Dr. Madan and His Colleagues Caution Patients on Weight Loss Research Such as JAMA Insurance Study

Share Article

A recent JAMA study says that bariatric surgery doesn't help patients save money. Dr. Atul Madan questions the data, and says that the best effects of weight loss surgery, such as LAP-BAND®, are seen after a two-year time frame.

Dr. Madan MD is a world-renowned expert in laparoscopic and bariatric program. (213) 973-2263

A new study posted in the highly regarded Journal of American Medical Association (JAMA) on February 2013, Titled "Bariatric Surgery Not Associated With Reduced Overall Health Care Costs", seems to show no health cost savings after weight loss surgery. Study results seemed to indicate that weight loss surgery, such as Lap-Band Surgery, patients spent the same amount on health issues after surgery as before. However, as reported in Florida Today on Apr 3, 2013 (Titled: Brevard doctors dispute bariatric surgery study; Report targets price tag, patient quality of life), some doctors dispute the numbers, saying that the study did not include adequate long-term factors, and depended on outdated information. Bariatric surgeon Dr. Madan cautions patients to properly research methods of weight loss before scheduling an operation, such as gastric bypass or lap band surgery, to see if it is right for them.

Per the Florida Today article, Dr. Madan does agree with comments made by bariatric surgeon Dr. Nathan Allison. It tends to take anywhere from 18 to 24 months to see the best results from lap band surgery especially, because unlike gastric bypass, gastric banding merely restricts access to food. Gastric bypass can permanently change how the internal organs process food, which can speed up weight loss in the first few years, but there have been studies showing that years down the road of weight loss, changes made via gastric bypass may not continue to be so positive.

Cost savings can be real, especially in the area of diabetic and cardiovascular medication, but it may take some years before the savings add up to the cost of surgery. The real savings, says Dr. Madan in agreement with Dr. Allison, comes through in the quality of life. One classic example is a Pennsylvania resident, whose post-surgery loss of nearly 200 pounds and multiple medications was reported in the York Dispatch on March 25, 2013 (Weight loss surgery leaves Dover Twp. man satisfied with less). The patient, Ron Dale, also said that he noticed a great difference in social interaction after losing weight. He said that rumors of a 'social stigma' attached to weight were “absolutely true”, and that he was listened to and respected much more as a thinner person.

Though the JAMA study seemed to say that the only real value of bariatric surgery seemed to be the “improved health and well-being of persons undergoing the procedure rather than on cost savings”, but there do seem to be issues with the study. Although the researchers claim to have reviewed 30,000 patient expenses over a six-year period (2002 to 2008), Dr. Allison says that only 10% of the patient data included a two-year span of data. In other words, not all of the patients were tracked consistently over that six-year period.

Dr. Mark Fusco of Florida agreed, stating there was a “very high fallout rate” within the patient data. Further, the study only documented claims made by Blue Cross Blue Shield patients, who may not have claimed non-insurance obesity costs, such as weight loss programs and over-the-counter medications. However, study results did show a marked reduction in “pharmacy and physician office costs”, and a significantly lower cost for laparoscopic methods (lap band and bypass) than for traditional gastric bypass surgery. What may have further skewed the numbers was that the old, full-on surgical method of gastric bypass (a much more expensive procedure) was out of favor by 2005, halfway through study data that ended in 2008. Currently, laparoscopic methods are advised much more, as indicated in a cohort study posted in Medscape, due to “lower complication rates, shorter length of stay, lower financial cost, and lower mortality”.

Many studies are made about weight loss medication and procedures, says Dr. Madan, and that's why he cautions patients to really do 'apples-to-apples' research before engaging in a life-changing operation. Although lap band surgery is one of the least invasive, and least time-consuming, it's true that life after surgery must be much different than pre-surgery. A low-calorie, higher protein diet plus regular exercise works just as well pre-surgery as post-surgery, and is required by many physicians. These lifestyle changes ensure that people get the most out of the procedure, instead of becoming discouraged by weight regain and having to spend more money on additional procedures, such as slipped band issues or follow-up inpatient procedures.

Dr. Madan has written 175 articles, and was the first in Memphis to perform a laparoscopic gastric bypass. To date, he has performed over, and was first to offer an incision-less treatment for post-operative weight gain. As the former Chief of Laparoendoscopic and Bariatric Surgery Division at the University of Miami, Dr. Atul Madan may well be considered an expert in his field. Dr. Madan won the 2007 SAGES Young Investigator Award, was honored by the American Medical Association Physican's Recognition Award, among others. Dr. Madan's patient reviews are consistently high, and he received the 2011 and 2012 Patients' Choice Award.

For more information on Dr. Atul Madan or the LAP-BAND procedure, call (213) 973-2263 , or review more on Dr. Madan on http://dr-madan.com/.

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Dr. Madan
Dr. Madan
(213) 973-2263
Email >
Follow us on
Visit website