Friday, January 1, 2010

After gastric bypass surgery, couple loses 249 pounds in a year

Chicago, IL
Their daily Starbucks drink of choice was once a Venti Java Chip Frappuccino -- a whopping 600 calories in a cup.

These days, Lorie and Todd Richmond splurge on coffees with Splenda and a dash of half-and-half. But they are more likely to be riding their bikes, shooting hoops with their three kids or shopping for new clothes.

The Chicago Sun-Times featured the Richmonds in a Dec. 22, 2008, story after the couple from northwest Indiana had weight-loss surgery at the University of Chicago Medical Center on the same day.

Before the surgery, Lorie weighed 402 pounds, Todd 305.

A year later, Todd is at his goal weight of 207 pounds. He's off cholesterol and blood-pressure medications. Lorie weighs 251 pounds and is confident she can lose another 60 pounds or more to reach her goal.

Together, the two have lost 249 pounds in one year.

"It makes you feel so good that people notice," Lorie said. "For the first time in my life, I don't mind telling people my weight."

The Richmonds' say their quality of life also skyrocketed as their weight decreased.

They vacationed in the Smoky Mountains, hiking and riding roller coasters -- things they couldn't do before.

They bought bikes, and Todd consistently rode about 10 miles every other day throughout the summer. When she started, Lorie could only ride a block before having to stop; by the end of the summer, she took an eight-mile ride.

And when she ran to pick up an errant basketball while shooting baskets with her 7-year-old son, he said words she had never heard before: "I just saw my mom run."

"I almost cried," she said. "I was so happy I could do that with him. It gives me even more drive to keep going."

Dr. Vivek Prachand, an assistant professor of surgery at the University of Chicago Medical Center, performed Lorie's duodenal switch and Todd's gastric bypass.

A duodenal switch involves removing part of the stomach and bypassing much of the small intestine to limit how many calories are absorbed. A gastric bypass shrinks the stomach.

But the surgery alone wouldn't help the Richmonds lose and keep off the weight. They altered their diet and exercise habits -- something they had tried repeatedly in the past but without success.

"You have to recognize the surgery is a tool, it's not a cure," Prachand said. "I only take half the credit for it. You accomplish the other half."

The Richmonds said they were stung by hostile online anonymous critics who said the surgery was "cheating'' and accused the couple of laziness.

Prachand said he has heard all the criticism before, but said they are unfair. He said the surgery is highly effective and corrects multiple medical issues with one procedure.

"What we're dealing with when we're talking about surgery for severe obesity, we're talking about people who are 10 to 15 times heavier than the 10 to 15 pounds all of us have struggled with at one point or another," Prachand said. "Sometimes it's hard to project the added difficulty of that much more."

Beyond the surgery and added exercise, the Richmonds dramatically changed what they ate.

Todd said a year ago, he could "put a buffet out of business."

Now, the couple eat off saucers to help control portions.

They eat small meals consistently throughout the day, including daily breakfast.

And while they haven't abandoned Starbucks completely, they cut out the oversize sweet drinks and other treats -- even though they say they are constantly celebrating.

"This year has been awesome for us," Lorie Richmond said. "There's so much, I want to shout at the rooftops. Life is opening up for us."
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Sunday, September 13, 2009

Indiana Court of Appeals rules that employer must pay for obese employees gastric bypass surgery to ensure success of back surgery for work injury

Indianapolis, IN
Experts say a court decision today in Indiana could make employers think twice before hiring workers who have health conditions that might prove costly down the road.

An appeals court ruled that a pizza shop has to pay for weight-loss surgery for a 340-pound employee. The surgery will ensure the success of another operation for a back injury that he suffered at work.

The ruling raises concerns among businesses bracing for similar claims.

The pizza shop had agreed to pay for the back surgery, but said it wasn't obligated to pay for the weight loss operation because the man was already obese before he was hurt.

The court found that the surgery was covered because the man's weight and the accident had combined to create a single injury.

There was a similar ruling recently in Oregon, where the state's Supreme Court ruled that the state workers' compensation insurance has to pay for gastric bypass surgery to ensure that a man's knee replacement surgery is effective.

The head of a consulting firm that helps businesses manage workers compensation says the Indiana case "draws a line in the sand" -- because it's based on principles used in several states.

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Wednesday, February 18, 2009

Medicare Announces Final Coverage Policy for Bariatric Surgery as a Diabetes Treatment

Washington, D.C.
The Centers for Medicare & Medicaid Services (CMS) announced today a clarification in its policy for Medicare coverage of bariatric surgery as a treatment for certain beneficiaries with type 2 (or non-insulin-dependent) diabetes.

The decision specifies type 2 diabetes as one of the co-morbidities CMS would consider in determining whether bariatric surgery would be covered for a Medicare beneficiary who is morbidly obese, as long as the surgery is furnished at a CMS-approved facility. An individual with a body-mass index (BMI) of at least 35 is considered morbidly obese. Normal body-mass index is considered to be between 18.5 and 25.

“Medicare beneficiaries who are morbidly obese may face tremendous health complications,” said CMS Acting Administrator Charlene Frizzera. “Today’s coverage decision assures that beneficiaries who are morbidly obese can access safe, effective weight loss options to help prevent these complications.”

