So my husband is obese, at 6' he's 350+lbs. I have been trying to get him to eat healthy & exercise but being in the oil field & gone for 2 weeks at a time there's no way I can get him to exercise or control what he's eating when he's gone. He wasn't always over weight.
As a teenager he was in shape & as an adult he was too. But when we got together we developed bad eating habits which got worse when I got pregnant. We both gained over 100lbs. I lost the weight after I had our son, he however hasn't stopped. Of course it's easier for me since I'm a stay at home mom. But he still eats garbage & drinks his calories. Plus he doesn't exercise when he comes home.
So I finally got my husband to see a doctor & to no one's surprise he is pre-diabetic & has high blood pressure. I guess that shocked him because he changed his eating habits, starting walking when he could when he was at work & said he would exercise with me when he came home.
Then the doctor put him on weight loss meds. First came Contrave, it worked GREAT! He ate so much less & lost weight. But he slept all the time and at a price tag of $200-$300 a bottle. It was expensive! But to me, I felt it was worth it. But my husband started to hate feeling tired all the time, I don't blame him. So he went back to the doctor & asked for new medication.
That's when she prescribed Saxenda and the insurance didn't even cover that! So at an even higher price tag of $1,000 a pop I said no way! So with another appointment coming up I'm hoping maybe there is another medication he can get that might be covered. But at this rate I'm not too hopeful.
I just have to wonder, why? Why doesn't the insurance company cover weight loss meds? He needs it, he is clinically obese. It's not like he's taking it to lose 20-30lbs. If he loses the weight his blood pressure will go down & he won't be pre-diabetic. I'm also thinking it would be cheaper for him to get gastric bypass ($1,200) than spend $200-$300/month on pills. Isn't that ridiculous? Thanks insurance companies & your horrible, backwards thinking!
Shouldn't we be trying to keep people *out* of the hospital? Prevent people from having surgeries? Lower the rates of comorbities? How is having to pay extremes for weight loss medications helping that?
If he's pre diabetic, why not ask if he can try something simple like Metformin ER first? It's pretty cheap and works great for some people to help them. Ask if he can see a registered dietitian - most insurance covers that. Have an actual full fat percentage done that uses calipers and muscle mass workups to get an accurate number for his overall fat/muscle ratio - after all Sylvester Stallone is considered "obese" if you just look at Height/Weight BMI numbers.
Yes he works in the oil field all the time, but he can still go for a walk for 10 minutes, take the stairs, or do 50 jump jacks and 50 leg lunges when he gets up in the morning, park his vehicle farther away from the front door. Food wise, have him keep a food diary for two weeks and BE HONEST so he can review it with his MD. Start REALLY SMALL with diet changes and exercise - that's the easiest way to change things. Switch to water from soda, ask for things without mayo, eat an apple instead of potato chips. Continue to make small changes every 2 weeks. As someone who is overweight myself, I find that the small things are MUCH easier to start with than trying to go all in 100% because that's just overwhelming and frustrating.
Please please please, DON'T hound him. Nothing makes a fat person want to quit more than someone nagging all the time about "you need to lose weight, I'm worrried." I know you are worried, I'm worried too, but stress just increases my cortisol levels, which makes it harder to lose weight.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
What about Qysmia? Even if insurance doesn't cover it, your PCP could write him an RX for Topimax and Phentermine - it's the same thing!
He was going to look into medication next. I didn't even think about asking the doctor to write a script for the two meds separately!
I talked to the insurance company & they don't cover ANYTHING for weight loss. Not meds, not the gastric bypass, NOTHING! Which makes me wonder why they told my husband they would if the doctor told the insurance it was medically necessary.
My husband does go for walks when he isn't out on a job. I will get him to start a food diary. I hope he will stick to it.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
If he's pre diabetic, why not ask if he can try something simple like Metformin ER first? It's pretty cheap and works great for some people to help them. Ask if he can see a registered dietitian - most insurance covers that. Have an actual full fat percentage done that uses calipers and muscle mass workups to get an accurate number for his overall fat/muscle ratio - after all Sylvester Stallone is considered "obese" if you just look at Height/Weight BMI numbers.
