Insurance-related hurdles are delaying timely and essential bariatric and metabolic surgery for Indians living with severe obesity, according to a new survey by the Obesity and Metabolic Surgery Society of India (OSSI). While 87.2% of bariatric surgeons reported higher patient interest after the Insurance Regulatory and Development Authority of India’s (IRDAI) 2019 mandate to include such procedures in health policies, actual utilisation of coverage remains low due to poor awareness, high out-of-pocket costs, and complex paperwork.
The cross-sectional survey, conducted among 109 bariatric surgeons across multiple states between November 2024 and March 2025, found that 95.4% of surgeons see patients delaying surgery while waiting for insurance approval, and 69.7% rated the approval process as complicated. Most respondents (76.1%) said patients are unaware that insurance can cover bariatric surgery even when they meet medical criteria, leading to underuse of available benefits.
OSSI president Dr Randeep Wadhawan stressed that patients advised metabolic surgery should not postpone treatment, as delays allow obesity-related diseases to worsen and undermine recovery and long-term outcomes. Former OSSI president Dr Manish Khaitan warned that months lost in approval queues can aggravate metabolic, hormonal and cardiovascular health, underscoring the need for faster decisions. The survey also highlighted India’s rapidly escalating obesity burden, with overall prevalence projected to triple by 2040 and obesity now recognised as a complex, chronic, progressive and relapsing medical condition linked to type 2 diabetes, hypertension, sleep apnoea, heart disease, joint problems, infertility and higher cancer risk. Bariatric and metabolic surgery can achieve 30%–40% total body weight loss and reverse many associated illnesses, making it one of the most effective options for severe obesity.
Most surgeons strongly supported expanding insurance eligibility by lowering BMI thresholds and covering more comorbidities than currently listed under IRDAI norms. Nearly all respondents (99.1%) agreed that insurance processes must be significantly streamlined to improve access, calling for urgent reforms to simplify documentation, broaden criteria and speed up approvals so that bariatric and metabolic surgery is treated as a medically necessary, life-saving intervention rather than a discretionary benefit.
