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?

  • gukleszl4hs48ughgxhr5xgd@fedia.io
    75·
    4 hours ago

    Eat healthier, eat more fruits and veggies, cut out excess sugar, walk more, exercise more, the whole kit and caboodle.

    Not to say you should be denied prescription coverage, but that is not the whole kit and caboodle. Weight loss results from consuming less calories; specifically, less than you are burning. You can lose weight on a completely unhealthy diet and without any extra effort to exercise.

    • gilokee@lemmy.worldEnglish
      51·
      2 hours ago

      Yep, this. I’m like 130 lbs and I literally sit around all day and I eat garbage. But just a little garbage.

      • Little8Lost@lemmy.worldEnglish
        1·
        1 hour ago

        Sadly there are some people i know who gain enough to look unhealthy if they dont eat a strict healthy vegan diet. And its easily to see in some cases. A friend of mine was very annoyed when she only got compliments after such rigorous effort. At that time her unhealtiest snack was dried strawberries.

        On the other spectrum is me who cant gain any weight how matter what and how much i eat (cant even donate blood ;.;)

        Bodies are VERY different and there are extremes where only meds can help and i think OP is one of them

        • gilokee@lemmy.worldEnglish
          11·
          1 hour ago

          True, and it could be easier for them to keep weight on, but CICO is a very basic science and will work if one keeps to it.