Fat State Stretched Thin: Tennessee Covers Gastric Bypass Like many state Medicaid programs, Tennessee covers bariatric surgery for the morbidly obese but doesn't pay for diet counseling. Critics argue that investing in prevention could save money for the strapped program, but the state's chief medical officer says there's no proof that's true.
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Fat State Stretched Thin: Tenn. Covers Gastric Bypass

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Fat State Stretched Thin: Tenn. Covers Gastric Bypass

Fat State Stretched Thin: Tenn. Covers Gastric Bypass

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ROBERT SIEGEL, Host:

From member station WPLN in Nashville, Daniel Potter reports.

DANIEL POTTER: Two years ago, Jane Leck weighed more than 250 pounds. She's in her mid-40s and TennCare was paying for her heart and blood pressure medicine and she was pre-diabetic.

M: I've always battled obesity, genetically. I have family members that are all obese.

POTTER: Leck says she's only ever been close to a normal size when taking diet pills. But she quit because of side effects, gaining back her old weight and then some. Eventually, TennCare paid for her to have a gastric bypass. Surgeons gave her less of a stomach so she feels full faster and eats less. She has since gotten rid of almost all of her old clothes.

M: We're over at the 3 or 4Xs.

POTTER: To show how much weight she's lost, she leafs through a swap rack for obese people at her former clinic where patients drop off old clothes as they slim down.

M: My jacket, my size 3X, before surgery I could barely zip it. And now me and another person can get in it and zip it, so I've lost a whole person.

POTTER: And dietitian Sarah-Jane Bedwell says Tennessee isn't one of them.

M: It's like saying we're going to fill your cavities, but we're not going to ever pay for you to get your teeth cleaned or teach you how to brush your teeth.

POTTER: Here's chief medical officer Wendy Long.

POTTER: For any benefit that we don't offer through the TennCare program, there is someone that would argue that it would be cost-effective for us to offer a new benefit.

POTTER: While Tennessee ranks among the nation's fattest states, TennCare's budget is stretched thin because of sagging tax revenues. Long says if paying for dietitians saved the state money, they'd do it. But...

POTTER: There's really no evidence to support the fact that providing those services would result in a decrease in medical costs, certainly not immediately, and to even in the longer term.

POTTER: Dr. Ronald Clements, head of bariatric surgery at Vanderbilt, sees no problem with the state paying for a gastric bypass.

POTTER: The biggest bang for the buck in treatment of obesity is bariatric surgery, hands down. Nothing else comes close. However, only a small percentage of obese patients qualify for it.

POTTER: For NPR News, I'm Daniel Potter in Nashville.

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