Health Insurance and Weight Loss

[Lola]

I received notification from my health insurance company that effective January 2005, they will begin covering weight loss programs. This includes: gastric bypass surgeries, pills, excercise programs, etc.

Initially, I thought this was a good idea. I mean, the less fat you have, the healthier you have, the less money insurance companies pay for diseases like heart disease and diabetes.

However, this will also mean that premiums, which are already way too high, will go up as well.

So. Do you think health insurance companies should cover weight loss programs and surgeries?

[Beck]

I feel there should be limits on it. A person that is 5' 7" should not be able to get gastric bypass when she weighs in at a 150-200lbs. Pills, dieticians, etc should be covered.

Now, same 5'7", 200 lbs lady has high blood pressure, uncontrollable through medications, should be able to get the bypass surgery.

There should be clauses and stipulations so it cannot (should not) be abused.

[Demona]

Agreed. If weight is such that it threatens health it is fair enough that it be covered by medical insurance, and I don't see why it should push up premiums because it's a preventative measure.

On the other hand surgery and pills are perhaps not the best responses to obesity. Payment for exercise programs and/or a dietician is reasonable, but not strictly necessary.

I don't know what health insurance normally covers, blessed as I am with a National Health Service. The thing about weight loss is that it's quite possible to do for free, in a way that treating disease or illness often is not. The main thing lacking is will power, so one is in effect paying to overcome a mental barrier. Is this extension of service in keeping with other aspects of your policy?

[Lola]

The thing about weight loss is that it's quite possible to do for free, in a way that treating disease or illness often is not. The main thing lacking is will power, so one is in effect paying to overcome a mental barrier. Is this extension of service in keeping with other aspects of your policy?

Good question. The new policy didn't say.

My concern is that most doctors who see you have health insurance will give you the "go ahead" for this. I fear that it will end up being abused. And yes, this will raise the premiums. Someone has to pay for the surgeries.

[Quamie]

My last health care United Health Care covered all of the above. I was so happy to hear that as a LOT of people in the US need help. I think to go even a step more, schools should offer nutrition in schools. If students learned better eating habits earler, we would need less help as adults.


I do understand the problem with higher cost in health care for the consumers/patients. But we are already looking at higer cost for patients when they are having other issues due to the excess weight. The cost of high blood preasure meds, hypertention, arthritis, diabetes, and on and on. Some people that are so over weight can take as many as 14 meds a day. That's a lot of meds, and a lot of Dr visits, and a lot of money that the consumer is helping pick up.

[RogueAngel]

The thing about weight loss is that it's quite possible to do for free, in a way that treating disease or illness often is not. The main thing lacking is will power, so one is in effect paying to overcome a mental barrier. Is this extension of service in keeping with other aspects of your policy?

I think this is a dangerous attitude to have. There are lots of medical reasons why one would be overweight and it doesn't have to do with will power. Certain medications, thyroid conditions, etc can make someones weight skyrocket through no fault of their own. Getting them back down to normal weight can be a very big struggle. I think all these things should definitely be covered under medical insurance.

[Demona]

I think this is a dangerous attitude to have. There are lots of medical reasons why one would be overweight and it doesn't have to do with will power. Certain medications, thyroid conditions, etc can make someones weight skyrocket through no fault of their own. Getting them back down to normal weight can be a very big struggle. I think all these things should definitely be covered under medical insurance.


I was referring to losing weight, not to how one gains it in the first place.

[Daethian]

Do insurance companies cover illnesses that arise from smoking or doing drugs? Do they pay for drug or alcohol treatment? Do they pay for your injuries if you get hurt while doing something like rock climbing or bungee jumping?

Then I think its fair to pay for weight loss.

[Lola]

Do insurance companies cover illnesses that arise from smoking or doing drugs? Do they pay for drug or alcohol treatment? Do they pay for your injuries if you get hurt while doing something like rock climbing or bungee jumping?

Then I think its fair to pay for weight loss.

Good points. I just hope they add liposuction and breast enlargements (for cosmetic purposes) too. If a person felt better about their body, they wouldn't need the mental health benefit either. ;)

[blaire576]

I received notification from my health insurance company that effective January 2005, they will begin covering weight loss programs. This includes: gastric bypass surgeries, pills, excercise programs, etc.

Initially, I thought this was a good idea. I mean, the less fat you have, the healthier you have, the less money insurance companies pay for diseases like heart disease and diabetes.

However, this will also mean that premiums, which are already way too high, will go up as well.

So. Do you think health insurance companies should cover weight loss programs and surgeries?

an issue before that has come up with health insurance is that they will price you a quote and everything will go thru at a great rate. THEN they will ask for proof of prior insurance and look up your record etc, then 2 months later your rates will go up. so be careful check see how diff. insurance
companies prices

do not spam us

[eva]

As long as they don't make it a requirement to have surgery to keep coverage - the death rate for gastric bypass is 1 in 100.

[abcNKH]

The death rate for gastric bypass is not entirely due to the surgery. Most insurance companies require at least 2 co-morbidity conditions as a condition of the surgery (HBP, diabetes, sleep-apnea, etc.). They also require 2-3 documented attempts at weight loss such as Jenny Craig or Weight Watchers, which is about a 6-month waiting period. These requirements all but insure that the patient is a poor candidate for surgery. Now, if you get rid of those conditions, and allow the surgery for people who are overweight simply because they believe that is their best option, then the patients going into surgery might be healthier overall, the death rate will go down, and maybe even the cost of the surgery due to lower malpractice insurance for doctors who perform this type of surgery.

For those who think weight loss is a simple matter of will-power, that is just not true. Many people have reactions to certain foods (such as processed foods or simple carbs) which cause the pancreas to go wacky. It sends out too much insulin when you eat these foods. The insulin doesn't work right, and ends up floating around in the bloodstream. This in turn causes hunger, which triggers more insulin in the bloodstream. It is a vicious circle and an additiction in the same manner as drugs or alcohol. But it is much harder to break than drugs or alcohol for several reasons. For those who are addicted to those, you can give them up totally to break the addiction. Not so with food. For those, it is clear exactly what the culprit is, not so with food. And for those, the medical industry and our social system are 100% behind you to get you thru it. Not so with weight, as shown by this exact thread.

Regardless of the cause, the evidence is clear that people need to lose to get or remain healthy. Why is there even a question that we should do whatever we need to to treat obesity, the same as we do to treat alcoholism or drug addiction?

[Liade]

The thing about weight loss is that it's quite possible to do for free, in a way that treating disease or illness often is not.
...as can stopping smoking, stopping drug use, turning around and preventing high blood pressure, high cholesterol, and diabetes also be done for free, but try taking these things out from under insurance coverage!

I think its about time that insurance agencies cover any and all kinds of treatments for weight problems, whether it be surgeries or long term behavioral therapy.