Yes he works in the oil field all the time, but he can still go for a walk for 10 minutes, take the stairs, or do 50 jump jacks and 50 leg lunges when he gets up in the morning, park his vehicle farther away from the front door. Food wise, have him keep a food diary for two weeks and BE HONEST so he can review it with his MD. Start REALLY SMALL with diet changes and exercise - that's the easiest way to change things. Switch to water from soda, ask for things without mayo, eat an apple instead of potato chips. Continue to make small changes every 2 weeks. As someone who is overweight myself, I find that the small things are MUCH easier to start with than trying to go all in 100% because that's just overwhelming and frustrating.
Please please please, DON'T hound him. Nothing makes a fat person want to quit more than someone nagging all the time about "you need to lose weight, I'm worrried." I know you are worried, I'm worried too, but stress just increases my cortisol levels, which makes it harder to lose weight.
The insurance won't cover anything for weight loss. Not a thing. I found that surprising & disappointing.
He goes for walks as often as he can & usually walks for 2-3 miles. But if he's out on a job, which can be 5 hours-36 hours, there's no time for exercise. But he does it when it's slow.
I will tell him about the food diary, I haven't thought about that. He is a big chip eater. He also makes bad food choices. This morning for breakfast he stopped at a convenience store & got a blue berry muffin for breakfast. I have told him what is a better choice but he goes for what is tasty vs what is healthy.
I try not to hound him, it's just frustrating when I tell him what the right food choices are & he ignores me. Same with the exercise. I gained a lot of weight but I lost it all as well.
Specializes in Psych, Addictions, SOL (Student of Life).
Well with him being in the oil field, he doesn't have time to do WW. We need to do what works for him.
I have found that when dealing with Insurance companies - you have to be very proactive. First you need to get a list of all medications in their formulary. Then you need to get a phone number for the Insurance company and start calling. Get a notebook and keep notes of who you talked when and what was said. Insurance companies are slow to cover medications and treatments for what are considered "Lifestyle disease's". You need to show what you are doing before the medication that did not work. This proof comes from your doctor in the form of a history saying a diet was started and maintained and no weight lost for 6 months to a year.
WW is avaliable on line - you don't have to go to meetings - I also strongly reccomend Dr. Phil's 20/20 diet plan - the diet is specifically designed to address metabolic syndrome and almost any meal needs only a few tweeks to meet the plan. Remember - Pills will help him lose weight but not keep it off, So he's going to have to develope some good habits.
My own Insurance company will not cover any weight loss drug unless you have had intensive weight loss counseling.
So first your doctor needs to resubmit a prior authorization claim - and go from there.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I have found that when dealing with Insurance companies - you have to be very proactive. First you need to get a list of all medications in their formulary. Then you need to get a phone number for the Insurance company and start calling. Get a notebook and keep notes of who you talked when and what was said. Insurance companies are slow to cover medications and treatments for what are considered "Lifestyle disease's". You need to show what you are doing before the medication that did not work. This proof comes from your doctor in the form of a history saying a diet was started and maintained and no weight lost for 6 months to a year.
WW is avaliable on line - you don't have to go to meetings - I also strongly reccomend Dr. Phil's 20/20 diet plan - the diet is specifically designed to address metabolic syndrome and almost any meal needs only a few tweeks to meet the plan. Remember - Pills will help him lose weight but not keep it off, So he's going to have to develope some good habits.
My own Insurance company will not cover any weight loss drug unless you have had intensive weight loss counseling.
So first your doctor needs to resubmit a prior authorization claim - and go from there.
Thanks everyone. I don't want him to take an easy way out because I know the easy way won't lead to permanent changes. He knows he needs to change his eating & exercise habits but I don't know how to help him with that. I really want to thank everyone for all of their great information! :)
He's not on any medication now to lose weight. So for now I might get him to write down what he eats, get that book & exercise. If that doesn't work then I'll go to plan b (get him on meds & talk to the insurance).
