Lasting Change – Plastics after Bariatric Surgery – Part 3

Our Case

Tammy Farrell

Body Contouring Surgery. Reconstructive Surgery. Wellness. Did I miss anything?

In parts 1 and 2 of this guest blog series, we identified the need for bariatric surgery patients and others who have lost significant amounts of weight to have their excess skin removed in order to achieve the long lasting benefits that the weight-loss has brought them. The evidence is there. Solid research.

Doctors and researchers have proven in controlled studies that:

      • Body contouring surgery after major weight-loss greatly improves patient success at maintaining their physical and health benefits that were derived from that weight- loss.
      • Physical quality of life is improved after bariatric surgery but mental quality of life as measured by stress and anxiety is lower for bariatric surgery patients who have not undergone body contouring surgery.
      • The majority of patients (88 percent!) want to have excess skin removed following bariatric surgery.
      • Cost is THE major barrier for bariatric surgery patients which keeps them from having their excess skin removed following their bariatric surgeries.

Canada recognizes the need for reconstructive surgery after significant weight-loss and provides 100 percent coverage to patients who meet their eligibility criteria. The primary considerations are maintaining a steady weight and having a weight-loss of 100 pounds or more.

The Need
One of the primary takeaways from ObesityWeek 2013 for the bariatric team of the Mayo Clinic in Scottsdale Arizona (and presumably many others) was the clear need to focus on the long term success of bariatric surgery patients and others who have lost significant amounts of weight.

Integrating body contouring surgery into a comprehensive medical plan of treatment for obesity is the perfect place to start.

The Chicken and the Egg
I haven’t (yet) been able to decipher which effort needs to be done in what order but I’m all about doing my PART to make things happen. (You may recall reading the Our Members Matter article in Your Weight Matters® Magazine Spring 2014 where I define doing my PART as working concurrently on Prevention, Awareness, Research, and Treatment.)

Here are some of the many things that we need to do with the information we’ve learned about body contouring surgery after major weight-loss –

    • Body contouring surgery must be re-categorized from being considered cosmetic surgery (elective surgery entirely focused on enhancing physical appearance) to being classified as reconstructive surgery (plastic surgery correcting dysfunctional areas of the body). These are some of the groups that can help make it happen.
    •  Medicare and Medicaid need to recognize and adopt body contouring as a covered benefit.
        • Their current coverage. I wasn’t able to find a reference to body contouring or even panniculectomy coverage so this is the basic coverage link of what’s available now.
        • How do Medicare and Medicaid coverages get changed? Congress. Be an advocate.
        • As goes Medicare, so go private insurers? Usually. It doesn’t have play out in that order though. YOU can lead the way on this.
        • We know the actuaries will want data to determine the premium rates. They can calculate 13 years of premiums that companies will lose for each person who weighs 100 pounds in excess of their healthy weight range. Statistics show that that’s how much sooner they’ll die than people not personally affected by obesity. Add on the costs of treating diabetes, heart conditions and knee surgeries for decades before that and the premium rate should get to a reasonable number.
        • To the stockholders – Obesity is a chronic disease and the healthier the public is as a whole, the better off your companies will be.
        • Don’t wait for the other guy. Start a trend. Be the first to cover it.
    • Employers need to include body contouring…in addition to bariatric surgery and other weight-loss treatments in their coverage.
        • This is another societal concern. Don’t think short term. Think about your brothers, your best friends, and the staff in who answers the phones who will remain healthier after their initial weight losses.
        • Insurers will write coverage for anything thing you ask. Start asking.
    • Each state must make a determination that Reconstructive Surgery After a Major Weight Loss is an “Essential Health Benefit” in order for them to mandate coverage under the Affordable Care Act for individuals and small groups.

Take Action
That should keep you plenty busy.

What will I be doing? I’ll continue to advocate for all of the above …and then some! And I’ll be over at my kids’ school this week to check in on the Healthy Kids program that I implemented with the great folks from the Mollen Foundation. I still want to get the recess activity program off the ground too and I’ll be taking another parent up on her interest in getting it rolling. There is strength in numbers…even when it’s just two!

Don’t forget that ObesityWeek 2014 is coming up shortly from November 2nd to November 7th. I’m excited for the Obesity Action Coalition to be holding their first Your Weight Matters Local event right there in Boston! It’s awesome that they’re taking it local and you can bet I’ll be there when they get back to Phoenix. Their YWM National Convention was held here in 2013 and provided incredible content to all the attendees.

I hope you’ll join me in following the research and information that will come from the thousands descending on Boston during ObesityWeek and work to spread the word in your own communities.

Jumping back to Plastics
You’ve now got a list of several steps and various organizations that can help move things forward toward getting adequate care and coverage for people affected by obesity. Including coverage for reconstructive surgery after major weigh loss makes sense. And it’s the right thing to do.

Don’t leave yet! Share with me what YOU will do in the comment section below or privately if you prefer. Together we SHINE.

About the Author:
Tammy Farrell, CPC, CPA, CFE, is a professional wellness coach who specializes in working with fellow bariatric patients in Scottsdale Arizona and nationally via phone calls, webinars, and Skype. Tammy’s company, Believe In Action Coaching, provides personalized guidance, group programs, and workshops as well as free monthly support groups, newsletters and resources for her community. As a mom to two young boys, Tammy loves to keep them active and curious about the world around them.

Disclaimer: This blog post does not reflect the views of the OAC, the National Board of Directors or staff. Information contained in this blog post is based on scientific research that has not been validated. The OAC does not endorse any merchandise or program mentioned in this blog post.

3 Comments for this Post
  • Jennifer Cooledge
    November 18, 2014 at 3:58 pm

    How does one who has limited knowledge of how legislation works or how to advocate for such things to congress go about this? I’m very interested in taking part in making this happen in New York state. Can you give any advice or point me in the right direction, websites perhaps, to work on this? Thank you.

    • Tammy Farrell
      November 18, 2014 at 7:38 pm

      That’s great Jennifer! I love to hear about people who want to make a difference. :) The OAC’s site has an advocacy page that provides a walk through of different ways you can help. Here’s the link:

      They walk you through everything from teaching how laws are made to providing links and templates on who to contact in your state. If you haven’t already joined the Obesity Action Coalition, becoming a member is really the easiest first step to make a difference.

      I was able to attend the National Advocacy Training Session at the Your Weight Matters Convention held in Orlando this year. It gave me insight on how to best tell my story as well as gave me exposure to meet and talk with lobbiests that the OAC works with to promote it’s mission “The OAC is dedicated to improving the lives of individuals affected by the disease of obesity.”

      Thanks for reaching out Jennifer. Feel free to follow up with the OAC staff if you have additional questions about how you can help.

      Best of luck and hope to see you at the Your Weight Matters Convention in San Antonio next year. :)

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