What my weight loss journey taught me about how healthcare works – Employee Benefit News

I’m a former fat person. Uncomfortable to read, even harder to write, but nonetheless true. Now, for the record, I don’t believe that being fat is inherently bad. It is just an adjective — the same as slim, blonde, short, etc. Yet somehow, it carries a different kind of weight (no pun intended) when we talk about it. At least that’s how I felt as a 300 pound woman, especially in sales. 
This journey (or escape) from morbid obesity — and a host of health problems — pried open my eyes in a major way that shaped and informed my approach to employee benefits advising. But more on that later. 
While being fat wasn’t automatically a negative thing, it had accelerating health consequences. By the time I was in my mid-twenties I had severe obstructive sleep apnea, high cholesterol, pre-diabetes, inexplicable body acne, daily heart palpitations, and I was huffing and puffing my way through life looking for a medical solution to a lifestyle problem. By the time I was 28, my doctor wanted to put me on a life-long maintenance medication regimen just to get my symptoms under control. But the truth is, I really needed to lose weight. 
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I had many outskirt conversations with a variety of doctors who tried medical intervention instead of tough love. I had a heart rate monitor strapped to me for several days in a row, had labs drawn incessantly and even did some stress tests to get to the root of this mysterious set of symptoms that were due, at least in part, to obesity. 
In my heart of hearts, I knew that if I could just figure out how to lose weight, I could cure myself of much of this and replace the bills to hospitals and physicians with an increase in my grocery budget for fresh food or spend a little of my deductible money on a gym membership instead. I would certainly be better off financially even if I didn’t lose a pound. 
Finally, in 2015, I met another doctor whose bedside manner left much to be desired. I remember leaving his office in tears as I told him my diatribe of attempts through the system to figure out why I was so unhealthy. He looked me square in the eyes and told me I was morbidly obese and needed to lose weight. There was nothing else to be done unless I wanted to continue down this rabbit hole of doctors and prescriptions. I thought he was a total jerk. But some jerks are right, and this one certainly was. 
Fast forward just a couple of weeks and my employer had posted a new “wellness” challenge for the entire company, intended to crown a winner for the most weight loss in a month. Given my competitive nature, I wasn’t going to finish without ranking in the top three — but I clearly had no idea how to actually lose weight, so I went looking for information. 
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Time and time again I came back to the same answer — it’s a mathematical equation: energy in, energy out. Exert out more than you put in and, voila, weight loss! I used online calculators to figure out what a calorie deficit looked like for me and with the contest looming, adjusted my meals and cooking style to make sure I could get enough food from the number of calories I had given myself. 
After losing 15 pounds and coming in second in the contest, I found more information online and joined fitness communities on social media platforms that taught me how to maximize my food intake and incorporate exercise. It took me 18 months to lose 150 pounds and become a competitive bodybuilder. (Yes, you read that right.) The only part of the healthcare system that helped me was the real-life version of TV’s Dr. House who told me I was simply too fat. Every other healthcare professional I encountered offered me tests, prescriptions and blood work. but none of them offered a nutritionist, trainer, or lifestyle changes. 
The reason I’m sharing all this highly personal information? As someone who runs a health insurance consulting business, I’ve seen how patients who even attempt to look to the healthcare system for good health are likely not getting nearly as much attention and resources as they actually need to be well. The system is not designed to keep people well; it is designed to keep people in the system. My deductible, coinsurance, and payer’s contribution behind the scenes fund a system that remains profitable when we remain sick. And, in our line of work, I like to believe that I have cracked the code on how to get the best from the healthcare system without going bankrupt. (I did that, too, by the way, but that’s another story.)
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Before I owned my own company and worked as an insurance carrier rep, I believed I could influence change from the inside, and I know now that change can only happen outside of the entities that systemically work to keep people behind the doors and claims dollars flowing in. 
It’s not just about the strategies I’ve executed over the years as an adviser, although they have been incredibly effective and fortuitous for our clients. It’s about my approach to the healthcare system and the way I consult with others on it. Frankly, the health plan benefits of the average, midsize employer are financially hurting the patients and employers that are paying the premiums, and while a wellness program may prompt a lightbulb for someone like me who is in it for the glory of the win, it isn’t going to affect much change if your client’s wellness plan or your health plan doesn’t provide the education, tools and guidance to take the next steps into really improving a person’s wellbeing. That’s why nowadays I talk to clients about how to make their health benefits more accessible, more affordable and as distanced from traditional health insurers as possible. 
Take reference-based pricing, which is going to save money on medical claims for a self-funded employer no matter what, because it means we pay less for healthcare. And as for the Direct Primary Care model that sits outside of the big insurance buildings, we’ve been witnessing talented and mission-driven physicians break out of the hospital systems and revert to simply delivering care to patients as it was always intended to be, and yes, this also saves money. 
My experience allowed me to see how the system was keeping me unwell and so, I had to go it alone, but gratefully, I can now call myself an ally to those who are where I once was — and I know where to look for the solutions. 
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