The costs of obesity-related illnesses are well known to insurance companies, contrary to what some weight-loss surgery providers seem to think (Viewpoint, 9-23).
Insurance companies want to make sure that the services they cover will be the most effective and have the greatest chance of a successful, long-term outcome. Otherwise, the service will simply add to the high cost of health care with nothing to show for it. That is why insurance companies use guidelines when deciding to cover weight loss surgery: Sometimes it works, sometimes it doesn’t.
There are a number of logical reasons why a conventional, medically supervised weight-loss approach and psychological evaluation should be documented first, the most important of which (in my opinion) is that it demonstrates the patient’s ability to adapt to a lifestyle that will be important to long- term success. Reversing obesity requires some sort of behavior modification.
While there have been many well-documented successes with weight-loss surgery, there also have have been failures. I know a few of them personally. These are people who initially lost weight after surgery but eventually gained it back again because they did not maintain a healthy lifestyle.
Weight-loss surgery should be used as a last resort, not a first. And it should only be used on those who truly need it, not by those who simply view it as a cure-all for years of bad behavior.