My husband passed away on 11-16-06. We tried for 2 years to get our health insurance carrier to approve gastric bypass. His primary care doctor and his heart doctor both said he was going to die if he didn\’t have the surgery. He suffered from congestive heart failure, diabetes, high cholesterol, high blood pressure, sleep apnea, COPD and emphesyma. I think at the very least, insurers should have to approve payment of the surgery if the patient\’s doctor says they will die if they don\’t lose weight. My husband hadn\’t worked for years so obviously we couldn\’t pay for the surgery ourselves. I work and pay for health insurance through my employer and am very bitter that I was still unable to save my husbands life by providing him the health care that he needed. I think it\’s a shame that the health care providers are allowed to say \”no\” to treatment that physicians have recommended.
1. Having a doctor tell you to lose weight and telling you to have the surgery are two very different things. Should we be paying for poor eating habits?
2. The many side effects and hazards of the surgery are as bad or worse than the effects of NOT having it done. My neighbor died from the surgery.
Sounds like getting on a good diet and exercise program is the way to go if you can.
I can\’t beleive people would expect insurance companies to pay for their years of overeating and overindulging, but then again, insurance companies pay for many different types of surgeries-i.e. heart surgery for people who have abused their health for years. So why not gastric bypass???
Call me callous, but I have a hard time finding sympathy for those who allow themselves to get the point where a doctor tells them lose weight or die! And I say allow because a very small percentage of the population has a \”glandular problem\” that, despite all they do, they cannot manage their weight. The rest of those people CHOOSE a poor diet, they CHOOSE not to exercise, they CHOOSE to ignore the numerous warnings their doctors gave as their weight ballooned to 300, 400, 500 lbs. You don\’t go from healthy to morbidly obese overnight. And now you want me to pay (through higher ins. premiums) for your gastric bypass surgery because you are lazy and show no self discipline?!?!?!
Sorry, no sympathy for you or the smokers who ignore the warnings and get lung cancer.
Interesting comments from the gallery. We all acknowledge that weight gain is easy and taking it off and keeping it off is very hard. There is a point of no return for many people and in these situations of morbidly obese the aches and pains of just moving can become untolerable to them. Bypass surgery for most is just the kickoff effort to turn their life around. These are extreme but many conditions of complex interactions that spiral downwards unless weight loss program addresses and is required for gastric bypass to include psycho-social and dietary counciling for the individual and all their significant others. I doubt that the success rate is low for those that do not accept a program appoach to self preservation and weight loss.
WLS is one of the more unusual medical treatments in that it\’s long term success is dependant more on patient behavior than other surgical procedures. About 30% to 40% of WLS post-ops eventually regain enough weight to again re-qualify for the procedure. Maybe these legislative bills should include provision for recapturing funds from the patients who, after five years, have a BMI of 40 with no co-morbidities or a BMI of 35 with co-morbidities. This open ended blank check for people who fail to use their \”tool\” has to stop. It\’s essentially insurance fraud to have an insurer pay $20k to $40k for a \”tool\” that you choose to not use properly.
After reading some of your comments I feel the need to put in my two cents worth. I\’m 47 years old and have had a weight problem since childhood. Although I tend to be a big eater its mainly healthy foods, fruits, vegetables, baked fish, and chicken. Not sweets and lots of red meat that most would assume to cause this weight problem. No doctor is going to tell you to have this surgery unless you have already failed several exercise programs and diets. I have sleep apnea, take two different perscriptions to control my cholesterol, have a family history of heart disease and a degenerative lower back. These conditions are caused by being overweight, except for the degenerative lower back which is aggravated by the extra weight and limits my exercise to walking and swimming. The lapband procedure has a cost of a little over $14000, but my insurance does not cover it. Yet they do cover my other health problems, sleep apnea($3000 yearly machine and supplies) Two perscriptions ($500 yearly) Chiropractor ($1500 yearly). After three years The surgery would have paid for itself. I believe if it were to become mandatory they would find out it saves them money in the long term.
To the the poor ignorant soul who wrote \”Are you kidding me\” you are truly an ignorant person. I\’m 39 yo and morbidly obese in the process of trying to have the gastric banding done. Ask me how I \”got this way.\” I had always been thin until I was 23 yo and started having back problems. I\’m 39 now and have had chronic pain for 15yrs and over that 15yr period I gained over 100lbs. It wasn\’t because I was lazy! I am in constant pain. I went to the gym on a regular basis but had to take 2 tylenol #4\’s just to walk into the gym and more when I got home. I pity you and your ignorance about obese people.
