We love old-school hand written reviews from our patients! Here are the Q3 2020 patient satisfaction surveys.
Anouncements
COVID-19 and Obesity: CDC Guidelines
The impact of the COVID-19 pandemic has been felt around the world, and is causing people to think hard about their overall health. The reason this is happening is that there is a wide spectrum of severity of COVID-19 infections. Healthy, young, normal-weight patients tend to have minimal to no symptoms, while older patients and/or those with multiple medical issues tend to present with much more aggressive cases that carry a higher risk for death.
The CDC has weighed in on what conditions can increase the severity of COVID infections. In addition to older adults in general, people of any age with the following conditions are at increased risk of severe illness from COVID-19:
- Cancer
- Chronic kidney disease
- COPD (chronic obstructive pulmonary disease)
- Immunocompromised state (weakened immune system) from solid organ transplant
- Obesity (body mass index [BMI] of 30 or higher)
- Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
- Sickle cell disease
- Type 2 diabetes mellitus
With regard to obesity and severity of ilness, nearly 40% of Americans have a BMI of 30 or higher, so this puts A WHOLE LOT OF PEOPLE at increased risk. Although we don’t yet have reliable statistics, there is a good chance that the risk of severity doesn’t just go up at a 30 BMI and stay put, it most likely continues to rise with BMI. So patients with a BMI of 50 likely have a significantly higher risk of death than patients with a BMI of 30.
If you are overweight or obese, now is the time to act, as it is a tragic event to think of a potential COVID-19 fatlity in a young, otherwise healthy but obese patient from COVID-19. We have surgical, incisionless, and medical-only options that can help patients lose weight and hopefully reduce the risk of severe ilness or death in a patient who contracts coronavirus.
If you are interested in learning about weight loss options, try our online weight loss navigator to learn what programs for which you might qualify.
New Columbus Location 8/1/2020!
We are excited to announce that we will be moving our Columbus office into a larger space! We will be in the new office beginning 8/1/2020, so any appointments scheduled at the Parkmead Drive office after 8/1/2020 will actually occur at the new location, which is less than a mile away at 2041 Stringtown Road Grove City, Ohio 43123. It’s located in a medical office complex directly behind the Sherwin Williams store that is visible on the south side of Stringtown Road, in between I-75 and the old location on Parkmead.
Insurance Exclusions and Weight Loss Surgery
Many times patients who do not have coverage for weight loss surgery will ask us to file an appeal. Will this work? The short answer is no. Read on for the long answer…
If your insurance does not cover weight loss surgery, this is called an “exclusion.” This means that the employer who provides the insurance chose to exclude surgical weight loss from coverage in order to purchase a cheaper plan. Once you understand this fact, it’s easier to understand why you can’t file an appeal and get them to cover it, no matter how severe your obesity might be.
If insurance companies were to allow this, then no employer would ever opt for the more expensive plans that do cover bariatric surgery. They would just buy the bare bones coverage and then tell their employees to all file appeals to get it covered anyway.
Unfortunately, when patients call their carriers, someone on the other end of the line (who actually works for the insurance company) will tell you that you can file an appeal. This is technically true, as you can file an appeal for anything your insurance denies. However, in this case the appeal will never work because the issue is not one of medical necessity; in otherwords the insurance company is not saying that you don’t need the operation, they are denying it because you do not have the right type of coverage. It would be somewhat like having a tree fall on your house and asking your car insurance to pay for it. Or, perhaps more appropriately, asking your homeowners to pay for flood damage when it is specifically excluded from your homeowners policy. It simply isn’t going to happen.
Also unfortunate (at least in Ohio, Kentucky and Indiana) is that marketplace policies purchased by individuals under the Affordable Care Act also exclude weight loss surgery. Medicare, Medicaid, and most managed-care Medicaid plans such as CareSource, do cover weight loss surgery, however.
We wish that all Americans had access to life-saving surgical weight loss procedures, and maybe some day that will happen. In the meantime, patients with exclusions essentially have two options:
- consider self paying for surgery
- look into a more affordable option such as one of our appetite suppression programs
Weight Loss Surgery In Lower BMI Patients
Unfortunately in the field of weight loss surgery we use the phrase “NIH criteria” frequently. What does this mean? If refers to a 1991 National Institute of Health consensus statement on which patients should qualify for weight loss surgery. That’s right folks, in many cases we are basing our decisions today on a loose set of mandates from 30+ years ago, when all procedures were open surgeries with 12 inch incisions, were mostly all gastric bypasses, and had a mortality rate of 1-2%.
