Bariatric surgery, also known as metabolic surgery, is designed to assist individuals in losing weight and improving health issues related to obesity. This article delves into the bariatric surgery options available through Kaiser Permanente, addressing both the procedures and their associated costs. It's essential to remember that bariatric surgery is a tool, not an instant solution, and requires lifelong changes in diet and lifestyle for sustained success.
Understanding Bariatric Surgery
Bariatric surgery is a treatment option for individuals struggling with obesity. It involves making changes to the digestive system to limit food intake and, in some cases, alter nutrient absorption. Kaiser Permanente offers a multidisciplinary approach to obesity treatment, recognizing it as a chronic disease with various metabolic and physiological disorders, including diabetes, cardiovascular disease, dyslipidemia, and obstructive sleep apnea.
How Bariatric Surgery Works
Bariatric surgery primarily works through three main mechanisms:
- Restriction: Reducing the size of the stomach to limit the amount of food you can eat. Most bariatric surgeries utilize this method.
- Malabsorption: Altering the digestive tract to affect how the body absorbs food. These surgeries are more complex, involving the rearrangement and reconnection of the intestines.
- Hormone Changes: Some bariatric surgeries use these tools to help with weight loss.
Types of Bariatric Surgery Offered by Kaiser Permanente
Kaiser Permanente provides several types of bariatric surgery, each with its own set of benefits and risks. The two most common procedures are gastric bypass and sleeve gastrectomy.
Gastric Bypass
Gastric bypass, or Roux-en-Y gastric bypass (RYGB), involves creating a smaller stomach pouch from a small part of the existing stomach. This pouch is then connected directly to the middle part of the small intestine, bypassing the rest of the stomach and a portion of the small intestine.
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How it works: This procedure reduces the amount of food you can eat and also limits the absorption of calories and nutrients.
Post-Surgery Expectations:
- Hospital stay of one or more days.
- Initial diet of liquids and soft foods, gradually progressing to solid foods.
- Working with a dietitian is recommended to ensure adequate water intake and a balanced diet.
- Rapid weight loss in the initial months, followed by a gradual slowdown.
Benefits:
- Significant weight loss.
- Improved or reversed health problems like type 2 diabetes and high cholesterol.
- Reduced healthcare costs for adults with Type 2 diabetes and obesity.
Risks:
- Narrowing of the connection between the stomach and small intestine.
- Leaking from the stomach into the abdominal area.
- Gastroesophageal reflux disease (GERD).
- Vitamin and mineral deficiencies.
- Weight regain in some individuals.
Sleeve Gastrectomy
Sleeve gastrectomy, also known as gastric sleeve surgery, involves removing a large portion of the stomach, leaving a smaller, sleeve-shaped stomach.
How it works: This limits the amount of food the stomach can hold, leading to reduced calorie intake.
Post-Surgery Expectations:
- Surgery is typically performed through small incisions in the abdomen (laparoscopically).
- Belly pain is common in the first week, requiring pain medication.
- Initial diet of liquids and soft foods, gradually progressing to solid foods.
- Potential for dumping syndrome, causing diarrhea, faintness, shakiness, and nausea.
Benefits:
- Significant weight loss, similar to gastric bypass.
- Improvements in other health conditions, such as diabetes.
Risks:
- Vitamin and mineral deficiencies.
- Leakage from the stomach into the abdominal cavity.
- Dumping syndrome.
- Stretching of the stomach if overeating occurs.
Choosing the Right Procedure
Research indicates that both gastric sleeve and gastric bypass surgeries yield similar weight loss results and improvements in health conditions like diabetes. The choice between the two depends on individual factors and should be made in consultation with a qualified surgeon.
Kaiser Permanente's Bariatric Surgery Program
Kaiser Permanente's Bariatric Surgery Program adopts a multidisciplinary approach to obesity treatment. The program includes a team of surgeons, bariatricians, case managers, dietitians, and mental health practitioners who provide consultative services before and after surgery. They offer nutritional and exercise guidance, as well as access to support groups.
