Congratulations! The coolest thing about this is that (assuming you get the surgery as scheduled) that is 5.2lbs you will never see again!
I realize that many insurance companies come off looking like complete and utter jerks by denying coverage for bariatric surgery, but there are reasons why some people get the run around. That doesn’t always mean they’re good reasons, but it’s not capricious.
You’ve got two sorts of people interested in bariatric surgery: 1) those whose obesity will like kill them in a short time frame, and 2) those who think they need the surgery, but really do need to try something less extreme, or who perhaps have psychological issues that the surgery won’t cure. I mean, anorexics think they’re obese, but can we all agree that in their case the problem isn’t the fat around their waist, it’s a dysfunction between the ears?
Insurance companies are worried about this turning into another fen-phen debacle. Fen-phen was intended for the morbidly obese - people for whom the weight was causing problems serious enough that assuming the risk of the drug combination was justifiable. It wound up being used by a lot of people who just needed to lose 20 or 30 pounds, and who were putting themselves at greater risk by taking the drugs than by simply remaining a little heavy. As a result, some people became seriously ill and some died who otherwise would have lived a long time.
The family of insurance companies I work for have tended to cover bariatric surgery when justified for a long, long time. As a prior poster mentioned, in many instances you have to document that you have, in fact, tried other methods of weight loss to no effect. If you are considering this sort of surgery you would do well to ask your insurance company what their policy is and what criteria you have to meet to be eligible. If you don’t meet the criteria, consider that perhaps in your case the potential benefits do not justify the risks.
Someone like Carnie Wilson is a shoo-in for the surgery – she really did need it. And clearly she went about it in a good way, she’s taken the weight off and kept it off for the most part. She also repeats ad nauseum the requirement to change eating habits, excercise, and basically completely remake herself. Someone like her is exactly why this surgery was developed in the first place.
On the other hand, you have people going to docs who don’t really have the necessary expertise. You have programs that do JUST the surgery and do not provide the necessary counseling and nutritional support - with sometimes disasterous results. This recent story in the New York Times illustrates bariatric surgery gone bad. And who pays for the aftermath? The insurance company. Whether they approve your initial surgery or not, they WILL wind up paying to treat this sort of bad outcome. Is it purely a financial concern? Well… no, most folks working for insurance companies are decent sorts who want people to get better and not have bad outcomes. But yes, finances do play a part. How many million-dollar bad outcomes can a company afford before it goes belly-up? Is it unreasonable to ask someone to justify their need for an expensive procedure before asking someone else to pay for it?
In our society, people do not like to be told “no”. Sometimes they need to hear it, though. Absolutely, for some people bariatric surgery is a godsend. But I cringe when I overhear someone on the commuter train who is carrying a little extra weight go on and on about how they’re going to have this done with clearly no notion of the fact that it permanently alters your relationship with food, your body, and it has real risks. Worse yet are instances where an unscrupulous doctor tells a patient to gain weight in order to qualify for this surgery, or otherwise play the system.
In conclusion (yes, you were wondering when the rambling would stop?) bariatric surgery can be a wonderful thing… but no one should enter into it lightly.
So, if you are getting bariatric surgery after carefully considering the options and risks vs. benefits… I wish you the best of luck. I hope you have a speedy and uneventful recovery, lose that weight, keep it off, and have a long and healthy life ahead of you.