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August 18th, 2009
08:45 AM ET

Should Insurance Cover Gastric Bypass Surgery?

Should Insurance Cover Gastric Bypass Surgery?

Jake Paikai is 22 years old and weighs more than 600 pounds. He can’t walk more than 20 feet without getting winded. He can’t reach his own shoes or ride in most cars.

Jake wants gastric bypass surgery, is afraid without it he’ll die soon. But his mother’s health insurance won’t cover the surgery and he can’t afford it on his own. So he’s started a web site and hopes through that he can raise money for the surgery…not just for himself but for others in his situation.

Gastric surgery costs tens of thousands of dollars. Our question for you: should insurance cover gastric bypass surgery?

Post your comments below.


Filed under: Heidi Collins • Rick Sanchez
soundoff (91 Responses)
  1. masimons

    cheaper band lap ok

    August 18, 2009 at 8:53 am |
  2. Robin

    I think insurance should cover the surgery as long as all other options have been exhausted and documented. For example, if the patient shows up to a doctors office weighting 600lbs and they have not tried dieting and exercise then the insurance should not cover it. The surgery shouldn't be the first option.

    August 18, 2009 at 8:57 am |
  3. michael armstrong sr.

    Rick yes they should either pay for his surgery or else get a long stick and tie a humburger to the end of it and let him chase the burger.

    August 18, 2009 at 9:04 am |
  4. Karen

    Absolutely insurance should pay. I had this surgery in 2003 when I weighed nearly 300 lbs. My insurance company approved it and then after I had the surgery they changed their mind and didn't pay. I had massive financial and legal problems after that, but the surgery changed my life. I no longer have type II diabetes, high blood pressure, high cholesteral and all the other things that posed future dangers for me. The surgery ended up lowering my overall health care costs. The insurance companies need to look at the results.

    August 18, 2009 at 9:05 am |
  5. benpeters

    Yes insurance should cover it, for some it could be life-changing and saving.

    August 18, 2009 at 9:08 am |
  6. Charlie Erickson

    Dieting and exercise usually is only be part of the answer, when dealing with people who are "morbidly obese".

    Any treatment which has shown to be effective needs to be covered.

    Again, this is the insurance companies' attempt at determining one's fate, for the sake of profit.

    Charlie.

    August 18, 2009 at 9:12 am |
  7. suhail khan

    if some one cannot tie his or her shoes i guess that person needs help and yes...............but there should be a clear guide line some needy person can use the same money for some serious situation

    August 18, 2009 at 9:12 am |
  8. Sharon,Daniel Island, South Carolina

    YES! and follow up treatment

    August 18, 2009 at 9:18 am |
  9. Kenny J Clements

    Hi:I am a middlle of the road Canadian.Glad to see a reporter with enough guts to tell it like it is.Those who would bring back the witch trials in Salem(Crazy right wing) Must really dispise you.Go Rick Go.

    August 18, 2009 at 9:42 am |
  10. Leigh

    In a life threatening situation, I say it should be covered. However, many in our society lead unhealthy lives and become obese. In these instances, it should not be covered. Try dieting!

    August 18, 2009 at 9:51 am |
  11. Karla

    Absolutely!! His life is in imminent danger. I had gastric bypass 5 years ago and it has changed my life. I would never go back. I lost over 100 pounds (which is what I needed to lose). My insurance did eventually cover the surgery. It took many many letters from all my physicians and many appeals through the insurance company. But, it was eventually covered. I found out 4 days prior to my surgery date.

    I absolutely believe in this surgery and if he truly wants it and understands the life change it will create then he should have the right to it and insurance should be required to pay for it – it is medically necessary in his case.

    August 18, 2009 at 9:54 am |
  12. Ivan Vazquez

    Here we have an example of not taking responsibility and then hoping that someone else will fix it for us. But, since it seems that responsibility is near dead, I guess that the answer is not all the cost. My first reaction was to say no at all. Overeating is in part a mental problem, and must be part of the solution. Now, if you ask me should the goverment pay for it, then without thinking I'll say NO.

    August 18, 2009 at 9:54 am |
  13. kathy kent

    first of all how in ??? name could his mother allow him to get to that weight and size,
    second, how about working with a dietician and instead of gastric bypass buy a treadmill and use it,

    August 18, 2009 at 9:57 am |
  14. Rosalynn

    Yes his insurance should pay for it because its not the tax payer responsibility!!!!!! I'm tired of paying for peoples problems i have to pay for my own and so should everyone else!!!!

    August 18, 2009 at 9:59 am |
  15. John

    As a registered nurse who has cared for hundreds of gastric bypass patients I can assure you that this is not an operation to be taken lightly. The justification of insurance paying for the surgery is that morbidly obese patients have numerous "co-morbity" or other health care problems such as hypertension, apnea, diabetes, hip and knee replacement potential and many other things. In the long run, gastric bypass is cheaper than paying for all of the other treatments that would be necessary without it. Also, many obese people have serious psychological issues resulting from sociatal rejection–you should see the happiness on their faces when I have seen them after they have lost hundreds of pounds! One woman told me with tears running down her face how proud she was to be able to walk into a department store and purchase underwear "off the rack." Such a simple thing for most of us but unreachable for the obese.

    August 18, 2009 at 10:00 am |
  16. Greg Varner

    It seems to me the real death squads already exist. They comprise those who would deny a young man gastric bypass and those who would not accept diabetics into their group co-op.

    August 18, 2009 at 10:02 am |
  17. R.E. Dalmeida

    I am doctor and have taken care of this type of patient. At this weight he is a walking medical emergency. Insurance should not only cover the gastric bypass, but the plastic surgery needed later to remove the tons of excess skin he will need removed. So should his surgery be covered–yes, yes, yes.

    August 18, 2009 at 10:02 am |
  18. Rene Monroe

    Well I am kind of torn on this. I mean what do we know about him? Does he have some kind of genetic/physical condition that is causing him to gain weight, or does he just love crispy creams. I am sorry but if he is not pursuing other means of trying to lose weight then the insurance company should not have to pay for this. It is nothing against him, but people should help themselves first and then seek the help and generosity of others second.

