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Some Desperate Obese Americans Stuffing their Faces to Qualify for Weight Loss Surgery Featured

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Fat-Man-Eating-BurgerDesperate for help, many obese people are piling on the pounds and putting their health at greater risk in order to qualify for weight loss surgery with their health insurance companies.

Dangerous Game to gain Weight to Get Surgery to Lose Weight

Because of strict health insurance policies that limit for weight loss surgery to people with high Body mass Indexes (BMIs) of 35 or 40, some obese people are actually purposely gaining weight, in order to lose weight.

Web sites devoted to weight-loss surgery are full of advice from other would-be losers who advise those seeking weight loss surgery to gain weight to favorable levels for weight loss surgery approval.

“That happens all the time,” said Dr. Robert Michaelson of Northwest Weight Loss Surgery in Everett, Wash., who was a clinical investigator for the FDA trial. “I’ve seen people come in with ankle weights on.”

Sometimes, it works. Elizabeth Marks, 32, of San Diego, Calif., was turned down for weight loss surgery once by her insurance company for being less than 100 pounds overweight, but approved her for weight loss surgery after she gained more.

“I just had two weeks of eating all the junk I could,” Mark said.

In general, a person who is 5-foot-6 and weighs 220 pounds has a BMI of 35. At 250, the BMI climbs to 40.

Gaining Weight for Weight Loss Surgery Regarded as Fraud?

Weight-loss doctors definitely discourage patients from gaining more and instead urge them to pursue non-surgical options, or to find other ways to pay for the surgery. One good reason? Some insurers regard the practice as fraud.

“I tell potential weight loss surgery patients to go home. You don’t qualify,” said Dr. Namir Katkhouda, a bariatric surgeon at the University of Southern California who has performed 2,000 procedures. “They come back six months later and their problems are much worse.”

Recent FDA Decision Affects Millions

The dilemma has been exacerbated by the recent FDA decision, which approved the use of Lap-Band in patients with BMIs as low as 30 with at least one weight-related disease, such as diabetes and high blood pressure. The FDA left the BMI level at 40 for heavy but otherwise healthy people.

The FDA decision opened the door to an additional 27 million people eligible to access weight loss surgery and prompted experts to predict a sudden rush toward lower BMI procedures. So far, despite great interest, that hasn’t happened, said Dr. Robin Blackstone, president of the American Society for Metabolic and Bariatric Surgery.

“The insurance hasn’t expanded to embrace that indication,” she said, noting that less than 1 percent of those eligible for bariatric surgery actually get it. In 2009, nearly 63,000 Lap-Band devices were implanted in the U.S., according to estimates from the Agency for Healthcare Research and Quality.

Insurers prefer that people try other less-drastic weight-loss options, including medically supervised weight-loss programs, said Susan Pisano, a spokeswoman for America’s Health Insurance Plans.

“Many, if not most, insurers look to less invasive, less-risky weight-loss approaches before they move on to the more invasive, more life-threatening weight-los approaches,” Pisano said.

As far as Sears is concerned, the January 2008 weight-los surgery changed her life; she says she doesn’t regret gaining a little weight to lose a lot.

“I would do it again, now that I’ve tasted what it feels like to be normal and not overweight,” said Sears.

Last modified on Friday, 15 November 2013 10:16
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