Question:
What if the insurance recomends another diet- THE OPTIFAST PROGRAM-
HHS SERVICES IN COLUMBUS WANTS ME TO DO A FASTING PROGRAM FIRST. NO FOOD FOR 12 WEEKS. JUST WHAT I NEED ANOTHER DIET. HAS ANYONE EVER DEALT WITH THIS ONE? — NATALIE S. (posted on March 4, 2001)
March 4, 2001
I did Optifast last December. I lost 5cm of hair. Quite a little bald
spot. The dermatoligist said it was from stress. I found out that I was
also pregnant and the same time, and miscarried. Overall though Optifast
sucks. Its proven unsuccessful time after time. Most people gain it back,
plus. However most insurance companies do require a medically supervised
diet or two prior to approval. Perhaps theres something else you could do
like Meridia? Thats also medically supervised. I cannot believe that they
would require one specific diet. Especially one that doesnt have great
success.
— [Anonymous]
March 4, 2001
My insurance co. is making me attend a three month weight loss program with
a registered dietician. I think you should find out if you can try
something else instead. I was taking xenical without success. I think
they just want documentation that you tried something else first. Good
Luck.
— Tammy W.
March 4, 2001
I did this program in 1996 and within one year of leaving it, I began
gaining the weight back. When I started it, I weighed 325, and I've gained
it all back, plus an additional 50 pounds. I personally don't recommend
it, and I doubt the insurance company would pay for it (because mine
certainly didn't - they said it was not approved for payment due to a low
success rate). I would personally appeal this if I were you. Good luck!
— Dee P.
March 4, 2001
Ask them for proof that Optifast has long-lasting results. As far as I
know the only thing that has long-lasting results re morbid obesity is
surgery.
— Mary H.
March 4, 2001
I did opti-fast around 1990 I did'nt think it was even still going the
failure rate is so hi.
I ended up in the hospital bad diet.
Of course you'll loose weight anyone would loose weight on it . Does your
insurance want to pay for it? It's very expensive and very bad for you .
— Mike H.
March 4, 2001
I participated in an Optifast program 12 years ago. The program itself is
highly successful during the fasting phase, but it has a greater than 98%
failure statistic for long-term maintainence of weight loss. The programs
that were operational in our part of the state closed down within 2 years
of my participation, and have not reopened. There were a high number of
participants in my groups who developed low potassium levels, requiring
frequent labs, physician monitoring, and potassium supplementation. It is
an expensive program to join, and at the time that I belonged, no insurance
companies were paying for the protein supplements...another high-dollar
expense not covered in the original joining fee. So, your insurance
company needs to be aware that it is asking you to participate in a highly
expensive, medically-unsound program with a statistically overwhelming
failure rate. WLS, on the other hand, is also expensive but has the
participative backing of board-certified bariatric surgeons and the
American Society of Bariatric Surgery and is a medically-proven procedure
with an extremely high success statistic for long-term resolution of morbid
obesity and the high costs of ongoing medical/pharmaceutical care involved
with this disease. In the global picture, your insurance provider will end
up paying out far less money for WLS now, compared to the amounts required
for your ongoing health care maintainence over the years to come if they
deny your WLS. Good luck!
— Diana T.
March 4, 2001
I agree with everyone who's posted, this is ridiculous. If you need a
supervised diet, there are far better options. I would discourage
medications though. They have a very high expense and a very low succcess
rate as well. Plus, the side effects can be much worse than obesity. If
this insurance company is so smart, they should refer you to a dietitian,
let that person monitor you for a little while. No, that probably won't
work either, but it's the least dangerous way to get medical supervision.
If you need documentation about failure rates of non-surgical approaches,
email me, I've found some great research. Stay strong, if this Ins.
company is this stupid, they probably will be no match for a good appeal.
— kcanges
March 5, 2001
I agree... they might as well throw out the money for the Opti-Fast right
out the window!!! I have done that program 3 times, all 3 times I did
sucessfully lose weight, until the refeeding stage. It does have better
than a 98 % Failure rate. I had one dietitian tell me that you can gain
weight no matter what you eat upon refeeding because it messes with your
metabolism. It was a waste of my time, MY money since the insurance didn't
pay for it. I would write or speak to your insurance company and try to
reason with them. Diane C.
— Diane C.
March 5, 2001
I went through OptiFast in 12 years ago at the age of 20. I lost 56 pounds
and managed, miraculously, to keep it off for about a year. Then, back it
came with much more fat for my trouble. I felt like a total failure and
decided I was never going to go on another diet again. Then a couple of
years later my new PCP found a lump on my thyroid gland. Big surprise, I
had a tumor. When he started me out on Levothroid, I lost twenty pounds in
a month, but of course could not take that high of a dose. He lowered it by
half and since then I have been on .05mcg after having the tumor and left
lobe of my thyroid removed in 1993. I have steadily gained weight, lost it
again on Redux/Phentermine, and gained it back. Now I know WLS is the only
way I can lose the weight. Your insurance isn't looking at the big picture
here, if they were they'd see they were paying out money on a program that
doesn't have the success rate that WLS has been shown to. I'm with everyone
else, appeal.
— Diana M.
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