    August 18, 2009 at 10:03 am |
  19. Vbeck

    Is his health in danger? Will this surgery increase his quality of life ? Has his doctor recommended this procedure? If yes, then the insurance should pay

    August 18, 2009 at 10:04 am |
  20. AndreinFL

    At 600 pounds I dont think diet will help him. Just do the surgery and monitor him. I can't fathom how one can get to his size. This is what happens when you allow someone to eat 8 servings plus a day. be healthy everyone, and if you have a family member going down this path, help them forcefully if needed.

    August 18, 2009 at 10:06 am |
  21. george in MD

    NO...NO... that was hi life choice ...continue eating good right? at 200 and 300 without ever effective thinking.
    I say absolute NO made your bad you can .....you know the rests...this new healthcare plan is a another form of welfare for risk takes and think-less folks.

    August 18, 2009 at 10:06 am |
  22. Nola Ellington

    I think the insurance should pay for the Gastric Bypass for the young man. There will be lots of health problems for him and possibly the expenses of a heart attack.
    I had Gastric Bypass even though I did not weigh as much as some people who get it. I had diabetes and was able to stop taking any diabetes medication even before I left the hospital.
    Research has shown that if a person with diabetes has sugery to remove the first 12 inches of small intestine it cures the diabetes. They realized this when they saw that all Gastric Bypass patients had diabetes cured even before they started losing weight from the surgery.

    August 18, 2009 at 10:09 am |
  23. Karri

    Insurance companies should certainly do anything they can to help someone avoid death. I hate that they deny so many people but continue to collect premiums. Both of my parents have many illnesses and we have weight issues on both sides. But, there is good news and hope for your situation like nothing you can imagine if you can embrace it. It has been a God-send for us. It's a product called Isagenix that I found because of my health issues. I KNOW that it will help you, too. I just came from their annual conference and there were many, many folks who had lost A LOT of weight. The biggest loser on stage had lost 358 lbs!

    The obesity issues that a lot of people are experiencing today are not their fault. The problems stem from chemicals in our food, water, air, and various consumer products that we are exposed to daily. The body's protective mechanisms can cause a person to gain weight and no typical diet regime will address helping you release those toxins so that you can then begin to lose weight as nature designed.

    Isagenix is supported by many Gastroenterologists and other medical professionals. You should really consider it and change to a doctor who is open to both eastern and western treatment methods. I believe it is the best option for you at this time and am glad to suggest it.

    I will keep you in my prayers. God be with you in your health journey!

    karri@cleansenutrition.com

    August 18, 2009 at 10:11 am |
  24. Cameron Wilson

    It is easy to say that one should be responsible for one's own health costs when the person stating that is healthy. Remember, power and strength in numbers; if everyone helps everyone, everybody benifits in the longterm. A country is stronger as a whole, not as a splintered disunited unit. Help the man, for if you were in his shoes I suspect that you maybe would not ask for help but would long for it internally.

    August 18, 2009 at 10:11 am |
  25. Paula

    The only way that insurance should even consider paying for a Gastric Bypass is you (HAVE) High Blood Pressure, High Cholesterol, Diabetes, or Heart Disease not just because you are obese and are looking for a quick fix. I have a friend who took classes on how to keep the weight off before she ever had gastric bypass, since her gastric bypass and since she has recovered from the surgery she has went back to her old eating habits. She has a ring in her esophagus that just allows so much food to pass through so she ends up eating what she can at a restaurant and then takes the rest to eat later which is usually right after she leaves the restaurant and once again is gaining weight/ What's wrong with this picture? She learned absolutely nothing of what she should have about eating smaller meals because now she eats like a bird which is all of the time! Gastric Bypass should be the last alternative to weight loss not just a quick fix to be thin!! With her age she figures by the time she would ever get really obese again she will no longer be here on earth! Lap Bands are much less evasive and have proven over time to provide weight loss. Like my doctor tells his patients you did not put all the weight on overnight and you are not going to take it off overnight!!

    August 18, 2009 at 10:22 am |
  26. Denise Roberts

    There are at least 3 problems with requiring insurance companies to pay for gastric by-pass surgery that come quickly to mind for me....

    1. It enables those who eat themselves into oblivion to carry on with knowledge that they can press the reset button when they're ready by having this type surgery at the expense of others.

    2. A gastric by-pass surgery free-for-all would bankrupt insurers or gov't (just look at the obesity rates - that's a lot of surgery)

    3. The surgery does not address the underlying issues. The behavior will not change by surgery alone. It requires a multi-prong approach, along with a huge dose of personal responsibility and behavior changes.

    This young man can loose the weight the good old fashioned way - eat less, eat healthy, and move his body more - and he can do all that at no cost to him or his fellow citizens!!

    August 18, 2009 at 10:25 am |
  27. chrisco71

    I feel for him his insurance could cover it but they don't. He probably did this to himself. Alot of happy meals when he was younger? I have Type 2 Diabetes, I gained weight while in the Army. I have insurance and have to pay for my medications. This is one of the few reasons I have against public health government insurance is the obese wanting ELECTIVE Surgeries. He should do some serious weight loss if he wants to.

    August 18, 2009 at 10:27 am |
  28. Gay

    I too had gastric bypass surgery 1 1/2 yrs ago and it has been wonderful. I wouldn't change it for anything. Even the sagging skin (I'm 62 yrs old). I am able to bend over, walk further, breathe better, have more energy, buy clothes that fit and feel better. OF COURSE he should be able to have the surgery and insurance should pay for it. The insurance company will actually save money since it is likely he will not suffer from other illnesses caused by obesity.

    How could his mother have let him get that fat???? What a #*@*% question! How could a mother LET her daughter get pregnant or LET her son impregnate someone else's daughter, or LET her son use meth or LET her child drive drunk, etc.

    Perhaps insurance companies should quit paying for viagra. That would probably save tons of money. They paid for viagra long, long before birth control pills. Oops I forgot. Insurance execs are men.

    August 18, 2009 at 10:29 am |
  29. christy

    This just drives me nuts. Insurance should cover this hands down. Especially if health is at risk.
    I had gastric bypass and my insurance covered it fully. I can not believe they are giving him a hard time. This insurance company is a disgrace.

    Best wishes

    August 18, 2009 at 10:32 am |
  30. Kari

    There should be single standard of what is covered under health care. The health care industry (aka vampire blood suckers) have controlled our lives long enough and only make decision based on their profitability – our health is meaningless since they only care about their profits.

