Wednesday, November 18, 2009

Obesity is going to kill us

A new report was released this week that concludes that the number one health threat to the U.S. population is obesity. Americans are getting fatter by the day, and the associated health toll is showing up in medical dollar signs.

The medical insurance companies claim they don't want to insure people who are obese. Let's face it, they don't want to insure anyone who isn't a specimen of perfect health and fitness living a risk-free life.

The thing is, my insurance company, Great West/Cigna, doesn't pay for anything except illness. The policy clearly outlines the many tools for wellness that are not covered including:
--Using the services of a dietitian or nutritionist
--Attending a university diet program (usually at a school's Center for Human --Nutrition)
--Personal trainer
--Gym membership
--Exercise education (classes)
--Fitness incentives

If you want to quit smoking, my insurance company, like so many others, will provide telephone counseling support 24/7, nicotine patches, literature, and if need be, consultations with a doctor. These tools will continue to be available over and over again, until the patient succeeds in quitting smoking or gives up trying.

My insurance will not provide any assistance toward my weight loss; however, it will pay for Lap Band surgery or traditional gastric bypass surgery, should I get to that point. In other words, if I gain another 30 pounds, I can have surgery, but at my current weight, Cigna is uninterested in my wellness.

I am not unique. The point here is that if obesity--which is expected to rise dramatically in the next few years--is such a serious and expensive health threat, wouldn't it make sense for health insurance companies to invest in just that--health?

I have taken a slightly different approach to getting what I need. For the most part, I have watched my weight spiral upward despite my many attempts to make it go the other way. I eventually stopped trying, and my weight, surprisingly, didn't change much at all. It hit a set point at 195 and seems to have found a home there.

This doesn't mean I'm content with that or resigned to it. Not at all. I recently made an appointment with a systemic wellness specialist who does a lot of endocrinology work. She's also a bariatric specialist, but I found that out after I got there.

I told her my story of frustration and fruitless attempts at getting skinny. I told her that being fit didn't matter to me. Being healthier didn't matter to me. I wanted one thing and one thing only and that was to look like an auburn-haired, purse-toting human toothpick.

She smiled. I was not the first to say this. She said something that took me by surprise. She said, "I believe you. I am sure you've tried. Before you can address the weight you're carrying, though, we need to figure out how it got there and we need to understand what your body is doing with its hormone and chemical processes. I suspect you have a lot of things out of whack, and a GP will tell you everything is normal, but as I'm scanning these lab reports you brought, I can tell you it's not."

Here's the thing. My insurance paid for this visit, but it won't pay for the nutrition plan and supplements needed to begin the repairs. Hormones, yes. Nutrition therapy, no. I'll be able to get some of that, but only because the doctor bills this kind of work as something that she knows will be covered. In other words, the only way to get it paid for is to lie.

Where I live, there is a large university with a hospital that does important research. One area they're known for is bariatric medicine. Several years ago, they launched a program to help very overweight (not morbidly obese) people reach a healthy weight through lifestyle changes, customized diet, group therapy, education, and behavior modification. The program has outrageously successful outcome statistics,but there is always a need for more participants. According to an article read, the biggest deterrent for participants is the price. No insurance company will pay for it.

I rest my case.

1 comment:

Ethereal Highway said...

It's a terrible shame that insurance companies won't make exceptions for programs that have a good track record that can be documented. You want to hear something really sick? I heard it from my sister, who is a nurse, when I raised the same logic that you have in your post. She said the insurance companies don't see investing in health as a savings because people change jobs often enough that they hope we will be on some other insurance company's dime by the time we are drastically ill. Now THAT is sick.

I'm glad you're smarter than the insurance company and not giving up on yourself. You are very much worth the effort.