Nope, still don\’t see it. I know of many people who haven\’t exercised a day in their lives yet somehow managed not to gain weight. It\’s a simple formula. Calories in vs. calories expended. If you are putting on weight, even over a 15, reduce your caloric intake! And are you telling me your doctor didn\’t give you many warning signs? Which you ignored? My doctor told me I needed to lose some weight. And for some odd reason, I considered him an expert in the field of health, took his advice to heart and lost weight. Hmmm… Funny how that works. Quit whinning and making me pay for your laziness!
If you\’re so perfect why did your doctor have to tell you to lose weight, or were you to lazy to get on a scale yourself. My guess is that you\’re young and still have your health. Well I have news for you, not many are able to stay slim and healthy all through life. If your doctor already had to tell you to lose weight, there is a good chance you will have weight problems in the future. Once you have fat cells they just shrink when you lose weight, they don\’t go away. So you may be in are shoes in ten years or so.
To: You gotta be kidding me. Obviously you are an uneducated person. I\’d like to see you trade places with me and then decide if it\’s just your simple formula of calories in and calories burned. I used to be a long distance runner and thin until my back problems started 15 yrs ago. Oh but I suppose my back problems are all in my head as well! My pain management doctor just recently obliterated the nerves in my facet joints in my spine and in the sacroilliac joints as well. Imagine yourself slowly deteriorating over a 15 yr period to where you literally can only walk or stand for 15 min. at a time. Your formula doesn\’t work here. When there is not an outlet to expend calories then weight starts building. So while you\’ve been living your life to the fullest for the last 15 yrs I\’ve been living in pure hell from pain. Is it so much to ask to have my life back and if bariatric surgery is a tool to help me do that why should I not have access to that? Trade places with me. I can quarantee you wouldn\’t do it if your life depended on it!!
What percentage of the population has a legitimate reason for being overweight? Probably a small percentage. Why do I constantly read articles in the newspaper on how america\’s youth is overweight and they are getting fatter? Do they all have legitimate reasons why they are fat? No, they don\’t. These fat kids are gonna be fat adults in a few years. I admit there is a very small percentage of the overweight population that realistically can\’t work out and lose weight. That is unfortunate and I would not trade places with any of them. For the rest of the population, put down the fork, get up off the couch and exercise. I see overweight people at the gym every day. My hat\’s off to them. Whether they lose weight or not at least they are doing something about it.
I\’m glad to announce to the ignorant that I\’m scheduled to have bypass on June 27, 2007! I\’m so excited to have the opporturnity to have my life back that\’s been zapped from me!!!
Having the surgery done? Great, hope it works out for you! Don\’t forget, old habits die hard. You are gonna have to make some MAJOR changes in your eating and exercise habits. \’Course, had you done that years ago, you wouldn\’t have needed the surgery in the first place. But I sincerely hope it gives you back the life you that you let slip away years ago.
I almost did not respond to that last commnet. Apparently you are going to think what you want and that\’s ok with me. I\’m not here to make you change your mind about anything. I\’m here to share my experience, strength, and hope with others who may share the same story as me. If you\’d like I\’ll send you a before and after picture and keep you posted as to how much I may or may not have gotten my life back. Just keep in touch now. I\’m a firm believer in \”what goes around, comes around\”. Seen it happen too many times!
I have no problem with you having the surgery. But don\’t make me pay for it.
I sincerely hope it works out for you. Doctors don\’t perform the surgery on every person who asks for it, so you must truly need it. I would never want to be in that position, nor would I wish it upon my worst enemy. Just remember that the surgery is not the total solution; only the first step. A severe lifestyle change is in order. I hope you have the strength to see it thru. Good luck!
And I would love to see before / after pictures, I don\’t know how that could happen. If you have any ideas, let me know.
I realize it is a life style change. I\’ve been a nurse for almost 20yrs. I\’m surprised at myself for even considering this surgery. I have taken care of people who have received a hack job from the surgery. However I feel very confident in the surgeon at MUSC. If I\’m considering the surgery myself then you should know I have been down every avenue prior to making a decision like this. I do not see it as a \”quick fix\” to my \”bad eating habits.\” By the way I do not have high blood pressure, diabetes, heart disease, congestive heart failure, or high cholesterol. I guess what I wanted you to see is that everyone has a story. One should not catergorize obese people and say \”they just need to put the fork down.\” Ok I\’m done with my soapbox. If you want more info. look me up.