    If there is no public option, there is no health care reform – the insurance companies will continue to suck us dry and deny coverage after they have bankrupted their "clients". For me, make it a universal single-payor system like the other advanced countries of this planet. Ignore the Party of NO (Republicans)!!!!!

    August 18, 2009 at 10:33 am |
  31. Edward C. Jones

    In the sad case – gastric bypass may be warranted, in order of trying for solutions – paying for sequestered, clinical diet & exercise intervention should be tried first then if this fails – bypass surgery. This produce success and preclude the need for surgery, but then not rule out surgery – not just the first course. By the way, to get an accurate weight for this young man – with one foot on each of two identical digital scales – a professional can take photos of the two digital readouts placed side by side – and add up the weights with a series of photographs. I did this in my research study when I had a boy who weighed 444 lbs and a single scale only went up to 400 lbs. I'm an obesity researcher on adolescents.

    August 18, 2009 at 10:33 am |
  32. Kim Jackson

    Yes, we should pay for his gastric bypass surgery. He is young and if the an insurance company can pay for this one surgery to avoid many future may health issues then I say it should definitely be paid for.

    August 18, 2009 at 10:35 am |
  33. Peter

    Can someone pay for a 'health coach' for this young man 5 years ago? We wouldn't have to have this discussion! His health coach would have cost much less 5 years ago than the surgery will cost today. I side with prevention.

    It's clear he's eating improperly and is not active enough. It's clear he has some form of eating/fitness disorder. Both sides strong argument for/against paying for this surgery. Prevention Prevention Prevention.

    August 18, 2009 at 10:36 am |
  34. D.Jackson

    Insurance SHOULD pay for the surgery. I had it 5 years ago and have maintained my weight, I have adopted a healthier lifestyle, the only medication Im on are my mutlivitamins, iron supplements, and B-12. I no longer have sleep apnea, infertility, hormonal imbalance, gastrointestinal discomfort or problems, and no more joint and muscle pain. The surgery is definitely a tool if followed with proper support and follow-up care.
    http://www.gastricbypassuccess.ning.com

    You can also order my book at http://www.blurb.com / bookstore. The A B C's of Gastricbypass Surgery

    August 18, 2009 at 10:36 am |
  35. Cecilia Shull

    This is what health care reform is all about. This man should be covered by his insurance policy. His life is in danger. Criticizing his past judgments on self care is not part of the equation. What is the name of the insurance company. SHAME on them

    August 18, 2009 at 10:39 am |
  36. george in MD

    hey rick rick!
    I have reasonable ideal for the young man ,hire yourself a lawyer and go after food companies that made you obese..not insurance company.
    just think of the ounces now like McAdam's,McDonalds, burger-king, kfc chicken, and many-more.

    August 18, 2009 at 10:39 am |
  37. Mark

    I researched and found the cost to range between $6,000 and $30,000 for this procedure. Took me all of ten minutes. He should research a good doctor at a price he can afford on a payment plan. I’m sure he would be more than willing to by a new car or purchase other goods with a loan yet complains when nobody will pay to undo his missplaced priorities in life. Nobody made him put on 600 pounds and nobody should be forced to remove it. This is the biggest problem we have in our nation. We have an enablement culture that strips all personal responsibility from individuals and places it in the hands of faceless beaurocracy.

    August 18, 2009 at 10:42 am |
  38. EYESJOY

    YES !! FOOD IS NO DIFFERENT THEN ALCOHOL IT CAN BE JUST AS ADDITIVE TO SOME PEOPLE. IF WE CAN HELP OUT PEOPLE WITH OTHER ADDITIVE DISORDERS WHY NOT WEIGHT,BESIDE IT WILL CUT COST OF OTHER DISORDERS CAUSED BY WEIGHT AND GIVE PEOPLE A SECOND CHANCE IN LIFE.

    August 18, 2009 at 10:46 am |
  39. Bill T

    It seems to me that it would be cheaper in the long run to cover the surgery. If this guy remains obese the insurance companies face Diabetes and complications, heart desease and the list goes on. This is one of the things wrong with health care, insurance does nothing prevetative then they do not want to pay off when someone suffers major illnesses. What is wrong with this picture!!

    August 18, 2009 at 10:48 am |
  40. steve

    absolutely yes.

    this is a perfectly good example of someone coming between the patient and their health care.
    and it's not the government!

    and a great reason for the public option in health care reform.

    August 18, 2009 at 10:50 am |
  41. Amy

    Perhaps the ins co denied him because they might only cover him until he is 24 y/o under parent policy as long as he is in school then he wouldn't be their "problem" ...... just a thought

    August 18, 2009 at 10:51 am |
  42. Joann

    Insurance companies should pay for the surgery. If a person wants the help for drug or alcohol addiction, most treatment center will find a way for anyone who wants help to overcome their addiction.
    Go after the companies that produce addictive products such as alcohol and cigs to help fund treatment programs. Insurance companies will only cover healthy people.

    August 18, 2009 at 10:56 am |
  43. Edward C. Jones

    The analogy Elizabeth Cohen made to the question of personal responsibility in paying for surgical treatment of the smoker (who chooses to smoke) but develops lung cancer... and we accept insurance covering lung cancer treatment... applies to obesity. Nobody "makes the smoker smoke." The more important question – especially related to children, is, how do our health & school infrastructures allow these cases to slip through the cracks to the point of such extremes that a teenager reaches 600 lbs before serious intervention is pursued. Patterns that lead to obesity tend to run in families – so blaming the parents may be convenient, but some parents may lack the agency to prevent/solve this outcome in their children on their own. Individual responsibility is important but will not be answer to the obesity epidemic.

    August 18, 2009 at 10:59 am |
  44. Mark

    Yes.....I know, I'm an evil conservative. I believe you reap what you sow. My brother-in-law stopped smoking through hypnosys. Can't even touch a cigarette without feeling ill. That would cost this guy maybe $500. Join a gym at the most would be $500 a year or use the college facilities for free. They may even have coaches or trainers that would advise him for free. His friends should slap the donuts out of his hands if he falls off the wagon. Eating less on your own is the same thing as having the surgery and it does not cost anything. It also avoids the risk of surgery. Spend another $1,000 on a psychiatrist and we just fixed this guys problem for about $2,000. It is not that complicated people. You mess up your life, you should be the first to try and fix it. People like this guy are the reason health insurance is so expensive. They muck things up through poor decisions and want the COMMUNITY to fix them. Whoever stated the mom is to blame is partially correct. She began his slide into the culture of enablement by feeding him anything he wanted and never taught him healthy eating practices. I know, it hurts to hear the tough love.

