OAC Community Perspectives by:
Amy Dumont, LCSW, Augustine Counseling, Middlebury, CT; and Tiana Massari, Hartford, CT
Amy’s Story: A Light Bulb Moment for Helping a Friend
I’m a licensed Clinical Social Worker, and I’ve also had bariatric surgery. That’s why it’s difficult for me to accept that access to obesity care is a concern for so many people. I myself successfully had surgery in 2007. I had wonderful insurance coverage for my surgery, as well as my pre and post-op appointments and procedures. Since my surgery, I’ve kept 185 lbs off and my life has changed forever.
Obesity is a complex disease. It’s also related to difficult conditions like diabetes and heart disease. Bariatric surgery is a safe and effective treatment option for obesity. In my case, it was life-saving. It resolved my diabetes, sleep apnea, hypertension and chronic pain. It also improved my quality of life as a mother, wife, daughter and employee. However, many insurance companies exclude it from coverage.
I had the wonderful opportunity to meet a young woman who is full of life and wants to live every day making the best of it. However, this is difficult because she has obesity and obesity-related health conditions. They bring her physical and emotional pain. And yet, the life-changing bariatric surgery that she wants, and needs, is excluded from her insurance policy.
This was my light bulb moment as a Clinician and a peer. I want to spark change for people with obesity to be able to live their best life. In some cases, surgery may be able to offer that like it did for me.
My friend Tiana shares her story of her need to access obesity care below.
Tiana’s Story: Why Access to Obesity Care is Important to Me
I must be honest. Like many adults, I never really thought about or understood the need for good healthcare and health insurance. Until now. I mostly just worried about how much my job would pay me. Would it be enough to pay my rent, light and gas bills so I could get to work each day?
It wasn’t until my mid-twenties that I noticed a difference in my body. I always struggled with my weight, but I never felt unhealthy. However, when I would look in the mirror, I noticed that my hair looked thinner. I also had hair growing on my face, and my skin looked discolored on different parts of my body. My menstrual cycle was also very irregular.
I decided it was time to see a doctor, so I made appointments with a new primary care provider and gynecologist. I was shocked when I found out that:
- I had Polycystic Ovarian Syndrome (PCOS).
- I had high blood pressure.
- I was suffering from sleep apnea (would I really stop breathing in the middle of the night?)
- I was pre-diabetic.
I was scared. As I walked out of my doctor’s office with scripts in hand, I said to myself, “I don’t want to live a lifetime of prescription medications ahead of me.” I knew it was time to make a change. So, I tried different diets, exercised more and I started to see improvements.
I lost 30 lbs. I was so proud of myself. But it’s hard – every day. Now in my 30’s, I find it harder and harder to lose the weight. I gained 20 lbs back from the original 30 that I lost.
“I Just Want to Start Living”
I just want to start living – but not living day by day, trying to survive. I know my health conditions make it difficult for me to lose weight, so I started to look at other options. I saw that a lot of people, some of them similar to me, have had success with bariatric surgery. I want to make this change within myself. I truly believe that surgery is a TOOL that I can use to reach my goals:
- A better job
- A future traveling around the world
- A family
- A date
- The ability to be spontaneous
- Meeting new people
I recently attended two informational sessions on bariatric surgery with my friend Amy (shown above). Amy suggested I look into a CPAP machine to wear at night to have more energy and sleep better. She encouraged me to check with my insurance to make sure I had coverage if I truly wanted bariatric surgery. I said to myself, “Insurance will pay for it, right?”
WRONG! Now I realize that the monthly portion of the health insurance premium which comes out of my paycheck only gives me false security. Why wouldn’t a machine that provides oxygen, an element necessary for living, not be covered under my insurance? The agent on the phone told me it is a covered service, but I have to meet my annual deductible fist. Okay, so what is my deductible? $2,800. I work on minimum wage, so I can’t afford this. I felt so discouraged when I heard this news.
Facing a Grim Reality
On that same call, I also discovered that my insurance excludes bariatric surgery. Even if I try to meet my deductible, it doesn’t matter. It’s still not covered. How does an insurance company founded by doctors not cover and restrict access to this type of care? Care that will help me live longer and feel better.
It’s like I’m supposed to stay sick or quit my job and go on welfare. I’m a strong, independent person, but dealing with this has been very stressful. I feel that I’m never going to get anywhere in life. I try to keep a positive mindset and lean on my support systems, but it’s hard. I hope I can figure out a way to overcome this hurdle in my health. I just really want to start living – not simply surviving from one day to the next.
Will You Help Tiana and Others Facing Similar Health Challenges?
You can help Tiana and others by supporting National Obesity Care Week (NOCW), September 15 – 21. This year’s campaign will focus on raising awareness about access to obesity care and improving it. The OAC is a proud Founding Champion of NOCW, but we need you to support it too!