I think then insurances should not be paying for men to have a hard on! Or drug addicts to be rehabbed! Or smokers to have their cancer removed! COME ON! Yes, it is all pretty pathetic that insurances have to pay for the result of peoples actions, & since no one in the world wants to take responsibility for their actions someone will pay for it! Since I have paid for coverage, I will have already paid for it-not you, this isn’t the welfare system! I think its quite comical that people who have never had a weight problem have all the answers for “us” who have! That’s pretty funny-kinda like telling someone how to raise kids & don’t have any-(classic!)I was however glad to see that someone understands the concept of “what goes around comes around!”
To Nauseous and You gotta be kidding. You don’t have a clue obviously about obesity, not a stinking clue…You are callous, know it alls, and probably skinny by nature. If you were to actually talk to a Bariatric Surgeon with his salt you might find that 98% of those who have the surgery lose the unwanted weight and that there is such a thing called genes, fat ones and skinny ones…We are all born with one or the other…Received from our parents. If you are born with the fat genes I would like to see if you’re still thin….For your neighbor who died, at least they died doing something they believed such as getting thin. If I had the choice and could get the insurance I would take the chance for sure. IT amazes me how ignorant some people are. You clueless small minded disgusting people.
I am a woman who has been over weight my whole life. I have not eaten a carb in 2 years and I no soda in 3 years, plus I work out 3 times a week for 45 minutes a day.. I have only lost 13 lbs in 2 years and I weigh 275 lbs…I need help with losing wieght and gastric bypass I feel would help my tremendously..So if your skinny dont be a hater on those who arnt..some people truely cant help it!
I’m back over a year later! I’m glad to announce my surgery went very well. I’ve lost 100 lbs and back to normal weight again for the first time in 15 years!! I haven’t had to have any more back procedures and pretty much live pain free. What an awesome decision to have the surgery….Let me think on the before and after…how I would get that to you.
Deborah,
I hope all goes with maintaining your weight loss. It is a tough road ahead of you. I don’t feel like reading all the old posts, so I don’t know what your background is, but keep in mind old habits die hard. I hope you pay special attention to any weight gain. One or two pounds doesn’t seem like much at first, but it does add up.
My husband passed away on 11-16-06. We tried for 2 years to get our health insurance carrier to approve gastric bypass. His primary care doctor and his heart doctor both said he was going to die if he didn\’t have the surgery. He suffered from congestive heart failure, diabetes, high cholesterol, high blood pressure, sleep apnea, COPD and emphesyma. I think at the very least, insurers should have to approve payment of the surgery if the patient\’s doctor says they will die if they don\’t lose weight. My husband hadn\’t worked for years so obviously we couldn\’t pay for the surgery ourselves. I work and pay for health insurance through my employer and am very bitter that I was still unable to save my husbands life by providing him the health care that he needed. I think it\’s a shame that the health care providers are allowed to say \”no\” to treatment that physicians have recommended.
1. Having a doctor tell you to lose weight and telling you to have the surgery are two very different things. Should we be paying for poor eating habits?
2. The many side effects and hazards of the surgery are as bad or worse than the effects of NOT having it done. My neighbor died from the surgery.
Sounds like getting on a good diet and exercise program is the way to go if you can.
I can\’t beleive people would expect insurance companies to pay for their years of overeating and overindulging, but then again, insurance companies pay for many different types of surgeries-i.e. heart surgery for people who have abused their health for years. So why not gastric bypass???
Call me callous, but I have a hard time finding sympathy for those who allow themselves to get the point where a doctor tells them lose weight or die! And I say allow because a very small percentage of the population has a \”glandular problem\” that, despite all they do, they cannot manage their weight. The rest of those people CHOOSE a poor diet, they CHOOSE not to exercise, they CHOOSE to ignore the numerous warnings their doctors gave as their weight ballooned to 300, 400, 500 lbs. You don\’t go from healthy to morbidly obese overnight. And now you want me to pay (through higher ins. premiums) for your gastric bypass surgery because you are lazy and show no self discipline?!?!?!
Sorry, no sympathy for you or the smokers who ignore the warnings and get lung cancer.
Interesting comments from the gallery. We all acknowledge that weight gain is easy and taking it off and keeping it off is very hard. There is a point of no return for many people and in these situations of morbidly obese the aches and pains of just moving can become untolerable to them. Bypass surgery for most is just the kickoff effort to turn their life around. These are extreme but many conditions of complex interactions that spiral downwards unless weight loss program addresses and is required for gastric bypass to include psycho-social and dietary counciling for the individual and all their significant others. I doubt that the success rate is low for those that do not accept a program appoach to self preservation and weight loss.
