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Even after a surgeon, mental health professional, dietician and physician who specializes in obesity has determined the patient should have bariatric surgery, the patient is told to try six months or a year of additional, medically supervised weight loss attempts before trying surgery, Shikora said.

"In our area, it's difficult for patients with Medicaid to get approval even if they meet all of the criteria," said Shikora, director of Weight and Wellness Center at Tufts Medical Center in Boston. "They seem to arbitrarily reject applications, require lots of paperwork and take a long time to approve anything."

Another study also scheduled to be presented Wednesday found that weight loss surgery may work just as well for older patients as it does for younger ones. Researchers found that morbidly obese seniors age 65 and older who had laparoscopic gastric bypass surgery lost about 76 percent of their excess body weight and had no more complications than younger patients.

"Bariatric surgery in the older population is underutilized because of a misperception that old age alone puts patients at higher risk for complications and mortality, said Dr. Joseph Kuhn, MD, study co-author and director of General Surgical Research at Baylor University Medical Center in Dallas. "We found seniors can benefit just as much as younger people from bariatric surgery without taking on additional risk."

Despite a higher prevalence of surgical risk factors such as sleep apnea, type 2 diabetes and hypertension, 100 patients aged 65 to 77 with an average BMI of 45 had hospital stays and complication rates that were comparable to younger patients, the team found.

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