    August 18, 2009 at 11:04 am |
  45. Mark

    eyesjoy says its an addiction. Correct. Fix the addiction with mental and physical training and the surgery is never needed. Having the surgery will not correct the addiction. It only enables him to continue his destructive ways by knowing no matter what he does, someone else is responsible to fix it. Like I said previously, eating less is the same as the surgery without the risks. It is that simple. Only thing left is for him to make the decision to do it.

    August 18, 2009 at 11:10 am |
  46. SandiRN

    I am a nurse and I see and have multitude of friends and patients who have had the bypass surgery.... 1st why is insurance company denying this young man, he may be a health risk for surgery and most programs require the patient to loose a % of weight before they can have the surgery. How has he tried to change his health behaviors. So many times bypass is seen as a quick fix... it does not work that way. Nothing was commented on what he does to loose the weight now..... if nothing then he needs to show good faith effort in changing his weight around. He may want to seek help with a doctor supervised weight loss program....like Optifast... I've lost 27lbs on it and exercise 3X a week aerobic and weight training at a local gym for $50 a month all on me not on my insurance. Doctor's visits, lab test are covered. Our health is our responsibility not the insurance company's,

    August 18, 2009 at 11:19 am |
  47. Denise

    In response to Steve

    In all due respect, I think you have it in reverse. In reality, this is a perfectly good example of someone sabotaging their own health. Nobody is coming between the patient and their healthcare - it is up to all of us to care for our health - we are presumably conscious beings, aware of our own actions - it's time everyone to wake up and take a little ownership for our own health. It's not up to others to pay the consequences of individual bad choices. That's a run-away train. As long as the price of and individual's bad choices are paid by others there is no incentive to make the right choice.

    My sympathies to this young man. But he is capable, on his own, of saving his own live - each and every day based on the choices he makes. It depends how badly he wants it.

    This is a great example of why the public option (which is the first step toward socialized medicine for all) will be bankrupt in no time, and then bankrupt this nation. We cannot afford all this nonsense. Have you read the national debt ticker lately? We need people to step up and start the process of health care reform at home!! It's called eat less, eat right, and exercise more. Plain and simple.

    August 18, 2009 at 11:21 am |
  48. Diane Ferine

    Only as a last resort and a lifesaving measure. All other options have to be proven to have failed, not given up on, but failed medically. Diet, exercise, lifestyle, etc. What is the cause of the obesity – self imposed through diet and/or neglect or a medical problem caused by problems within the body. When all these avenues have been investigated and exahausted, then, and only then., should this procedure be considered and only with medical recommendation , guidance and approval.

    August 18, 2009 at 11:34 am |
  49. Greg

    Only if all other options have been exhausted and the primary doctor agrees there are no other options. I think the insurance companies have a right to make sure that exercise and diet can't do the trick. With free online tools out there like Holosfitness.com that can help track exercise and give advice on healthy lifestyles, it has never been easier to lead a healthy life.

    August 18, 2009 at 11:34 am |
  50. SandiRN

    by the way... if a person is in need of a liver transplant because of alcoholism he just doesn't get the ok. He may be on the list until he can prove that he is sober for atleast a year... he may die in that year but if he chooses to continue with his unhealthy habits he doesn't get the transplant. Not just a quick fix for anything in life. You need to own up to the change.If this young man is so worried about dying... then the choice of a better health is his not on the insurance company....As many of our young and others they are looking for a free ride with no work.

    August 18, 2009 at 11:36 am |
  51. harold Schulman MD

    Yes it saves lives and prolongs life.

    August 18, 2009 at 11:44 am |
  52. Pam Martin

    For most of my life I was LUCKY enough to be very thin – and to be able to eat whatever I wanted! But I've always been aware of my "luck" and felt bad for those who struggled. While diet and exercise are factors in weight control, many people struggle throughout life (as seems to be the case with this young man).
    With reports of insurance companies making huge profits and with our tax dollars bailing out many of those companies, I say let's give this young man a "shot" at a good life. It seems a far better thing to do with my tax dollars than providing for wealthy executives who KEEP abusing their power and position and cheating the people who pay their salaries.

    August 18, 2009 at 12:35 pm |
  53. Nate G.

    Lose some weight, gain some respect.
    or
    Put down the fork, hop on the treadmill.

    August 18, 2009 at 2:24 pm |
  54. Patricia Scanlin

    This story revolves around a decision by this young man's insurance company to deny him potentially life-saving surgery, but the company was not identified while I was watching this morning and no spokesperson came on to explain the insurer's decision. The identities of the key players in this drama are essential to an understanding of the problem, particularly at a time when the issue of just who will make crucial decisions about everybody's health care is so controversial. I feel strongly that the insurance company should pay for this man's surgery or explain why not, and should not be allowed to remain anonymous in the background.

    August 18, 2009 at 2:31 pm |
  55. whitey in Texas

    Our government is the worst "enabler" of all. Before long I'll be able to get them to "take care" of my wife's honey due list because I'm tired and don't want to do them anymore.

    Cut the umbilical cord(& cost to the American taxpayer) and quit enabling us. Gee, our parents & their parents never had it this way. We're soft.

    August 18, 2009 at 2:51 pm |
  56. Theresa

    This is EXACTLY the problem with our system, the insurance should cover what ever your DOCTOR says you need!!!! People are so worried about the "government" getting between them and their doctor, but we've all accepted insurance companies being there! Any thing that your doctor certifies is "medically necessary" should be covered by your insurance.

    August 18, 2009 at 3:49 pm |
  57. Sandy

    Incredible! Assuming this guy is not a victim of a disease, he is a perfect example of why the terrorists can relax and take a long vacation. We Americans are perfectly capable of killing ourselves with fat, sugar, and salt.

    August 18, 2009 at 3:49 pm |
  58. Em

    I think it should be paid for. Jake deserves it! And so do many people out there. Ps visit his website at http://www.mbypasssurgery.com

    August 18, 2009 at 3:50 pm |
  59. Sallylemuns

    I think if they payed for the procedure it would save them a lot in the long run. But if they choose not to, surely some other company will now.