WLS is one of the more unusual medical treatments in that it\’s long term success is dependant more on patient behavior than other surgical procedures. About 30% to 40% of WLS post-ops eventually regain enough weight to again re-qualify for the procedure. Maybe these legislative bills should include provision for recapturing funds from the patients who, after five years, have a BMI of 40 with no co-morbidities or a BMI of 35 with co-morbidities. This open ended blank check for people who fail to use their \”tool\” has to stop. It\’s essentially insurance fraud to have an insurer pay $20k to $40k for a \”tool\” that you choose to not use properly.
After reading some of your comments I feel the need to put in my two cents worth. I\’m 47 years old and have had a weight problem since childhood. Although I tend to be a big eater its mainly healthy foods, fruits, vegetables, baked fish, and chicken. Not sweets and lots of red meat that most would assume to cause this weight problem. No doctor is going to tell you to have this surgery unless you have already failed several exercise programs and diets. I have sleep apnea, take two different perscriptions to control my cholesterol, have a family history of heart disease and a degenerative lower back. These conditions are caused by being overweight, except for the degenerative lower back which is aggravated by the extra weight and limits my exercise to walking and swimming. The lapband procedure has a cost of a little over $14000, but my insurance does not cover it. Yet they do cover my other health problems, sleep apnea($3000 yearly machine and supplies) Two perscriptions ($500 yearly) Chiropractor ($1500 yearly). After three years The surgery would have paid for itself. I believe if it were to become mandatory they would find out it saves them money in the long term.
To the the poor ignorant soul who wrote \”Are you kidding me\” you are truly an ignorant person. I\’m 39 yo and morbidly obese in the process of trying to have the gastric banding done. Ask me how I \”got this way.\” I had always been thin until I was 23 yo and started having back problems. I\’m 39 now and have had chronic pain for 15yrs and over that 15yr period I gained over 100lbs. It wasn\’t because I was lazy! I am in constant pain. I went to the gym on a regular basis but had to take 2 tylenol #4\’s just to walk into the gym and more when I got home. I pity you and your ignorance about obese people.
Nope, still don\’t see it. I know of many people who haven\’t exercised a day in their lives yet somehow managed not to gain weight. It\’s a simple formula. Calories in vs. calories expended. If you are putting on weight, even over a 15, reduce your caloric intake! And are you telling me your doctor didn\’t give you many warning signs? Which you ignored? My doctor told me I needed to lose some weight. And for some odd reason, I considered him an expert in the field of health, took his advice to heart and lost weight. Hmmm… Funny how that works. Quit whinning and making me pay for your laziness!
If you\’re so perfect why did your doctor have to tell you to lose weight, or were you to lazy to get on a scale yourself. My guess is that you\’re young and still have your health. Well I have news for you, not many are able to stay slim and healthy all through life. If your doctor already had to tell you to lose weight, there is a good chance you will have weight problems in the future. Once you have fat cells they just shrink when you lose weight, they don\’t go away. So you may be in are shoes in ten years or so.
To: You gotta be kidding me. Obviously you are an uneducated person. I\’d like to see you trade places with me and then decide if it\’s just your simple formula of calories in and calories burned. I used to be a long distance runner and thin until my back problems started 15 yrs ago. Oh but I suppose my back problems are all in my head as well! My pain management doctor just recently obliterated the nerves in my facet joints in my spine and in the sacroilliac joints as well. Imagine yourself slowly deteriorating over a 15 yr period to where you literally can only walk or stand for 15 min. at a time. Your formula doesn\’t work here. When there is not an outlet to expend calories then weight starts building. So while you\’ve been living your life to the fullest for the last 15 yrs I\’ve been living in pure hell from pain. Is it so much to ask to have my life back and if bariatric surgery is a tool to help me do that why should I not have access to that? Trade places with me. I can quarantee you wouldn\’t do it if your life depended on it!!
What percentage of the population has a legitimate reason for being overweight? Probably a small percentage. Why do I constantly read articles in the newspaper on how america\’s youth is overweight and they are getting fatter? Do they all have legitimate reasons why they are fat? No, they don\’t. These fat kids are gonna be fat adults in a few years. I admit there is a very small percentage of the overweight population that realistically can\’t work out and lose weight. That is unfortunate and I would not trade places with any of them. For the rest of the population, put down the fork, get up off the couch and exercise. I see overweight people at the gym every day. My hat\’s off to them. Whether they lose weight or not at least they are doing something about it.