Nowadays the gastric sleeve is the most commonly performed procedure, and nearly all procedures are done with a laparoscopic, minimally invasive technique. Therefore both the short-term and long-term risk of bariatric surgery is a least an order of magnitude lower than in 1991. Yet most insurance companies still follow these outdated guidelines.
The truth is that lower BMI patients suffering from class I or II obesity have an increased risk of weight-related medical issues and mortality.
Weight loss and metabolic surgery in lower BMI patients who continue to struggle with class 1 or II obesity, in the setting of failed attempts at lifestyle modification & weight loss programs is proven effective at leading to significant weight loss and an overall reduction in comordities and cardiovascular risk.
Also, it has been shown that diet, exercise, and weight loss drugs are largely ineffective for achieving durable weight loss, even in lower BMI patients. In this setting, weight loss surgery is reasonable and is supported by the recent American Society of Metabolic and Bariatric Surgery’s position statement in 2018 (Surgery for Obesity and Related Diseases 14 (2018) 1071-1087).
Obesity is probably the only disease where we make patients wait until they are sicker and a higher operative risk to offer them the most successful treatment option, which is weight loss surgery. We need a change in thinking here as lower BMI patients often times have a higher success rate and are almost always a lower operative risk. Waiting until a patient is heavier and sicker is not the best strategy!
Weight loss 1 month after surgery predicts long-term success!
Recently I attended a lecture by Dr. Dana Portenier, a respected bariatric surgeon from Duke University. He spoke about a study published by their practice showing that a patients success after weight loss surgery can be predicted as early as at the 1 month post-op visit.
In the graphs below, you can see that for a patient with a BMI under 50, if they have lost 6% of their excess body weight at the 1 month visit, they will be in the bottom 5th percentile at 36 months. A patient who has lost 26% of excess body weight, on the other hand, will be in the 95th percentile!
Weight Loss At First Post-operative Visit Predicts Long-Term Outcome Of Roux-en-Y Gastric Bypass Using Duke Weight Loss Surgery Chart
Surgery for Obesity and Related Diseases 8 (2012) 556-550
This is something that I’ve always suspected but have never seen presented in such an elegant fashion. You might ask, what is percent excess body weight loss? In order to know this, you must first know what your excess body weight is. This is simple: your excess body weight is your current weight minus your ideal body weight. You can look up your ideal body weight multiple ways, such as here.
So let’s say you weigh 250 lbs and your ideal body weight is 150 lbs. This makes it easy, as your excess body weight is 100 lbs! If you lose 50 lbs then you have lost half (or 50%) of your excess body weight. Surgeons will often abbreviate as 50% EWL or 50% EBWL.
Here is an excellent article that will help you figure out what your excess body weight loss is, and you can refer to the graph above to see where you fall on the curve.
One of our goals at JourneyLite Physicians is to provide the best outcomes for our patients, and given this data we want patients to adhere to the follow-up schedule of:
- monthly visits for the first year after surgery
- visits every 3 months during the second year
- visits every 6 months starting in the third year and beyond
We feel that more closely-spaced appointments will help patients stay on track better and give them every opportunity to succeed!
Click here to request a follow-up appointment.
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We Take Great Care Of Our Patients-Q4 Patient Satisfaction Surveys
Our patients rate us highly!
Sometimes when you see a bunch of 5 star reviews you think to yourself “are these real or fake?” Chances are, if there are only 5 star reviews and no 1 star reviews they probably are! At JourneyLite, we pride ourselves in our top-notch patient care and regularly receive glowing, old-fashioned hand-written patient satisfaction surveys from our patients. We have de-identified these and posted our Q4 2019 surveys just to show how our patients feel about our experienced and caring team.
Great news from CareSource: coverage for diabetics with BMI 30-35
We received some great news from the Ohio chapter of the American Society of Bariatric Surgery regarding weight loss surgery and CareSource. Up until now, no insurance company has covered bariatric surgery when the patient’s BMI is below 35. Now, however, CareSource has updated its policy to cover gastric sleeve and gastric bypass for patients in the 30-35 zone if they have uncontrolled diabetes. Their definition of “uncontrolled” is a hemoglobin A1C of 8 or greater.