    August 18, 2009 at 3:51 pm |
  60. pejay

    i had lap band surgery and i feel fine. this is a young child and if he doesn't get it, the insurance company will spend alot more money on health problems. if he has no insurance, then we will pay as tax payers. even medicare pays for the surgery now. obesity can be cured with help. my son died at 34 before he could get help. over weight caused a blood clot to form in his leg (its hard to exercise) and it traveled to his lungs. and all the problems caused other health problems which led to his death. did he want to die-hell no !! he gets support before and after the surgery. the people who say no, probably has never been over weight or have health problems. but that can change in time and as they get older. they may need at some point a procedurer and the insurance company tells them no. it could life or death and they say no. just walk in their shoes for a while. beleieve me no one wants to be over weight, i hope he gets it. check into other ways to get the surgery. they may be some orgaanization to help him to get it. i love my lap band.

    August 18, 2009 at 4:51 pm |
  61. Scott Swan

    Everyone that is saying rude comments, would you make fun of someone for being diabetic? having psoriasis? black? male? female? If someone has a medical condition or is in a state where surgery is required be supportive. Be grateful for the life and experiences you have and allow others to have them too.

    August 18, 2009 at 4:54 pm |
  62. Betty Phillips

    absolutely!! being obese is a sickness, same as alcohol, I firmly believe over weight people need the help they can get. Here is a scarey thought "what if the government controlled our insurance, do you think they (the ones in need of the surgery) would get it? No way, they would be put on a waiting list and played like a fiddle. Check out how many patients come from Canada and other countries for our medical services, this is what will happen if we do not stop Obama in his tracks. Please!! we do not need Bill Clinton to tell us he has worked with Obama and we need to push the Health plan. Why does Bill Clinton we will trust him now? He is one President that almost got impeached, so where is the truth in either Clinton. NO WE DO NOT WANT THE OBAMA HEALTH PLAN!!!!!!!!!!!!!!! Betty

    August 18, 2009 at 7:39 pm |
  63. Paula

    I whole heartedly agree with SandiRN. No one forced this young man to make the food choices that he has made. I have seen and heard where there are just way too many gastric bypass surgeries being performed anymore and once most of the people get over their initial pain from having the surgery they end up gradually eating more and more until they are right back where they started from, needing the surgery all over again. What is wrong with this picture? Why would anyone want to subject themselves to the surgical pain and then there is always the risk that they will not survive the gastric bypass too, all to regain it back and then some. It's just not what we put in our mouths but how we view food in general that affects a person being overweight . I am obese and have been just diagnosed with having Type II diabetes which as of right now I am managing without any meds or shots. I don't blame anyone else for me being overweight. I did this to myself...no one held a gun to my head making me eat fattening foods. With having gastric byppass surgery and due to losing weight rapidly one is left with unsightly loose skin and then some people have to end up going under the knife again to remove all of the excess skin, what a pain! This one lady that I have written about in an earlier blog today has a lot of loose skin so she is still confined in some ways as to what she can wear, she will never ever be able to wear a bikini and a one piece bathing suit is questionable. I don't care what other people think about me I am the same person now as I was when I weighed a whole lot less, just a whole lot more of me. I also feel that when people make fun of me they are showing their own insecurities in themselves. There are some who will criticize others no matter what it is doesn't just have to be about a person's size! I have not heard if this young man has tried to diet and exercise first before wanting gastric bypass? All weight loss options should be tried and exhausted with him before ever even thinking about wanting such an evasive procedure!! It's amazing how (most) of the people who have written blogs before me who are all for having gastric bypass surgery have had the surgery themselves!! Surgery is not always the answer to everything and (most) people who have had or are having having gastric bypass surgery are just looking for a quick fix for being obese! I did not gain all of my weight within a short period of time so why should I think that it should disappear within a short period of time. Patience is a virtue!! If people would try and lose their weight on their own and all of the hard work that comes from a person's success it might just keep them from ever wanting to regain it all over again. I do know that you don't only have to change your eating habits but you also have to change the way that you think about eating food or nothing that is done to help a person loose weight will keep the weight off!

    August 18, 2009 at 10:21 pm |
  64. Mini Me

    I feel really bad for this guy. His quality of life must be incredibly low – at 600 pounds you can't function like a normal person.

    It would be interesting to know the facts about how he got to where he is and what he has done thus far to combat his weight problem.

    I actually know Jake and I haven't heard anyone talk about any measures he's taken. Then again, it might just be that I've missed out on those conversations. Still, he's at a point now where he's running out of options. Could he conceivably lose that weight in 10 years? That's all his doctors are giving him at this point.

    I agree with what a lot of people are saying about Public health care enabling people to abuse the system. A public option would drive our country so deeply in to debt that inflation would sky-rocket and our economy would go down the toilet even more. And while it sounds good, it's not practical. The list of issues that citizens in England and Canada have with their public health care is massive. We need to reform our existing system, not create a new one. It's widely known that an overwhelming majority of Americas are happy with their current coverage.

    August 19, 2009 at 3:43 am |
  65. Mrs. Eileen Curras widow to Hernandez (WWII)

    Certainly Health Insurances should cover health conditions. When did Gastric Bypass Surgery stop being a health condition? I do not think that having a any person that weighing more than 600 pounds without health care is the answer. Most persons can’t walk more than 20 feet without getting winded. Certainly the fact that they can’t reach their own shoes should be trouble enough.

    August 19, 2009 at 7:30 am |
  66. David

    Why would his health insurance not cover treatment, whatever it is, whatever is medically indicated, that would be obviously life saving? If he needs emergency care for some other illness or injury how is that going to be affected by his weight?

