In recent years, bariatric surgery has become more appreciated. Many studies show that bariatric surgery is not only the most effective way to lose weight, but also helps to alleviate/eliminate other comorbidities like diabetes. And with improved technologies for conducting the surgery safely as well as expanding insurance coverage, bariatric surgery is positioned for growth. Recently, the COVID-19 pandemic has had a significant impact on bariatric care and the bariatric specialty as a whole.
In the United States, 42.4% of adults are obese. The associated comorbidities have always been a cause for concern, but the spread of COVID-19 has underscored the importance of bariatric surgery as a protective treatment for obese patients.
This leads us to the two major ways that COVID-19 has transformed bariatric care.
Key Takeaways
- Obesity is a comorbidity for COVID-19.
- Recent studies have found that bariatric surgery is significantly associated with a reduced risk of severe illness for obese patients with COVID-19.
- These findings indicate that bariatric care should be reframed as a medical necessity rather than elective surgery.
- Coupled with the widespread rollout of healthcare technology, these findings will have a significant impact on the future of bariatric care.
The Prevalence of Obesity in the US
Today, almost 20% of the US adult population is considered severely obese (BMI >35) and that population will grow another 25% by the end of this decade. This reality is having a profound effect on the healthcare system, with costs related to obesity-related health issues costing billions of dollars annually.
Obesity is a complex disease associated with a wide range of comorbidities. The presence of multiple and simultaneous health conditions is often referred to as the comorbidity burden, and it is estimated that more than half of all obese individuals will develop at least one comorbid condition during their lifetime. The most common comorbidities associated with obesity are hypertension, type 2 diabetes, hyperlipidemia, and sleep apnea. Another comorbidity of recent concern is COVID-19.
COVID-19 and Obesity as Comorbidities
Since the outbreak of the pandemic, COVID-19 has been highlighted as a comorbidity of obesity.
Obesity increases a patient’s risk of severe illness from COVID-19, including tripling their risk of hospitalization and raising the likelihood that the patient will need intensive care and a ventilator. According to Matthew Hutter, MD, MPH, president of the American Society of Metabolic and Bariatric Surgery and director of the Massachusetts General Hospital Weight Center, “Many people don’t think of obesity as a disease; in fact, it’s a pandemic. And when you introduce a new pandemic—COVID-19—on top of that, the result is very dangerous.”
Bariatric Surgery May Reduce the Severity of COVID-19
Given the strong correlation between obesity and hospitalization during the pandemic, bariatric surgery may be an effective treatment to reduce the severity of COVID-19 in patients with obesity.
A study from the Cleveland Clinic looked at patients with obesity who tested positive for COVID-19 and found a significant association between patients with prior weight-loss surgery and lower rates of hospitalization and admission to the intensive care unit (ICU). This and subsequent studies indicate that obesity “can be a modifiable risk factor for the severity of COVID-19 infection.”
These findings come in the wake of millions of canceled or postponed bariatric procedures. During the COVID-19 pandemic, many countries assessed bariatric surgery as elective surgery that can be postponed with “minimal adverse consequences”. In contrast, the studies indicate the importance of bariatric care in protecting obese patients from the life-threatening complications of COVID-19. This reframing is one of the ways in which COVID-19 has changed bariatric care forever.
2 Ways COVID-19 Has Changed Bariatric Care Forever
The COVID-19 pandemic has triggered two major changes in the bariatric industry.
1. Reframing Bariatric Surgery as a Medical Necessity
Bariatric surgery is widely considered elective surgery. But the findings that weight-loss surgery reduces patients’ risk of severe illness caused by COVID-19 should, according to Paulina Salminen, MD, PhD, of the University of Turku, Finland, reframe our understanding.
Salminen insists that this recent perception fails to consider “Obesity as a life-threatening and life-limiting disease and does not acknowledge the intertwined double pandemic of COVID-19 and obesity.”
Backed by the American Society for Metabolic and Bariatric Surgery, Salminen and colleagues are calling for bariatric surgery to be considered a medical necessity rather than an elective surgery, and therefore widely resuming the procedures where they had been postponed due to the pandemic.
This acknowledgment of the health benefits of bariatric care in the face of a pandemic will reframe the procedures as necessary rather than elective and underscore their importance going forward.
2. Widespread Rollout of Telehealth Technology
The COVID-19 pandemic has accelerated the adoption of technology throughout every sector, particularly in healthcare.
Telehealth has been implemented quickly and has become a viable and convenient option for many patients. In addition to reducing the transmission of the virus, telehealth visits allow patients to avoid the risks and inconveniences of attending a traditional office visit.
The impact this has on bariatric care is significant. Telehealth allows surgeons to continue to provide bariatric care, now better recognized as a medical necessity, to their patients during COVID-19 whilst minimizing their exposure. Consultations, preparation, and patient education can be completed primarily online, which:
- Minimizes patient contact and potential exposure to COVID-19 by keeping in-person visits to a minimum.
- Provides greater access for remote patients to bariatric care, allowing them to commute only for the necessary surgery rather than the whole series of preparatory and follow-up appointments.
- Creates new opportunities to build patient engagement via digital solutions like wearables, apps, and other devices as patients become accustomed to the technologies.
These new opportunities may prove vital, as studies are finding that lockdown and isolation due to COVID-19 are associated with poorer postoperative weight outcomes and increased postoperative disordered eating. Improved online resources such as personalized care automation can be leveraged to combat these difficulties by engaging patients in new and more effective ways.
The Future of Bariatric Care
Together, the reframing of bariatric surgery as a medical necessity and the widespread adoption of healthcare technology have changed bariatric surgery forever. These two aspects will work in tandem for the future of bariatric care.
If you want to learn more about equipping your surgical practice with the personalized, automated tools that can help your patients thrive during COVID-19 and beyond, Wellbe can help.
Contact us today to learn more.
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