I am about 140 pounds overweight. I have a clubbed foot, which makes it hard to exercise. I also have lower back pain, hip pain and leg pain. I want to lose the weight, but diets haven't worked. Will insurance cover the cost of stomach stapling? Is there ever a medical reason for the procedure?

Dee

The treatment strategy for obesity is complex, requiring an adherence to strict diets, regular exercise, behavioral interventions and, occasionally, medical or surgical therapy. All people who want to lose weight must attempt to diet and exercise before other therapies are considered.

It is true that many people with severe obesity will not be able to exercise adequately or safely because of other medical problems such as arthritis or heart disease. In such cases, behavioral therapies and medications are tried. Behavioral therapy, usually administered by a psychologist or psychiatrist, helps to maintain the patient's focus on the treatment regimen. Medications for obesity are a relatively new addition. Although the popular fen-phen drug combination is no longer on the market because of the possible long-term health risks, other effective weight-loss medications have been developed and even more are in the pipeline.

Finally, surgical treatment may be an option for some people with severe obesity or those with moderate obesity accompanied by medical complications related to excess weight (such as high blood pressure, diabetes, arthritis or sleep apnea). The current standard surgeries for obesity are vertical-banded gastroplasty, which involves stapling the stomach to reduce its size, and gastric bypass, which involves a bypass of part of the stomach. There are also variations that combine these two procedures in an attempt to enhance the weight-loss effect.

These procedures are usually effective if done by surgeons experienced in weight-loss surgery. Patients can typically expect to lose 50-70 percent of their excess weight. However, potentially serious complications, such as stomach leakage and obstruction, can occur in 5-10 percent of cases. Thus, it is very important for someone who is considering such a procedure to consult with an experienced surgeon.

So, to answer your specific question, weight-loss surgery can be an accepted form of therapy for obesity in certain cases. Whether it is covered by your insurance depends on the details of your particular plan, and you should raise the issue with your doctor and/or insurance administrators.