Maybe try victoza? It's the same med as saxenda just a lower dose and marketed for diabetics. I'm insulin resistant not diabetic and my insurance is covering it for me. It's worth a try.
One will NEVER be able to understand all of the decisions insurance companies make. Once you get to understand a plan and what is covered- they change it . Some months the brand name is covered, others it is generic only.. Then as a PP discussed - something can work for years and since it is working they want them to try something else. It will make you lose your mind if you try to make reason out of it.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
One will NEVER be able to understand all of the decisions insurance companies make. Once you get to understand a plan and what is covered- they change it . Some months the brand name is covered, others it is generic only.. Then as a PP discussed - something can work for years and since it is working they want them to try something else. It will make you lose your mind if you try to make reason out of it.
What gets me is he talked to them on the phone & they said "Oh yeah, you only have to pay $1200 for lap band." But then when I emailed them they said it wasn't covered, AT ALL.
I understand he should try to lose weight on his own first. I want him to try to. But it's frustrating to get two different answers. I don't get it.
I'm trying to help him. I want him to lose weight on his own. Because I know the medications & surgery is only temporary if he doesn't change his lifestyle. But Oy vey!
Best wishes to your husband on his weight loss journey!
I finally committed to getting my butt in gear and start losing weight. I'm currently 5'5 and about 250ish lbs. I'd lost a lot of weight back in 2011, but then gained it all back when I had to stop going to the gym for personal reasons. I looked into the C25K program this time (starting today actually), but am at a loss for what to do foodwise b/c I just don't like many things at all and usually don't have money to buy healthy food. At this point, I don't overeat, I just eat too many of the wrong things. >.
But thanks for creating this thread. Reading through the comments has given me a bit of a starting point. :)
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Best wishes to your husband on his weight loss journey!
I finally committed to getting my butt in gear and start losing weight. I'm currently 5'5 and about 250ish lbs. I'd lost a lot of weight back in 2011, but then gained it all back when I had to stop going to the gym for personal reasons. I looked into the C25K program this time (starting today actually), but am at a loss for what to do foodwise b/c I just don't like many things at all and usually don't have money to buy healthy food. At this point, I don't overeat, I just eat too many of the wrong things. >.
But thanks for creating this thread. Reading through the comments has given me a bit of a starting point. :)
It's so easy to gain weight, if only it were as easy to lose it. I'm 5'2" & got up to 220lbs during my pregnancy. Thankfully I have lost most of the weight, there are still some stubborn pounds that won't come off. If you can't go to the gym have you looked into workout dvds you can do at home? There are at lot of options! That's what I have done & lost the weight that way.
I started with Shaun T's T25 then went to Insanity Max:30. I then went to the HIIT workout Stronger. I also use FitnessBlender because they have a bunch of different workouts. Good luck!
It's so easy to gain weight, if only it were as easy to lose it. I'm 5'2" & got up to 220lbs during my pregnancy. Thankfully I have lost most of the weight, there are still some stubborn pounds that won't come off. If you can't go to the gym have you looked into workout dvds you can do at home? There are at lot of options! That's what I have done & lost the weight that way.
I started with Shaun T's T25 then went to Insanity Max:30. I then went to the HIIT workout Stronger. I also use FitnessBlender because they have a bunch of different workouts. Good luck!
I used P90x for a long time and got in the best shape of my life (abs and all) but one day I hurt my back doing it so I decided to just lift weights and run. Now I'm huge from lifting and enjoying my three times a week 3 mile runs. The tapes are great one just has to be careful. Oops, time for my daily run!!
But he does it when it's slow.
. Some months the brand name is covered, others it is generic only.. Then as a PP discussed - something can work for years and since it is working they want them to try something else. It will make you lose your mind if you try to make reason out of it.
DowntheRiver
983 Posts
What about Qysmia? Even if insurance doesn't cover it, your PCP could write him an RX for Topimax and Phentermine - it's the same thing!