As part of today’s decision, CMS announced bariatric surgery will not be covered by Medicare when it is used to treat type 2 diabetes in a beneficiary with a BMI below 35. While recent medical reports claimed that bariatric surgery may be helpful for these patients, CMS did not find convincing medical evidence that bariatric surgery improved health outcomes for these non-morbidly obese individuals.

“Limiting coverage of bariatric surgery in type 2 diabetic patients who are not considered clinically obese is part of Medicare’s ongoing commitment to ensure access to the most effective treatment alternatives with good evidence of benefit, while limiting coverage where the current evidence suggests the risks outweigh the benefits,” said Barry Straube, M.D., CMS Chief Medical Officer and Director of the agency’s Office of Clinical Standards & Quality.

In 2006, CMS expanded coverage of bariatric surgery for Medicare beneficiaries who received surgery in high-volume centers from highly qualified surgeons (as certified by the American College of Surgeons or the American Society for Bariatric Surgery, and as reported on the Medicare Coverage Web site).

Under the 2006 decision, to be considered for coverage, Medicare beneficiaries were required to have a BMI of 35 or higher, and to have exhibited a serious health condition in addition to morbid obesity, such as hypertension, coronary artery disease, or osteoarthritis.

In that same decision, CMS covered four types of bariatric surgery procedures: gastric bypass, open and laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and open and laparoscopic biliopancreatic diversion with duodenal switch. No other bariatric surgery procedure is currently covered.

Today’s decision memorandum is available on CMS’ Coverage Web site at:

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Tuesday, August 5, 2008

Workers' compensation insurer must cover obese worker's gastric bypass costs

Portland, OR
A 350-pound worker in Oregon injured his knee while on the job. But treatment for the injury wouldn't be effective because of his weight, and the physician recommended gastric bypass surgery. A lawsuit was brought and an appeals court sided with the state's Workers' Compensation Board, saying SAIF, a state-chartered workers' compensation insurer, had to cover the cost because the "injury was more than a minor cause of the claimant's need for gastric surgery and was therefore compensable."


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Saturday, March 8, 2008

Bariatric patients find more options than just gastric bypass surgery

Wausau, WI
Local weight-loss surgery programs are facing competition for patients from an eastern Wisconsin program.

Midwest Bariatric Solutions and Theda Clark Medical Center in Neenah will hold a bariatric surgery information session Thursday. Dr. Raymond Georgen, a member of the practice, said it holds seminars outside the Fox Valley on a regular basis.

"Our practice is statewide," Georgen said, noting he has had several patients travel from Wausau, central Wisconsin and Michigan's Upper Peninsula for gastric bypass surgery and a procedure using an adjustable band to reduce the stomach's capacity. More >>

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Friday, January 18, 2008

TRICARE now covers gastric lap-band surgery

Falls Church, VA
TRICARE beneficiaries whose weight poses a serious health risk now have a new surgical alternative available.

For those who medically qualify, TRICARE now covers laparoscopic adjustable gastric banding, also commonly called Lap-Band surgery. Although the TRICARE policy change has only recently been made, coverage is retroactive to February 1, 2007.

"We at TRICARE are careful to only cover procedures that have been proven safe and effective, and are accepted by the medical community," said Maj. Gen. Elder Granger, deputy director of the TRICARE Management Activity. "We've added this procedure because, for some beneficiaries, it may be the right course of action to preserve their health."

Granger adds that, like gastric bypass, gastric stapling or gastroplasty, Lap-Band surgery is only for those suffering morbid obesity. In medical terms, that means their body weight is 100 pounds over ideal weight for their height and bone structure, and their weight is associated with severe medical conditions known to have higher mortality rates. Body weight that is more than twice the ideal weight for the person's height and bone structure may also indicate morbid obesity.

In addition, TRICARE will cover the surgery if a patient has had an intestinal bypass or other surgery for obesity and, because of complications, requires a second surgery.


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Kansas considers insurance coverage for weight-loss surgery

Topeka, KS

Insurance spokesman: Paying for procedure would cost everyone
More than half of adult Kansans are overweight and almost a quarter are obese, which caused an estimated $657 million annually in medical expenses between 1998 and 2000.

On Thursday, a Senate committee heard from a Wichita man and a Topeka doctor who said the morbidly obese could be helped, and lives could be saved, if insurance companies paid for weight-loss surgery.

Sen. Jim Barnett, R-Emporia, a physician, said he called the meeting of the Senate Health and Welfare Committee to "nudge" the conversation forward. But he said he doesn't favor legislation requiring such coverage.

And one Kansas insurance spokesman warned that covering such surgery could drive up costs for everyone.


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Saturday, December 29, 2007

Gastric Bypass Surgery on Again for 500 lb. Florida Man, New Insurance Covers Bariatric Surgery

Orlando, FL
Neal Pittard, the dangerously overweight Longwood man who came within 3 1/2 weeks of gastric-bypass surgery last summer, is still waiting for the procedure that he and his doctors think will save his life.

Pittard's plight was chronicled earlier this year after Florida Hospital's in-house insurance company refused to cover the procedure. Florida Hospital offers gastric-bypass surgery at its Celebration Health campus, touting the procedure as "the only proven consistently effective treatment for morbid obesity."

Pittard, who is 34 and weighs 500 pounds, was insured through his wife, then a nurse at Florida Hospital Orlando. His doctors strongly recommended gastric-bypass surgery for Pittard, but Florida Hospital's insurance policy does not cover it.
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