    August 19, 2009 at 9:10 am |
  67. gloria lewis

    Hell no , i do not have health insurance i have been living in this country for 22years .I had insurance in my first 7 years from my now exhusband insurance .I have not hadinsurance from 1994 to now i probably went to the doctor about 3 times from 92 – now .I hate doctors they are nothing but scam artist ,they put the fear in everyone for no reason .I could careless if i have insurance if i get sick i am from an island that has a government healthcare system or a private option .If you can pay go right ahead if you can you dont complain about what you get .You are greatful for what you get for free .I would gladly go home .
    Why should they pay for gastric surgeries it is no ones faults these people eat like pigs .American in general are too last eat too much and complain too much .They always complain about aproblem but are they helping to find solutions no . I am a waitress it make me sick the way some people eat .I had an overweight customer eat for breakfast a cup of grits ,2 lg oj ,a bagel with creamcheese and a bltsand and fries .Is this ignorant or what .
    I do not worry about getting sick i have been working in restaurants from 1993 – present but i do not eat out .I cook 7 days a week i have done this for my 22 years of livig here occasionally i skip i day if i have leftovers .I also fix breakfast everyday no one go out the house without breakfast .If i do not fix my 19 year old breakfast he fix it himself .Which always consist of a cup of tea and oj along with some eggs and toast or a bagel .We stop drinking sodas ,no coffee ,hardly eat chocolate ,candy or ice cream .It is impossible for anyone in my home to go weight .My myself i have not gain weight in 27 years We only get a cold once a while and we use home remedies .When i grew up on the islands although we had free healthcare we did not run to the doctor ,we use simple home remedies .
    America wake up you do not need all this medication ,you do not need to go to the doctor so much .Start eating healthier ,give up the junk and fast food ,learn how to cook ,too much people handling the food that goes in your mouth .Its mind over body do not let your mind control you .You control your body .By the way cnn your own Dr Sanja walking into a surgery in the wee hours of the morning with a coke zero in his hand .Shame on him tell him to grab a cup of tea the next time .

    August 19, 2009 at 10:03 am |
  68. James Molina

    Only a small percentage, say 25-40%. There are new procedures that are less expensive & reversible.

    August 19, 2009 at 11:28 am |
  69. luckii

    I don't know. has he been eating too much and being lazy, if so, he's looking for a quick fix to solve his problem. or is it a case of complusive eatin and can't help it? why was't someting done before now.?

    August 19, 2009 at 11:56 am |
  70. Susan

    of course it should be covered. insurance covers lung cancer surgery and treatment for smokers, drug and alcohol treatment for those who are addicted, all kinds of care for those who develop Type II diabetes when we know that diet, exercise and weight play a huge roll in why it developes.

    This debate is really fundamentally about how we "blame" or don't blame people for their illnesses. And, it's about how our culture de- humanizes obese people generally.

    August 19, 2009 at 12:27 pm |
  71. Ken, Long Beach, CA

    No, gastric bypass is the lazy way of not putting down the fork. What this guy needs, (like many others) is education in nutrition and proper eating. With proper diet guidance and oversight, the weight could literally fall right off. 2/3's of America is overweight, and over 1/3 of them are clinically obese. The reason? We gorge ourself on food, especially fast foods and junk that should not even be classified as food.

    August 19, 2009 at 12:33 pm |
  72. Robert Lake,MI

    Heck no, thats like saying a drunk should be able to have his liver replaced due to his own drinking! NO WAY! Tell this guy to put the fork down, eat a salad, dont expect the rest of the pool to pay for something you did to yourself! One only aquires pounds by eating and laying around! Its called get off your butt and take a walk, move around, stop eating junk!

    August 19, 2009 at 2:18 pm |
  73. Tim

    Yes, I can't wait until we have government run health care! I can't wait until the government has the power to start telling all of the smokers, drinkers and people who don't excersise enough what they can and cannot do. If they don't conform, they will lose their health care benifits or will face fines or even jail for abuse of the health care system/money. Yes, more government control will help get rid of these nasty habits. They have already tried to snuff out smoking and drinking once before...now this will finally give the government the power to control you!

    August 20, 2009 at 7:28 am |
  74. James of Houston

    The question should be how did he get up to 600 pounds in the first place? He had to have enablers around him to allow him to do this.

    Let’s have the enablers work and pay for his surgery! I admire Jake for doing something on his own to have the surgery and accepting personal responsibility for his heavy overeating and a life of no exercise.

    August 20, 2009 at 10:05 am |
  75. Pattie Scanlin

    Of course this surgery should be covered. Not only is this young man's situation probably metabolically related, it is life-threatening, and also probably less expensive than the medical care that he will require if he doesn't get it.
    I have a problem with the coverage given this story because it centers on a decision of an insurance company, but the company was never named and no representative of the company was interviewed on the record. II wonder why the people who oppose a public option for health care because they don't want "the government" involved in their health care decisions are so willing to have nameless, faceless, and unaccountable insurance company employees make the same critical decisions. It makes no sense.

    August 20, 2009 at 11:27 am |
  76. Mini Me

    Atten: Pattie Scanlin,
    "I wonder why the people who oppose a public option for health care because they don’t want “the government” involved in their health care decisions are so willing to have nameless, faceless, and unaccountable insurance company employees make the same critical decisions It makes no sense."

    I'm NOT willing. I think it's a bunch of garbage. If we can reform the Insurance industry rather than totally revamping our entire system, we'll save our poor country and economy a lot of grief.

    August 20, 2009 at 1:43 pm |
  77. Mini Me

    Myths and Facts about the "Public Option"

    The Myth: "If you like your private insurance plan, you will be able to keep it, even if health reform creates government-run health insurance."

    The Facts: Politicians who want government-run health care claim their legislation will let you keep the plan you have. But, both the nonpartisan Congressional Budget Office (CBO) and researchers at the nonpartisan Lewin Group found that with a government-run health plan many millions of people will lose their employer-sponsored coverage. After 5 years, new government rules will apply to all plans, overseen by the Health Choices Administration.

    The Myth: "Government health insurance won't lead to a single payer health system."

    The Facts: Politicians in Washington have admitted that a public option is the path to single payer government-run health care.

    The Myth: "Creating a public option will lower costs for everyone, even those with private insurance."

    The Facts: Everyone agrees that health costs need to come down, but while some politicians claim that health reform with a government-run plan will lower costs, the CBO finds that the House and Senate bills will increase health care costs.