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Specialized multidisciplinary bariatric care is available at designated centers of expertise located in Fremont, Fresno, Richmond, South Sacramento, and South San Francisco. The experienced surgeons and bariatricians at these centers perform a high volume of bariatric surgeries and procedures, which results in superior outcomes for patients.
Pre-Surgery Preparation
Before undergoing bariatric surgery at Kaiser Permanente, you'll need to:
- Undergo a thorough medical assessment to determine eligibility for the program.
- Participate in nutritional and exercise instruction.
- Potentially attend support groups.
- Change eating and exercising habits before surgery.
Post-Surgery Care
After bariatric surgery, ongoing care and support are crucial for long-term success. Kaiser Permanente provides:
- Continued monitoring of health and progress through periodic checkups and lab tests.
- Guidance on diet and exercise.
- Support groups.
- Adjustments to medications as needed.
- Continued support from physicians and health educators.
Kaiser Permanente Medical Weight Loss Program
Kaiser Permanente Mid-Atlantic States offers a Medical Weight Loss Program designed to help individuals achieve their weight loss goals with a customized meal replacement program. This program emphasizes long-term success through a team of experts who provide support every step of the way.
Program Components
- Expert Team: Physicians and health educators guide participants through the program, aiming for lasting success.
- Health Monitoring: Regular checkups and lab tests to monitor health and progress, with the goal of reducing reliance on medications.
- Customized Meal Replacement: A plan tailored to individual needs, with adjustments made by the physician.
Program Phases and Costs
The program typically involves several phases, each with its own costs:
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- Medical Assessment: A one-time, non-refundable fee covering medical assessment and lab work to determine program eligibility.
- Active Phase: Focuses on rapid weight loss with a high reliance on meal replacements.
- Maintenance Phase: Gradually transitions back to regular meals, with partial meal replacements for the first four weeks.
Cost Considerations:
- The total price for each phase includes medical monitoring, group classes, and meal replacement fees.
- Meal replacement costs vary based on individual consumption, with an average weekly price calculated on the consumption of 7 meal replacements per day during the active phase and 3 per day during the maintenance phase.
- Shipping charges for meal replacements are extra.
Cost-Effectiveness of Bariatric Surgery
A Kaiser Permanente study found that bariatric surgery reduced health care costs for adults with Type 2 diabetes and obesity. Both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) helped reduce health care costs for people with Type 2 diabetes 5.5 years after surgery. The reduction in total health care expenses was mainly due to a decrease in medication costs. Both types of surgery also led to a decline in outpatient expenses. Inpatient expenses varied widely before and after surgery for both groups but generally increased after surgery.
Factors Influencing Cost
The cost of bariatric surgery can vary depending on several factors:
- Type of surgery: Different procedures have different costs.
- Location: Costs may vary based on the Kaiser Permanente facility.
- Insurance coverage: The extent of coverage will affect out-of-pocket expenses.
Considerations Before Choosing Bariatric Surgery
Before opting for bariatric surgery, it's crucial to consider the following:
- Lifestyle changes: Bariatric surgery requires a lifelong commitment to healthy eating and regular exercise.
- Potential risks and complications: All surgeries carry risks, and it's essential to be aware of them.
- Emotional impact: Significant lifestyle changes can lead to emotional challenges, and support is essential.
- Alternative options: Explore non-surgical weight loss options before considering surgery.
Kaiser Permanente's Commitment to Quality
Kaiser Permanente is committed to providing high-quality care to its members. The organization has received several accolades, including:
- Rated #1 overall among 70+ competitors in the Best Health Insurance Companies of 2024 by Insure.com for the fourth year in a row.
- Commercial plan rated 5 out of 5 in the NCQA Commercial Health Plan Ratings 2024, the highest rating in the region.
- Three-Year Accreditation with Commendation granted to the Kaiser Permanente cancer care program by the 2022 Commission on Cancer.