OSSI Survey Warns: Insurance Delays And High Costs Worsen India’s Growing Obesity Crisis

Mumbai, Dec 04: A new national survey by the Obesity and Metabolic Surgery Society of India (OSSI) has revealed serious gaps in insurance coverage that are delaying access to lifesaving bariatric and metabolic surgery at a time when India is facing a rapidly rising obesity burden.

Led by Dr. Aparna Govil Bhasker, Bariatric and Metabolic Surgeon at Saifee Hospital, Mumbai, the study highlights that despite the Insurance Regulatory and Development Authority of India’s (IRDAI) 2019 mandate to cover bariatric and metabolic surgery when medical criteria are met, implementation remains inconsistent across insurers.

Obesity Rates Rising Rapidly In India

India’s obesity prevalence is expected to triple by 2040, affecting millions from young adults to older citizens. Doctors stress that obesity is not a lifestyle flaw but a chronic, progressive medical disease that leads to type 2 diabetes, hypertension, sleep apnea, heart disease, infertility, joint problems and several cancers.

Bariatric and metabolic surgery remains one of the most effective treatments, achieving 30–40% total body weight loss and reversing many associated illnesses. Yet, the high cost of surgery combined with insurance hurdles leaves many patients untreated or forces them into long delays.

OSSI Survey: High Patient Interest But Low Approval Rate

The OSSI survey, conducted among 109 bariatric surgeons across multiple states between November 2024 and March 2025, revealed that 87.2% of surgeons observed higher patient interest after the 2019 IRDAI mandate. However, real-world utilization remains low due to limited awareness, heavy paperwork and significant out-of-pocket expenses.

An overwhelming 95.4% of surgeons reported that patients postpone surgery while waiting for insurance approval. Nearly 70% rated the overall approval process as complex, and 91.7% said it was more cumbersome than approvals for routine surgeries.

High rejection rates were also noted, with one-third of surgeons reporting 50–75% denials due to reasons including obesity exclusions, waiting period issues and documentation discrepancies. Despite coverage, 81.7% of surgeons said patients still incur major out-of-pocket costs.

Guideline–Eligibility Mismatch A Major Barrier

A significant concern raised by OSSI is the mismatch between medical guidelines and insurance eligibility criteria. OSSI recommends surgery for patients with a BMI ≥ 35 kg/m² regardless of comorbidities, and for those with BMI > 30 kg/m² when serious conditions are present.

However, insurers generally restrict approval to patients with BMI ≥ 40 kg/m² or ≥ 35 kg/m² with documented severe comorbidities, leaving many without timely access.

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Call For Insurance Reform & Awareness

Senior surgeons stressed that delays worsen obesity-related diseases and ultimately increase long-term healthcare costs. The survey concludes with a clear call for urgent reforms: simplified processes, expanded eligibility and greater awareness to ensure timely treatment for a disease now threatening India’s public health and economic future.

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Published on: Thursday, December 04, 2025, 07:14 PM IST