    (Compiled from the Campaign for Responsible Health Reform)

    August 20, 2009 at 1:46 pm |
  78. Tarno Greene

    Try two time tested programs.
    1] Transgender surgery candidates must live as the chosen gender for a year (or more) before the surgery.
    Let the young man commit to community service, motivating others to weight loss, until he has helped e.g. 100 people to lose 100 pounds each. Of course, his lack of mobility will require creative solutions: virtual appearances, etc.
    He could then commit to a community service program for post surgery.
    Then he could have the surgery.
    2] Students have to repay loans. The young man, or other candidate, would then continue community service to motivate, and educate others to lose weight, as he loses more weight.
    The cost of the surgery could be considered as a way to reduce health problems and expenses, for many other overweight individuals. Imagine the loss of 10,000 pounds, of other people's overweight, before he has the surgery!
    Self esteem, confidence and general health would improve for at least 101 people, including himself, even before he commits to continue motivating others: his promise for post surgery.
    He will be repaying his medical procedures many times over, with measurable results. Psychologically, and emotionally, he will be impressed with his ability to get results.
    Waking up each day with an agenda to help others is our goal for this young man who wants and needs our help.
    It's working for Shaq. His program with school age children is proof that education and example work wonders and get results.
    Thank you for asking. Tarno Greene

    August 21, 2009 at 9:36 am |
  79. mara paytez

    Yes, A Gastric Bypass Surgery should be covered, of course– it's
    a necessary need for some people health. Why is The America Country so- – pettie? and lacking in treating citizens right. All of the need of Healthcare treatment should be covered.

    mara,

    August 24, 2009 at 1:58 pm |
  80. Harris Morison

    Simply,Yes.

    August 24, 2009 at 5:29 pm |
  81. ANGIE

    I THINK THEY SHOULD..I'M HAVING THE SAME PROBLEM, MY INSURANCE DOSENT WANT TO PAY FOR MY SURGERY AND IM SO FRUSTRATED AND ANGRY. ITS A NECESSARY NEED WHEN YOU BIM IS MORE THAT 35 AND YOU HAVE ALL THIS HEALTH PROBLEMS BECAUSE OF YOUR WEIGHT.

    August 25, 2009 at 8:33 pm |
  82. Chiquito

    Those of you who think he reached 600 lbs by 'lifestyle choice' are quite frankly idiots. To reach this weight requires a genetic predisposition. To lose weight by diet and exercise alone at this level is impossible. The real question is "Should insurance cover the operation or just let him die?".

    August 26, 2009 at 3:12 pm |
  83. Jeremiah O'Dell

    Anyone who thinks that this is Pornography should get a life. The nude human body should not be something to be disgusted by. The human body is the purest form of art on the earth and we as human beings should be proud of our bodies. Wearing cloths is the only "weird" or "pornographic" problem in this equation. It is great to see this photographer going out of popular norm and capturing the amazingly beautiful, and purest form of the human race. The models are wonderful too for doing this. Thank you sooo much for doing this project!! :) Good job!
    Jeremiah -Topeka, Ks

    August 28, 2009 at 10:18 am |
  84. Stephen B

    Overall I would have to say no. Insurance should not cover Gastric Bypass Surgery. We have the ability to make choices in life. Life is not easy and doing the right thing is most often easier said than done.

    People go to jail for the mistakes they make, they all had the opportunity to make a choice that would not have them locked up. If you make the choice to eat the amount and type of food that eventually gets you to weight 600 lbs, then you cannot expect insurance to bail you out.

    There is not enough money to just hand out to people who choose to be unhealthy. We need to teach society to be more disciplined or there will be consequences.

    I wish the man all the best and hope he finds a way to solve his health issues, but he does not deserve insurance money. If you simply hand insurance money over to him, then insurance money would have to be given to other similar people.

    August 28, 2009 at 10:24 am |
  85. Dawn

    Im so upset, started crying when I found out Jakes surgery was going to be done for free. I know he is big and weighs 600lbs. I weight 255lbs and my doctor is threating to take me off my medications unless something happens and I lose weight. I have firbromyalgia. There are many reasons why i can't have the surgery. Money for one, No insurance at all. Can't get a loan. I have been crushed by coming so close to having my surgery. I have a meltdowns of depression over not having this surgery. I have scheduled surgery 2x having faith in the lord that he would help me find a way. I gathered up guts to ask my neighbors for money, whom I have a good relationship with. They said yes, I made my appt and then the days before they backed out.. Due to the stock markets... I wanted to die, I just didnt care.
    Im happy for Jake, I wish I had the talent to earn some doctors respect to have my surgery for free.... or some talent to start a web-site for donations...
    Again reading that, makes me feel upset all over again.. knowing how close i came and then i fell... turning rocks over and over and not getting anywhere....How easy it is for one person, how hard for another...

    September 9, 2009 at 1:03 am |
  86. russ

    I have looked threw all the comments here and am totaly mortified. those who say" dont cover it,"or"try dieting." have no clue. however if that is your thought let see what you think of those drinking themselves to kidny or liver failer. should insurance cover them? and what about those who smoke of chew tobbacco, cancer and lung problems are very common, so is insurance coverage for there treatment. those also are as a few put it, self inflicted, but why is it not a problem for them to get treatments? it is because if those are limeted more than a 4ourth of the world will not be covered. to not cover tis procedure is simply a form of singeling out a group or person for anothers view, hum sounds like descrimination to me.

    September 9, 2009 at 8:21 pm |
  87. Lin

    I too am in need of gaastric surgery to to lack of cartilage in my joints. My Dr. indicated to my Bluecross Blueshield of Montana that she recommends I have the surgery, but the still say no. I have only used my covergae 4 times in the past 5 years and would never abuse it. If any one has any tips on how I can raise funds please let me know. I would like to say to Jake and his mother. "Never give up keep trying as I will. "

