The Ontario government’s OHIP does cover some weight loss procedures. However in general, it doesn’t pay for cosmetic surgery unless these services are deemed to be medically necessary.
Bariatric surgery, or weight loss surgery, is covered by OHIP if you meet certain conditions. You must have failed previous attempts at weight loss through one of the medically-supervised programs, and in most cases must have a Body Mass Index higher than 40.
Weight loss surgery is recommended for morbidly obese people who have been unable to lose sufficient weight with diet, drugs, and exercise. There are several types of bariatric surgeries, which either reduce food intake by removing a portion of the stomach, or reducing the size of the stomach with a gastric band, or bypassing part of the intestines so there is less absorption of food.
People who have lost a great deal of weight may be left with excess, sagging skin and loose muscles which cannot be dieted or exercised away. This can result in extreme self-consciousness and embarrassment. However, there are several extremely successful plastic surgical procedures which can remove sagging skin, tighten muscles, and restore tone to the body.
Abdominoplasty and Panniculectomy: removal of excess skin after weight loss
An abdominoplasty is a cosmetic surgical procedure which removes excess skin and tightens muscles around the abdomen, and is very effective at toning the body after extreme weight loss. It is also effective at correcting some post-pregnancy conditions. The abdominoplasty procedure is not covered by OHIP.
However, a panniculectomy may be covered under certain conditions. Much like an abdominoplasty, panniculectomy is a surgical procedure to remove excess skin and fatty tissue. However, it does not tighten muscles nor does it remove as much skin as an abdominoplasty.
Panniculectomy eligibility conditions
You may be covered under OHIP if you have lost 100lbs or more, and have other symptoms which significantly affect your daily living. For instance, you may be eligible if the excess skin extends below your pubic symphysis. Other symptoms include back problems, and skin disorders like rashes and ulcers caused by the excess fatty tissue and skin. Some patients find walking and even standing difficult due to this excess skin.
Please note, prior authorization of payment from the MOHLTC is needed for OHIP coverage.
Liposuction is not covered by OHIP. Liposuction and other body sculpting procedures, including thigh, arm, and breast lifts, are classified as cosmetic surgery.
Counselling and Guidance
Certain weight loss clinics are partnered with OHIP. Office visits will be covered by OHIP, though an administrative fee may apply. Weight loss clinics offer nutritional, medical, psychological, and fitness assessment, as well as metabolic testing. Through weight loss clinics you also may have access to counselling, support, books, DVDs, nutritional supplements, and other supplementary materials.
If you feel you can lose weight without surgery, a weight loss clinic may be a good option for you. You may want to also look out for other free services such as support groups, and online weight-loss programs.
It may be discouraging to read about the difficulties surrounding bariatric surgery, especially the cost of cosmetic re-sculpting, and reshaping surgery. Indeed, some people feel depressed after bariatric surgery and the ensuing weight loss, due to the loose skin and muscles.
You should not let this discourage you. Obesity has many negative impacts on your health, happiness, and general quality of life, including:
Increased risk of heart disease and stroke.
Type II Diabetes.
Breathing problems, including sleep apnea.
Pain and discomfort.
As you can see, obesity has drastic consequences for your health (physical and mental), and can dramatically shorten your lifespan. Obesity is a disease, and must be treated as such. While there are many lifestyle measures you can take to lose weight, such as increasing physical activity and making changes to your diet, some individuals simply cannot combat the disease on their own.
If you fall into this category, and have a BMI over 40, then you may qualify for OHIP coverage of bariatric surgery. The surgery itself however, is not the be-all-end-all. Those who go into the surgery with the expectations that it will improve everything immediately may face disappointment, and even depression.
However, for those who understand that weight loss is a long-term process, bariatric surgery is a lifesaver–literally and figuratively. They experience huge improvements in health, and happiness.
Ideally, bariatric surgery is supplemented by counselling, or therapy, nutritional and exercise guidance, and, cosmetic surgery. Procedures like abdominoplasty can improve the look of the stomach following a dramatic weight loss.
Dr. Kesarwani is a specialist in after weight-loss procedures. These may include:
Since these cosmetic procedures are not covered by OHIP, some may find the cost prohibitive. Please contact us at Cosmedical today to discuss these concerns. We strive to keep our services as reasonable as possible, and offer you full quotes upon consultation.
We also offer financing on all procedures, which can be a big help for those who have financial limitations. Your health and happiness are important. Contact us today to set up a consultation.