this Duke Health location or provider you plan to visit is included in your network. Your insurance company will also be able to inform you of any co-payments, co-insurances, or deductibles that will be your responsibility.
Plan your trip to Duke Center for Metabolic and Weight Loss Surgery, Durham Clinic through GoDurham bus routes 4 and 9A/9B. The closest bus stop is Crutchfield St at Pendergrass St.
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Hospital-Based Clinics
Hospital-based clinics are outpatient departments of an individual Duke hospital and have additional facility charges. Some insurance companies process bills with a deductible and coinsurance rather than as a co-pay as for an office visit. This may impact the amount of the bill you are responsible for after payment from your insurance plan.
Comprehensive and Accredited Program
Jacob A. Duke Center for Metabolic and Weight Loss Surgery is the Triangle's longest-established weight loss surgery center. We are proud to see patients at Duke Regional Hospital and Duke Raleigh Hospital, as well as Alamance Regional Medical Center. Additionally, Duke Regional Hospital is an MBSAQIP Accredited Center.
The weight loss program at Duke Regional Hospital is accredited as a Comprehensive Center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP. In addition, our weight loss surgery program is recognized by private insurance companies, including Blue Cross Blue Shield, Cigna, and Optum.
Duke Regional Hospital is accredited to perform weight loss surgery in adolescents by the MBSAQIP of the American College of Surgeons and the American Society of Metabolic and Bariatric Surgery.
Surgical Expertise and Innovation
The Duke Metabolic and Weight Loss Surgery Program is committed to employing new surgical approaches designed to improve outcomes. For example, we use different robotic techniques, magnets, and tiny surgical instruments to decrease incision sizes to the point where only one incision may be needed and leave an almost invisible scar. One of the main goals of the Division of MIS is to create programs that will provide the best surgical care for all patients through efficiency.
The Division of Minimally Invasive Surgery is actively involved in research and clinical trials designed to improve patient care and outcomes.
Minimally Invasive and Bariatric Surgery Fellowship Program
We’re equally focused on developing the next generation of minimally invasive surgeons. Our Minimally Invasive and Bariatric Surgery Fellowship program is designed to expand the skills and knowledge of participants, both clinically and scientifically. The Duke Minimally Invasive and Bariatric Surgery Fellowship Program is accredited through the Fellowship Council for training in advanced gastrointestinal minimally invasive surgery and bariatric surgery. The one-year program is designed to expand the skills and knowledge of participants, both clinically and scientifically.
Addressing Complications from Previous Surgeries
Our surgeons work with people who experience complications from old weight loss procedures, such as stomach stapling (vertical banded gastroplasty, or VBG), jejunoileal bypass, and other historical procedures that are no longer performed. If you are experiencing complications, we can diagnose your concerns and offer solutions. Our experience handling all complications associated with weight loss surgeries is well-known.
Weight Loss Surgery Revision Options
If you have weight recurrence following weight loss surgery, we evaluate your anatomy, behavior, and medical conditions to determine a treatment strategy.
Endoscopic Procedures
We Use the Latest Advances in Endoscopic ProceduresWhile these procedures are not covered by insurance and have not been available for as long as the standard weight-loss surgeries, they show promise. Our bariatric surgeons and our gastroenterologist are trained to perform endoscopic weight loss procedures, such as the gastric balloon.
Conditions Treated
Several members of the Division of Minimally Invasive Surgery have clinical interests and expertise in disorders of the esophagus and stomach such as gastroesophageal reflux disease, hiatal hernias, achalasia (a rare swallowing disorder) and gastroparesis.
Hernias of the abdominal wall are incredibly common problems that may affect patients over the course of their lives. Whether patients have a groin hernia (inguinal hernia) or a hernia of their abdominal wall (ventral/incisional hernias), our surgeons are well-equipped to care for you and help guide you through the best approach to repair your hernia.
Complications due to surgery covered under another policy or self-pay will only be covered if due to a medical emergency and then only covered until you are stabilized. For general health plan inquiries, you may call the health plan customer service number located on your health plan member ID card.
The Impact of Bariatric Surgery
According to data from the American Society for Metabolic & Bariatric Surgery, 96% of patients who have bariatric surgery experience remission in obstructive sleep apnea, 92% see remission in type-2 diabetes, 75% experience remission of hypertension and 58% see remission of cardiovascular disease.
Patient Success Story
Candace Neely, 40, a Pediatric Ambulatory Nurse at Duke Children’s Specialty Services of Greensboro, underwent bariatric surgery at Duke Regional Hospital in 2020, which was covered after a $2,500 copay by her Duke employee health insurance.
“I knew I had to get healthier so that my kids wouldn’t be orphans,” said Neely, a Pediatric Ambulatory Nurse at Duke Children’s Specialty Services of Greensboro.
In the more than four years since the surgery, Neely has experienced plenty of change. Her new diet, which is built around eating small, 2-ounce snacks of protein-rich nuts or yogurt throughout the day, has become second nature. She now weighs around 158 pounds and has gone from clothes that were as large as size 4XL to wearing smalls and mediums.
“It’s a complete lifestyle change,” Neely said. “The surgery is part of it. It’s a tool. But it’s really a complete lifestyle change. You have to put forth the effort, it’s not an easy fix.
“It has made my whole quality of life better,” Neely said. “I have my confidence back. I have a husband. And I can be more present for my kids.
Meet Dr. Dana A. Seymour
Dr. Dana A. Seymour is an Associate Professor in the Department of Surgery, Division of Metabolic and Weight Loss Surgery.
Dr. Seymour received her undergraduate degree from Boston College in 1999 and her medical degree from Midwestern University in 2007. She was a resident and Chief Resident in General Surgery at State University of New York Upstate from 2007-2014 and completed a fellowship in Bariatrics and Minimally Invasive Surgery at Duke in 2015. Upon completion of the Fellowship program, she joined the Department of Surgery, Division of Metabolic and Weight Loss Surgery. She is an Associate Professor and is a Fellow of the American College of Surgeons. While serving as a fulltime surgeon in the Department of Metabolic and Weight Loss Surgery, she also completed the Masters of Health Sciences program at Duke University in 2019.
Dr. Seymour collaborates with faculty members at Duke University in the investigation of non-alcoholic fatty liver disease, adolescent obesity, and the metabolomic and nutritional impact of obesity surgery. In her research she uses uniquely large administrative datasets to examine the relationship of obesity surgery and healthcare outcomes.
Dr. Seymour holds leadership positions and committee memberships in national and statewide societies including Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), the American Society for Metabolic and Bariatric Surgery (ASMBS), and the American College of Surgeons (ACS). She is the State Access to Care Representative for the ASMBS Chapter of the Carolinas and President of the North Carolina Chapter of the American College of Surgeons. Her service in these organizations is focused on access to care, clinical outcomes, and quality improvement.
Dr Seymour’s clinical practice is devoted to benign diseases of the esophagus, minimally invasive morbid obesity, and abdominal wall reconstruction. She is a core teaching faculty in the Department of Surgery on these topics. Additionally, Dr. Seymour serves as the co-site director for the Department of Surgery Residency Program and surgeon champion for the National Surgery Quality Improvement Program at Duke Regional Hospital.
Monthly Support Groups
Meet people coping with similar experiences. We encourage you, your family, and your friends to attend these free, virtual support groups before and after your weight loss surgery. Watch this video to learn about our program.