I found this link in Yahoo! News this morning:
http://story.news.yahoo.com/news?tmpl=story&u=/latimests/20040716/ts_latimes/revisedpolicytreatsobesityundermedicare
According to the story, weight-loss treatments will be covered by Medicare. Here is a partial quote from the article:
"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and to die prematurely," Tommy G. Thompson, secretary of Health and Human Services (news - web sites), said at a Senate subcommittee hearing where he announced that Medicare officials were removing the statement that "obesity itself cannot be considered an illness" from the Medicare manual.
Mr. Secretary, I understand that; but, should I waste more tax dollars for some one that is too lazy to go for a brisk walk, and to homecook a meal? I do not think so. When will the vicious cycle of handouts ever stop?
People need to realize that the only way things will change is for them to look in the mirror, and say, "I am going to do something about it right now! It is time to stop feeling sorry for myself. YES, I CAN! I can do it!"
At this point, I believe, things can change. It all starts with you! The sooner you realize that, then you will be heading in the right direction.
Friday, July 16, 2004
Obesity to be treated by Medicare?
Posted by William N. Phillips, Jr. at 7/16/2004 11:16:00 PM
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I think what is meant by including obesity in with Medicare is not tummy-tucks or something for vanity like that. My impression is that it's for morbidly obese people only who can walk very little or can't walk at all now and live in their beds, wheelchairs, and have to use meat scales to get weighed. American Society for Bariatric Surgery has a lengthy article online titled "RATIONALE FOR THE SURGICAL TREATMENT OF MORBID OBESITY" from late 2001 http://www.asbs.org/html/rationale/rationale.html that goes more into this. In a highlight near the end of their article they say:
"WHAT SPECIFIC RECOMMENDATIONS CAN BE MADE FOR THE TREATMENT OF SEVERE OBESITY?
Patients seeking therapy for the first time should be evaluated by a knowledgeable physician and provided with sufficient information on which to make a reasonable choice for therapy.
In spite of the failure of medical therapy by drugs, diet, behavior modification and exercise to achieve documented long term weight loss in the morbidly obese, it is accepted practice to require that the potential candidate for surgical treatment have made good faith attempts to achieve weight loss by dietary means. Although the segment of the morbidly obese population able to lose significant weight by non-surgical means is miniscule, candidates for surgery must be given the opportunity to try, a proposition which justifies insistence on at least one attempt at dietary weight loss prior to acceptance into a bariatric surgery program.
Decisions on what therapy to recommend to patients with morbid obesity should depend on their wishes for outcomes, on the need for therapy, and on the physicians explanation of options for therapy and the current information on probable safety, efficacy, advantages and risks. The need for close nutritional monitoring during rapid weight loss and the need for lifelong medical surveillance after surgical therapy should be made clear to the prospective patient and their relatives.
The operation should be carried out by a surgeon substantially experienced with the appropriate procedures and working in a clinical setting with adequate support for all aspects of perioperative assessment and management. These include hospital facilities geared to care for the morbidly obese patient, medical specialty availability, psychological support, dietary and nutritional counseling, and patient support groups.
PREOPERATIVE PSYCHOLOGICAL TESTING:
There are two possible reasons for pre-operative psychological testing prior to bariatric surgery. One is to weed out those with significant psychopathology in whom surgery would be contra-indicated, the other to pre-select those in whom the surgery is likely to be a success. Unfortunately psychologic evaluation has proven of limited value in both these situations.
Studies of severely overweight persons conducted before their undergoing anti-obesity surgery have shown a) that there is no single personality type that characterizes the severely obese. b) that this population does not report greater levels of psychopathology than do average-weight control subjects; and c) that the complications specific to severe obesity include body image disparagement and binge eating. Studies conducted after surgical treatment and weight loss have shown 1) that self esteem and positive emotions increase; 2) that body image disparagement decreases; 3) that marital satisfaction increases, but only if a measure of satisfaction existed before surgery; and 4) that eating behavior is improved dramatically. The results of surgical treatment are superior to those of dietary treatment alone. Practitioners should be aware that severely obese persons are subjected to prejudice and discrimination and should be treated with an extra measure of compassion and concern to help alleviate their feelings of rejection and shame. [74]
In addition, numerous studies in the literature attempting to identify patient characteristics related to outcome have been reported, but no reliable psychological predictors of success have been identified. (See Vallis and Ross 1993[75] for a comprehensive review of this area). Only two general recommendations emerge from this study. (1) The more distressed patients are by their obesity , (reflected by exogenous depression) the more likely they are to lose weight and (2) Serious psychiatric disturbance, to the extent that psychiatric treatment or admission is required, appears to be a negative predictor of outcome. While other psychological variables have been shown to be associated with post-surgical weight loss, none have been replicated in independent studies. [75]
Accordingly, routine pre-operative psychological evaluation should be required in patients who have a history of severe psychiatric disturbance or who are currently under the care of a psychologist/psychiatrist. Such patients, and those under the age of 18 years, should be required either to have psychiatric clearance in writing from their counselor or to undergo psychiatric evaluation before surgery. Other patients who wish to have the benefit of psychologic counseling before surgery should be encouraged to do so. Post-operative support can be extremely important, especially for those with preoperative psychological difficulties, and should be actively pursued by patient, surgeon and psychologist/psychiatrist."
I think that if Gastric Bypass (where most of the stomach is cut off) can give somebody mobility and basiclly their life back, I say go for it. This is not for everyone so these surgerys are mainly for saving the person's life not vanity.
Joyce
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