Chasing Hoops for Obesity Care

In the New York Times recently, our friend Maya Cohen described her experiences chasing the hoops set before her by health insurance – interfering with medically necessary obesity care. But she did not stop there. She came to the YWM Engage conference to connect with and inspire other advocates for people living with obesity. So we are grateful that she is sharing more of her story here on ConscienHealth today.

I started dieting at the age of 13. I would lose the weight, gain the weight, and inflict myself with more deprivation and misery. Rinse and repeat. I was never a slender person. Although I was told in college that if I lost some weight I could be a stunning model.

Asking for help is hard for me and asking for help with losing weight is an even harder task. With each diet I lost weight and then would gain it all back. Because I could not control my weight, I felt that I was a failure. Just as everyone told me to, I ate less and I moved more. But still, I hated myself. I continued to nibble around the edges of my excess weight issue and then finally asked my primary care physician for help. I was desperate. He sent me to a dietician and noted that I probably only needed to eat less and move more. I tried this strategy yet again with no results.

Finally, a Referral

My follow up appointment with my doctor had a request: I wanted a referral to a specialist. I had suffered enough. I felt awful physically and mentally. My weight continued to increase and I had done my level best in trying to lose excess weight on my own. He agreed to a referral and admitted that his knowledge in managing excess weight was learned in a class in medical school.

My first appointment with Dr. Caroline Apovian, an obesity care specialist, had the most impact of just about any other day of my life. After my evaluation she said “Maya, this is not your fault. We can help. It will be ok. YOU will be OK.” I cried that day and felt something for the first time – hope.

What I was not prepared for was once you have the help, you might have other challenges in keeping the help. I paid for Saxenda (liraglutide) out of pocket for several months at a cost of about $1,500 a month since my insurance company informed me that they would cover some methods of treating obesity, such as bariatric surgery, but they would not cover the cost of medication to treat obesity. The simple reason was because they consider medications used for “weight loss” to be “vanity drugs.” Those were the exact words that were used on the phone that day. Vanity drugs.

Good News and Bad News

Ultimately, the good news for me was that I was able to switch to a related drug called Ozempic (semaglutide) and get it covered by insurance. But the bad news was that it was due to type 2 diabetes. My insurer covers Ozempic for diabetes treatment. Obesity treatment should not be a second-class consideration.

My story is not unusual. My story happens every day in offices around the country. Patients seeking obesity care should have access to all the tools their care teams have. It is that easy and that hard, all at once.

Girl with a Hoop, painting by Oleksandr Bogomazov / WikiArt

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August 1, 2022