Let me explain with my current situation. I am 22 F and I currently weigh 305lbs.

I am obese. Morbidly obese.

Even though I have been trying for 5 years at this point to lose the weight on my own. Eat healthier, eat more fruits and veggies, cut out excess sugar, walk more, exercise more, the whole kit and caboodle.

But I still am not losing the weight. I am still very fat. And I am worried that it will cause very serious health problems.

So I talked with my doctor and she told me “We need to get you on a weight loss medication. Let’s try Ozempic”.

But my insurance told us that they don’t think I need the Ozempic so they won’t pay for it.

So we tried Wegovy and Mounjaro. But my insurance still rejected our requests.

They’re saying because I am young, and I am a diabetic with good numbers, I dont need the weight loss meds and I can just lose the weight naturally.

But ive been trying to and it hasn’t been working. So that’s why my doctor prescribed me the weight loss med.

Why is this allowed? Why is it that your insurance can deny you a medication, even if your doctor says you need it?

  • SirSamuel@lemmy.world
    3·
    12 days ago

    While CICO is universally true, it doesn’t account for a few other factors. For instance, gut microbiome. Gut flora has a strong affect on cravings. Also mental and emotional health also affect self control and regulation. Food “science” has created craving monstrosities snacks that are as addictive as cigarettes. Personal health issues like PCOS and thyroid dysfunction will affect how many calories are consumed by the body and how those calories are used within the body.

    So yes, eat less and lose weight. Sure. Some people can lose weight eating junk. For others it creates a reward cascade in the brain that leads to overeating. Just eat less. For some that’s as practical as telling a lifelong smoker to give up the habit. And that’s why medical alternatives to self control exist, but aren’t successful without addressing the root cause of the obesity.

    • Clent@lemmy.dbzer0.comEnglish
      3·
      12 days ago

      All those behavior cycles and feedback mechanisms are also literally what these GPL drugs suppress.

      It’s like anxiety meds for someone who has diabilitating anxiety to just relax. Or more commonly telling the clinically depressed to just smile more.

      Telling someone it’s a personal failing only fuels the feedback mechanism.

      Medications exist because they stop the biological feedback loops.