95% of surgeons see patients delaying bariatric and metabolic surgery while awaiting insurance approval: survey

The survey was started last year and completed in March 2025. At least 109 surgeons across the country were surveyed. “The aim was to assess the experiences of metabolic and bariatric surgeons regarding insurance approvals, identify common challenges faced in the reimbursement process and gather insights on the impact of insurance coverage on patient access to metabolic and bariatric surgery,” Dr Bhasker said.

The Insurance Regulatory and Development Authority (IRDA), it may be recalled, had in 2019 mandated coverage for metabolic and bariatric surgery in cases where medical criteria are met. According to experts, obesity has emerged as a significant public health concern. As per the National Family Health Survey data, the combined prevalence of overweight and obesity among women aged 15-49 rose from 12.6 per cent in 205-2006 to 24 per cent in 2019-2021. Among men in the same age group, the prevalence increased from 9.3 per cent to 22.9 per cent.

“Bariatric and metabolic surgery is one of the effective treatment options for severe obesity, which can lead to total body weight loss of 30 to 40 per cent and reverse many of the associated illnesses. It can help patients regain health and mobility and improve their quality of life.
However, limited insurance support continues to leave many patients untreated or delays their care for months or years,” Dr Bhasker said.

Ignorance about insurance cover for bariatric surgery

As per the survey, most surgeons (76.1 per cent) said patients are unaware that insurance covers bariatric surgery even when medical criteria are met, and actual utilisation remains low. The approval process was largely viewed as difficult, with 69.7 per cent rating it complex and 91.7 per cent stating that it is more cumbersome than approvals for other routine surgeries.

High denial rates were noted, with nearly one-third of the surgeons reporting 50–75 per cent rejections. Common reasons for rejection were obesity exclusions, waiting period issues, or documentation discrepancies. And 81.7 per cent of surgeons reported significant out-of-pocket costs despite insurance coverage.

“This has a major adverse impact on long-term healthcare costs related to chronic disease management. Those recommended for metabolic surgery should proceed without delay, as postponing treatment only worsens obesity-related diseases. Early treatment supports faster recovery, better health outcomes,” said Dr Randeep Wadhawan, President, OSSI.

“Obesity is not a cosmetic issue; it is a chronic, progressive, and often disabling disease that affects every organ of the body,” said Dr Sumeet Shah, Secretary, OSSI.