To lose weight, one needs to have an active lifestyle and maintain a healthy diet, but while there are alternatives to losing weight naturally, such as through bariatric or weight loss surgeries, these often come at a high cost and risks. Worse, many obese Americans, are finding it difficult to find insurance plans that would cover their weight loss surgery.
Mercer, a human resource and related financial services consulting firm based in New York city, said that only 37 percent of the health plans sponsored by employers include coverage for weight loss surgery, a procedure that would cost anywhere from $15,000 to $ 25,000, and while the coverage rate is 58 percent for employees working in large companies, many Americans are employed by smaller businesses.
Almost two-thirds of employer-sponsored health plans, on the other hand, do not cover weight loss surgery. And, those that do, require certain requirements before the procedure could be covered.
The patient, for instance, needs to pass a psychological evaluation to show that his condition is not due to an eating disorder or mental problem that leads to weight gain. He is also required to undergo a doctor-supervised special diet that lasts six to 12 months during which he has to maintain a journal for his eating habits and visit the doctor regularly for weigh-ins and check-ups.
Special requirements and evaluations are also imposed to ensure that bariatric surgery is the patient's last resort. Carson Liu, a bariatric surgeon in Los Angeles, said that insurers are aware most patients will drop out because of these requirements. "Half of the people I see drop out because they can't commit to the time away from their jobs," he said. "Insurers know that 50 percent of patients will drop out."
The problem persists in state-run insurance exchanges as well, as only 24 states require insurers to provide coverage for weight loss surgery and even if the procedure is covered, many of the plans require the patients to shoulder up to 50 percent of the costs.
The American Heart Association, the American College of Cardiology and the Obesity Society have issued guidelines last November that recommend surgery for adults with BMI of 40 or higher with serious health problems. Those with BMI of 35, however, do not have to undergo bariatric surgery.
Some health practitioners believe a better solution is needed for the obesity epidemic. David Katz, of Yale University's Prevention Research Center, said that teaching kids early about the importance of healthy eating and exercise habits is important. "We created the problem of severe obesity and we have to deal with it, but scalpels aren't the only solution," he said. "There is a better way."
