The Kratons Vaudeville Hoop Act

Hoops to Delay and Discourage Obesity Care

Hoops are fine tools for play and entertainment. But the hoops which health insurers put people with obesity through serve only to delay and discourage obesity care. The implicit message is clear enough: “You probably don’t deserve this, so you have to prove yourself first.”

A recent study demonstrates once again that these insurance mandates do nothing for the health of a patient. Co-author Deborah Hutcheon explained that any belief these programs might be helpful is completely disconnected from the evidence:

“Believing is one thing, proving is another. Patients in the insurance-mandated weight management programs did not achieve greater weight loss before or after bariatric surgery, did not have fewer post-operative complications, and did not have better resolution of obesity-related diseases when compared to patients who had no such insurance requirement. The data shows the requirement only served to diminish outcomes and unnecessarily delay patient access to a life-saving medical intervention.”

Retrospective Analysis

This study analyzed 1,056 patients who underwent either gastric sleeve or gastric bypass surgeries between 2014 and 2019. Among those patients, 277 had insurance requirements to complete a weight management program before their surgery. The remaining 779 patients had no such requirements.

Three years later, the patients without the extra hoops before surgery were actually maintaining a greater reduction in body weight than the others, though the difference fell short of statistical significance.

What was significant was the delay of two to three months in getting to surgery experienced by people with the extra insurance hurdles. The conclusion of the investigators was succinct:

“Insurance-mandated WMP completion before bariatric surgery delays patient access to surgery without improving postoperative weight loss potential and must be abandoned.”

A Meaningless Performance

These rituals of insurance mandates add up to a meaningless performance that can only delay and discourage patients from effective obesity care. The implicit message – maybe you should try DIY weight loss again – is frankly an insult to people who often have been doing this over and over for their entire lives.

It’s medically unnecessary and cruel. We have no doubt that the day will come when health insurers can no longer get away with this unethical practice.

Click here for the study and here for reporting on its presentation earlier this year. For further perspective on insurance hoop games for obesity care, click here.

The Kratons Vaudeville Hoop Act, photograph from the J. Willis Sayre Collection of Theatrical Photographs / Wikimedia Commons

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December 12, 2022

One Response to “Hoops to Delay and Discourage Obesity Care”

  1. December 12, 2022 at 9:45 am, Allen Browne said:

    People with the disease of obesity need what they need when they need it! Quite simple. We have the tools and we have the data. Time to move on to a new patient centered paradigm guided by respect and by improving health.