    September 14, 2009 at 2:59 pm |
  88. brook

    Here's my take... Someone mentioned that this surgery should not be paid for using an example of a drinker getting a liver transplant due to drinking. How ignorant! Dont you know there are PLENTY of social programs in place that PAY for treatment for alcholism and drug addicts to get help over and over and over? Not only that but they can get on permanent disability and yet not a PEEP about them using government money, getting government assistance, housing, food, insurance and aid to kick their habits. They cant have a surgical procedure to address their addictions and morbidly obese people can. This surgery actually will CHANGE these people and they will no longer BE heavy nor will they have a need for a lot if not ALL their meds. You can not eat like you did and you DO lose weight. I know people who have had the surgery and have not put any weight back on. They are quite healthy. The truth is there are far MORE successful and permanently changed lives than failures. "EAT a SALAD" That's like saying "if you'd just BREATH faster you'd get the oxygen you need" to an emphsema<sp patient. Did they do it to themselves- yes, in a lot of cases they did. Do they DESERVE the ridicule and prejudicial hate. NO. I'd consider the way some of these commentors talk to be hate. We can not discriminate based on color, race, religion but oh boy let's pull the hate out for the fat people (they're safe targets) Afterall, they are less likely to fight back seeing as how most of them suffer some form of depression. Do you honestly think they are HAPPY people? Dont you think they may do what they do as a result of what society has engendered- disgust and revulsion. Do you really think its ok to attack someone instead of reaching out to them? Some of you do. It's alright to make broad sweeping and ignorant statements such as "fat people are lazy". I know people who are morbidly obese that will work harder on the job than some 'thin' people. Yes, life choices often put us in places where we'd rather not be... I'd guess that the difference between some of the commentors on this page and an overweight person is that you can SEE their issues. Now LIE a little and say you are perfect- come on I dare you too. I'd say if a light was shone into the little dark corners of your life you've done things that have been less than 'healthy' or 'right'. People who are addicts are applying and GETTING welfare, disability payments and the like and yet- oh God in Heaven, a fat person is a criminal for overeatting (it's an addiction too btw). here's a solution- Pay for the surgery the first time, offer counseling for afterwards that moniter the person's behaviour or mental issues (a lot of times it can be a mental issue) and if they gain back all the weight after all the help the first time THEN they live with it. He who is without sin (that means ANY hangup, people) cast the first stone. Come ON people- we are HUMAN BEINGS. We lack empathy in a time when we are SUPPOSED to be more concerned with our fellow man. How sad- how very very sad... and too all the people negatively commenting I wonder who is really the 'digusting and ugly' people. U can be outwardly attractive and very nasty on the inside. too much emphasis is on outward beauty instead of looking at what makes a person who they really are and that's their soul- their mind not the body... Paula where are your facts about that? MOST PEOPLE GAIN THE WEIGHT BACK? not true. Some do yes not all and certainly not MOST. what tripe. Most people are so grateful for a new life- able to do things they couldnt before they are afraid to regain the weight. And what of those who must lose the weight FAST or die? Let them die? Im talking need to in a few mos or be dead not take three years huffing and puffing it in a gym. And who is hiring the personal trainers and dieticians to help these people for the three years it will take to lose all their weight? We arent talking 20-50 lbs here. I guess when your mom, dad, loved one needs oxygen or surgery we should say nope sorry you're too old and it would be a waste cause you'll just wind up sick again and need help again- easy to pass judgement when you never lived that way or had anyone in that position. Also, for every negative story about it there are hundreds of positive ones- it's easy to focus only on the negative though isnt it... Why doesnt CNN get some facts and figures on success stories versus failures? Poll gastro pts to see how many have been successful before you make asinine comments like that.

    October 2, 2009 at 2:32 pm |
  89. brook

    one more thing to Paula- I apologize I did not read your entire entry. I have now done so.
    I actually agree with Paula and others who say these people need to understand and change the way they look at food. That's where therapy can help but if your very discouraged, depressed, socially scourned and mentally beaten down, emotionally drained to the point of why try anymore, and keep failing cause unlike other addictions you have to keep eatting (not like alcohol or drug addiction where you can stop doing them and still live) then you will not be able to do it on your own without help. Also, please consider that 'willpower' is not universal. Some people just dont have it. Thats what makes addiction-addiction. Nothing is more irritating and frustrating to an obese person than hearing thin people preach to them that they need to get some willpower. where do you get that exactly at Kmart? Walmart? The mall? The reason people can and do attack obese people is that obese people take it and society allows it even encourages it. They've (heavy people) seem to often convince themselves, on some level, that they deserve it. They are told often or shown by looks, comments, discriminated for jobs, among other things, that they are lower than low, lazy and deserve their plight for they've done it to themselves. Just like any emotional abuse, you hear it enough you begin to believe it so they give up, give in and believe such hurtful things. For any of you who've managed to lose weight the 'hard' way good for you. If you weighed more than 100lbs over the "norm", I do applaude you.. However, I know too many people where you'd be the exception not the rule. The heaviest states are southern states. Mississippi being the state with the highest percentage (I believe almost 1/3 of the poplation) being obese. Should we punish people for the way they were raised or help start a change by changing the ones who cry out for help especially in the top ten obese states? educate the kids, help the adults to (maybe for the 1st time in their lives) be a healthy weight, and make a stronger Union because of it. Also, if any type of tax should be imposed why not close fast food resturants. make them illegal for they are the biggest contributors to obesity in the nation. Also why make healthy food so expensive? why cant we have "health fast food"? It's just as easy to throw together a salad as a burger, grilled foods can cook faster than some deepfried offerings. I think more than an individuals choices are going to have to change. these fast food giants should change their menus to healthy cuisine. Just cause your thin doesnt mean you should eat the junk you condemn a fat person of eatting. That's a little hypocritical.
    Whew okay- I'm off the soap box. Sorry, everyone, this has been a sore point for me for a long time. I never thought I'd ever get the opportunity to state some of the things that seem so wrong to me.

    October 2, 2009 at 3:08 pm |
  90. pladd04

    Insurance companies today make no sense what's so ever.
    1. they want to charge you more each month because you smoke or because of your weight but...
    2. they will not cover surgery or medication that will help you correct those problems.
    It's just another stupid way for the insurance company to make even more millions then they have already and I'm so sick of it!
    Yes, I think they should pay for weight loss surgery and prescriptions that will help you stop smoking. They would save so much money and so many lives in the long run if they did so. But all they can think about is the all mighty dollar they can make TODAY!

    November 14, 2009 at 3:09 pm |
  91. Marie Lowe

    Yes the surgury should be covered. People are cruel, do you really think someone wants to carry around excess weight by choice!! I am sure with all the Health issues no matter what is done the weight just keeps adding on. He needs serious help and the surgury is a step in that direction. It is not a easy road and it will be a lot of hard work, but still his best option. People should give him credit for being brave enough to want to do it. It is a dangerous precedure and can have many complications and many other surgurys needed along the way. I for one am tired of paying high costs of Health Insurance only for them to dictate to me what they feel like my life is worth in terms of if they will pay of not pay for percedures. They do not have to live with the pain we go through.

    November 15, 2009 at 2:38 am |