I\’m glad to announce to the ignorant that I\’m scheduled to have bypass on June 27, 2007! I\’m so excited to have the opporturnity to have my life back that\’s been zapped from me!!!
Having the surgery done? Great, hope it works out for you! Don\’t forget, old habits die hard. You are gonna have to make some MAJOR changes in your eating and exercise habits. \’Course, had you done that years ago, you wouldn\’t have needed the surgery in the first place. But I sincerely hope it gives you back the life you that you let slip away years ago.
I almost did not respond to that last commnet. Apparently you are going to think what you want and that\’s ok with me. I\’m not here to make you change your mind about anything. I\’m here to share my experience, strength, and hope with others who may share the same story as me. If you\’d like I\’ll send you a before and after picture and keep you posted as to how much I may or may not have gotten my life back. Just keep in touch now. I\’m a firm believer in \”what goes around, comes around\”. Seen it happen too many times!
I have no problem with you having the surgery. But don\’t make me pay for it.
I sincerely hope it works out for you. Doctors don\’t perform the surgery on every person who asks for it, so you must truly need it. I would never want to be in that position, nor would I wish it upon my worst enemy. Just remember that the surgery is not the total solution; only the first step. A severe lifestyle change is in order. I hope you have the strength to see it thru. Good luck!
And I would love to see before / after pictures, I don\’t know how that could happen. If you have any ideas, let me know.
I realize it is a life style change. I\’ve been a nurse for almost 20yrs. I\’m surprised at myself for even considering this surgery. I have taken care of people who have received a hack job from the surgery. However I feel very confident in the surgeon at MUSC. If I\’m considering the surgery myself then you should know I have been down every avenue prior to making a decision like this. I do not see it as a \”quick fix\” to my \”bad eating habits.\” By the way I do not have high blood pressure, diabetes, heart disease, congestive heart failure, or high cholesterol. I guess what I wanted you to see is that everyone has a story. One should not catergorize obese people and say \”they just need to put the fork down.\” Ok I\’m done with my soapbox. If you want more info. look me up.
I think then insurances should not be paying for men to have a hard on! Or drug addicts to be rehabbed! Or smokers to have their cancer removed! COME ON! Yes, it is all pretty pathetic that insurances have to pay for the result of peoples actions, & since no one in the world wants to take responsibility for their actions someone will pay for it! Since I have paid for coverage, I will have already paid for it-not you, this isn’t the welfare system! I think its quite comical that people who have never had a weight problem have all the answers for “us” who have! That’s pretty funny-kinda like telling someone how to raise kids & don’t have any-(classic!)I was however glad to see that someone understands the concept of “what goes around comes around!”
To Nauseous and You gotta be kidding. You don’t have a clue obviously about obesity, not a stinking clue…You are callous, know it alls, and probably skinny by nature. If you were to actually talk to a Bariatric Surgeon with his salt you might find that 98% of those who have the surgery lose the unwanted weight and that there is such a thing called genes, fat ones and skinny ones…We are all born with one or the other…Received from our parents. If you are born with the fat genes I would like to see if you’re still thin….For your neighbor who died, at least they died doing something they believed such as getting thin. If I had the choice and could get the insurance I would take the chance for sure. IT amazes me how ignorant some people are. You clueless small minded disgusting people.
I am a woman who has been over weight my whole life. I have not eaten a carb in 2 years and I no soda in 3 years, plus I work out 3 times a week for 45 minutes a day.. I have only lost 13 lbs in 2 years and I weigh 275 lbs…I need help with losing wieght and gastric bypass I feel would help my tremendously..So if your skinny dont be a hater on those who arnt..some people truely cant help it!
I’m back over a year later! I’m glad to announce my surgery went very well. I’ve lost 100 lbs and back to normal weight again for the first time in 15 years!! I haven’t had to have any more back procedures and pretty much live pain free. What an awesome decision to have the surgery….Let me think on the before and after…how I would get that to you.
Deborah,
I hope all goes with maintaining your weight loss. It is a tough road ahead of you. I don’t feel like reading all the old posts, so I don’t know what your background is, but keep in mind old habits die hard. I hope you pay special attention to any weight gain. One or two pounds doesn’t seem like much at first, but it does add up.
Good luck.