Summary of this article
Over 95 per cent of bariatric surgery patients face major insurance-approval delays.
Low awareness and complex claim processes block access to obesity coverage.
Rejected claims and old exclusions push patients into costly, risky postponements.
Experts urge simpler paperwork, faster approvals, and revised BMI eligibility norms.
India’s obesity care system is hitting a bottleneck, with 95.4 per cent of eligible patients forced to delay bariatric surgery because insurers take too long to process claims, according to a recent survey by a new national survey conducted by the Obesity and Metabolic Surgery Society of India (OSSI). Despite rising demand for medical intervention, only 9.2 per cent of surgeons said that more than three-quarters of their patients could actually use insurance to fund surgery, underscoring a widening gap between policy and access.
Coverage Exists, But Access Doesn’t
Although metabolic and bariatric surgery has been covered under health insurance since 2019 for patients meeting defined clinical criteria, the OSSI survey shows that the uptake remains strikingly low. A large 87.2 per cent of surgeons reported increased patient interest after the coverage mandate, yet most patients remain unable to benefit from it.
Surgeons cited three major hurdles. First, 76.1 per cent said patients are not aware that such surgeries are even covered. Second, nearly 70 per cent described the claim process as complex or very complex, involving extensive paperwork and repeated follow-ups. Third, many insurers continue to reject claims due to old obesity-exclusion clauses or incomplete documentation, forcing patients into long waiting periods or out-of-pocket payments.
1 November 2025
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Why Delays Are Dangerous
Obesity is rarely a standalone issue. Patients who end up waiting for their insurers to clear a claim often find their other health problems creeping up on them. Issues like type two diabetes, heart conditions, or even disrupted sleep tend to get harder to manage during this period. And as the paperwork drags on, the surgery itself slips further away, adding to both the medical strain and the financial pressure they already live with.
Surgeons noted that while the coverage mandate was a milestone, the real-world experience of patients is defined not by policy but by processing time. When approvals stretch for weeks or months, people who urgently need intervention are left in medical limbo.
The Way Forward
The surgeons who took part in the OSSI survey were clear about what needs fixing. They want insurers and hospitals to cut down the paperwork, move approvals faster, and explain coverage rules in plain language. Several also felt that the current eligibility norms need a second look, especially the Body Mass Index (BMI) cut-offs and how related illnesses are assessed, so that people who genuinely need the operation are not turned away on technicalities.
Without such corrections, India’s obesity-care ecosystem risks leaving a vast majority of patients behind, even as the burden of the disease continues to rise.
