Weighting for insurance

I have a friend who had weight loss surgery a few months ago, and so far, is very happy with the results. She paid for the surgery herself (no doubt costing thousands of dollars), because her insurance did not cover it. I have another friend who has considered weight loss surgery, either for herself or family members, but the cost would be a significant obstacle. Her medical insurance, while a very good plan, specifically excludes coverage for anything related to weight loss.

I suspect that most insurance plans are the same way - no coverage for weight loss surgery or any kind of treatment or program designed to produce weight loss. (I have no idea, though, whether that would include prescription drugs if the plan otherwise covers prescriptions.)

I myself did not have weight loss surgery or participate in any kind of organized plan that has a fee. That doesn't mean I didn't spend plenty of money to lose weight. Oh no. I suspect that I have spent as much money on my own weight loss plan as anyone who has sprung for gastric bypass or other surgery. My money has been spent on gym membership and a used treadmill; twice monthly massages; salmon and other good food (expensive, but I eat everything I buy and waste very little); lots of magazines to read at the gym, plus stacks of fitness/diet/health books and magazines; and most especially clothes, clothes, clothes - work clothes and play clothes, workout clothes and eating out clothes - many thousands of dollars worth. Some I needed because my old clothes were too big, but mostly I shop because it makes me feel happy and good about myself, and I believe has truly helped me lose weight and keep it off. All this could easily translate into one of those Mastercard "priceless" ads, except I use Visa. And there is definitely a price.

But this isn't about my borderline shopping addiction. It's about insurance coverage for weight loss. How I wish that insurance would cover all my weight loss related expenditures - but I know that's silly. However, I find it a little hard to understand why insurance does not cover other weight loss programs, even including surgery where medically necessary.

It's pretty well established that obesity is a problem and a disease which can contribute or lead to numerous other diseases. High blood pressure, diabetes, heart disease, and even cancer are only some of the medical conditions which obesity can contribute to. Decreasing obesity can prevent, decrease, or control many of these conditions, all of which can require long term medical care at great expense. Preventative care to avoid costly and serious future illness? Makes sense to me.

I think that there is a bias against people who are overweight that leads people, including insurance companies, to feel that obesity is caused by a lack of self-control or willpower, and therefore it doesn't merit treatment in the same way that other diseases do. If overweight people just ate less/exercised more/ate healthier food, they could lose the weight without medical intervention.

That may be true, in some cases, but it's also a lot more complicated than that. But even if that were completely true, it does not explain the inequity in the way that insurance companies treat obesity as compared to another comparable disease - alcohol and drug addiction.

Most insurance plans have some coverage for chemical dependency treatment. Mine includes both outpatient and in-patient treatment. But think of this. While addiction is a disease, it almost always occurs as a result of a person's voluntary choice to consume controlled substances recreationally. In the case of drugs other than alcohol, the consumption is also usually illegal. And addiction doesn't happen after one use. It takes repetitive consumption before use becomes abuse, then dependency. One might say that the user has had multiple opportunities to stop using before becoming an addict.

As anyone with a weight problem knows, food addiction has a lot in common with drug addiction. But the drug user, once he or she is in treatment and begins the process of recovery, does not have to continue using drugs through treatment. In fact, continued use is absolutely contrary to recovery; abstinence is mandatory. The food addict cannot just stop eating. We need to eat to survive. So one of the challenges is how to resist our "drug" while consuming it every day. A lot of people need help getting to that place; sometimes medical help. But the cost of that help? It's not coming from the insurance companies. At least not now.

It seems like every day I read an article or see a piece on TV about childhood obesity, adult obesity, the obesity crisis, and the medical risks of obesity. Yet the insurance companies won't treat it. I guess they'd rather treat the real diseases instead of helping us avoid them. Too bad.