In addition, they have added the following medical conditions as “weight-related medical issues” that can be used to potentially qualify for surgical weight loss:
- Non-alcoholic fatty liver disease
- Nonalcoholic steatohepatitis (NASH)
- Pseudotumor cerebri
- Gastroesophageal reflux disease (GERD)
- Asthma
- Venous stasis disease
- Severe urinary incontinence
- Debilitating arthritis
This is great news as it will significantly open access to care for many CareSource patients. We can only hope that other carriers will follow suit!
JourneyLite Surgery Center: Now An Optum Center of Excellence!
An Optum Center of Excellence
JourneyLite Surgery Center in Cincinnati, Ohio is proud to be one of the first ambulatory surgery centers in the country to be accepted into United Healthcare’s Optum Bariatric Resource Services Center of Excellence! Data shows that Optum Centers of Excellence (COE) have a 19% lower mortality rate than non-COE providers, a 30% lower hospital re-admission rate, and a 20-30% lower cost than non-COE providers. Since its founding in 2007, JourneyLite has been focused on providing the highest-quality, state-of-the-art care for weight loss patients, including surgical AND non-surgical options. With procedure offerings from the powerful SIPS procedure to the non-surgical gastric balloon, JourneyLite has a weight loss option in Cincinnati to fit your needs. In addition, JourneyLite Physicians offers satellite care in Columbus, Dayton, and Northern Kentucky.
Becoming a Center of Excellence can be a complex process. Usually there is a high volume requirement as it has long been known that centers performing many of a few procedures have lower complication rates than those doing few of many different procedures. Secondly, a multi-disciplinary team must be in place to ensure that all the needs of the patient can be met both before and after surgery. Thirdly, there is a verification process in place where a third party reviews the information, and even sometimes travels to the facility for a site review.
JourneyLite of Cincinnati has achieved many Center of Excellence milestones!
- first outpatient surgery center to be reviewed and accredited as an SRC Bariatric Surgery Center of Excellent in 2010
- first outpatient surgery center to be reviewed and accredited as an MBSAQIP Comprehensive Center in 2016
- One of the first outpatient surgery centers to be reviewed and accredited as an MBSAQIP Outpatient Center in 2017
- One of the first outpatient surgery centers to receive Anthem Blue Distinction Plus certification in 2015
- One of the first outpatient surgery centers to receive UHC Optum Center of Excellence accreditation
Whether its JourneyLite Physicians or JourneyLite Surgery Center, we will never cease our quest for continually improving patient outcomes while providing affordable access to care!
Saxenda: A New Injectable Weight Loss Medication
Saxenda: A New Injectable Weight Loss Drug
Other Weight Loss Medications
Saxenda (generic: liraglutide) is derived from the diabetes medication Victoza. Researchers found that patients who were on Victoza frequently lost a small amount of weight. Eventually, studies were done utilizing Victoza at double the regular dose and its effect on weight loss, and results revealed that patients who were taking Saxenda lost more weight than those on a placebo, and the results were statistically significant. This led to FDA approval of a 3mg dose of Victoza for weight loss, but under the name Saxenda.
Saxenda is injected from a pre-filled pen with a dial to adjust the dosage, similar to many diabetes medications. The dosage is increased gradually over several days until 3mg is reached. Generally the medication is well-tolerated, with the most common side effects being nausea and diarrhea. Patients on Saxenda will be required to have monthly office visits to meet with a medical provider and a registered dietitian.
Saxenda works by interacting with GLP-1 receptors in your body. GLP-1 (glucagon-like peptide) is an appetite hormone that is naturally produced in humans that helps to regulate hunger. Saxenda works like GLP-1 by regulating your appetite, which leads to decrease calorie consumption and therefore weight loss.
Saxenda, being a new medication, can cost upwards of $1000/month for patients without insurance coverage, so it is important to explore your options. If you are interested in Saxenda please click here to find out about coverage prior to requesting an appointment.
It is always exciting to see new treatment options for weight loss coming to fruition, and JourneyLite Physicians is proud to be on the forefront of fighting the disease of obesity!
Infosession
Meet Dr. Curry online!
Navigator
Interactive Online Weight Loss Navigator
eStore