Posts filed under 'obesity'
The NBC reality show Biggest Loser has kicked off another season and another chance to drive home to our country just how out of control obesity is and, well, how much work it takes to overcome it once you’ve lost control.
I haven’t watched the show since I followed an entire series in my blog a few years back and was very disappointed when the whole point of the show was lost by one contestant playing games with the system and, frankly, NBC allowing it.
In concept the show is right on the money for what we American’s need. We need to have fat thrown in our face, visually and intellectually. We need to know, and I fault NBC for not taking more license to do it, that obesity is the tip of a deadly iceberg. Being overweight is just the first step off into a world of health problems that include high blood pressure, type 2 diabetes, heart attack, coronary artery disease, stroke and cancer.
From a life insurance underwriting standpoint the potential risks have to be weighed. All life insurance companies have build charts and all of them have a limit. While there are a few companies that will still insure someone who is, say, 6′1, 425, they do so cautiously. Insuring someone of that stature at all requires them to be healthy at the time. They can’t have started down the slope of health risks described above.
It is that list of potential disasters waiting to happen that leads more life insurance companies all the time toward a more lenient stance toward bariatric surgery, gastric bypass. What was often derided by the public and a lot of health professionals as the lazy way out of a self induced problem, is now seen as a prudent way to regain a foot hold on health that might not otherwise be achievable.
Bottom line. So Biggest Loser makes a reality “game” show of it. I truly hope that it inspires some to follow and tackle their challenges head on, but I also truly hope that NBC will see the chance they are missing for real education and allow 5 minutes of their precious air time per episode to make that education a reality.
January 18th, 2010
I was working with a client on quotes the other day and he was telling me about a friend who had decided not to even pursue life insurance because he was convinced that he was probably not insurable.
You know it’s kind of like that old saying, “The only stupid question is the one you don’t ask”. Well, the only sure way to get declined for life insurance is to just not apply. The client went on the explain in quite a bit of detail what his friend’s heart issues were and the truth was that he was, in all likelihood, insurable at a standard or maybe a slightly rated premium.
I would be the last one to claim that I can get traditional insurance for anyone that wants it. The truth is that there are folks that are only eligible for guaranteed issue life insurance. But don’t ever declare yourself uninsurable without putting in an honest effort to see what might be available. What most people find is that life insurance companies aren’t nearly as brutal as one might think.
In the recent past we have placed pleasantly surprised clients with a history of heart disease, diabetes, obesity, certain types of cancer, sleep apnea, mood disorders including bipolar disorder and people who have undergone gastric bypass surgery, angioplasty, and other heart procedures such as ablations to stop arrhythmia.
Many of these people had been declined by one or more companies before we were able to successfully get them coverage. So, don’t ever declare yourself uninsurable and don’t assume that all companies will view you the same or that all agents will know where to take your business in order to be successful.
Don’t take agents at face value. If an agent listens to your health history, especially a challenging one, and then just shoots a quote from the hip, they’re either very, very good or foolish. And I would go so far as to say that they would probably all be foolish shooting from the hip. The very, very good agents don’t want to waste your time, their time or paperwork by not getting it right the first time, so they will ask you to wait a few days while they informally shop your information and get multiple underwriting opinions. They may ask you to provide documentation to help with that process.
I routinely ask for copies of labs for diabetes, copies of stress tests for heart issues and copies of sleep studies when shopping sleep apnea cases. It’s a much better and more rewarding process when done right the first time.
Bottom line. Don’t be afraid to find out the truth about where you fit into the life insurance picture. I know I tend to make things bigger than they need to be when I don’t know where to turn for help. Seek out an independent agent who seems to truly understand your health issue, spell out your goals and do all you can to work with the agent. In most cases success will follow.
December 30th, 2009
Like smoking, another issue that gets a lot of interest in life insurance but very little follow through, is weight.
I’ve offered several posts concerning companies that will underwrite obesity at fair rates. I’ve also mentioned frequently that what is fair for someone 6′1, 394#’s is not going to be the same as what is fair for someone 200#’s lighter. These companies are underwriting known mortality risks when they choose to make offers on those who don’t even fit on most companies build charts at all.
For whatever reason, smoking and obesity are two areas where I see customers who want the insurance but decide nothing is better than something when they see the price on what they would like to have. By this I mean that, for instance, a person would like to have $1,000,000 worth of life insurance. When they find out that it doesn’t fit into their budget due to the premium charged for smoking or obesity, the opt to do nothing rather than look at $500,000 or $250,000. It’s kind of like the kid that takes his bat and ball and goes home because he can’t get what he wants. So he goes home and then he has a bat and ball and no one to play with. Somehow that doesn’t work out to be a good deal.
In life insurance, deciding that nothing is better than something may work for you, but how’s that going to work out for your family? Do you have some sense that your family is better off with nothing than $250,000? Do you really think that it would make sense to your wife that because you couldn’t afford $1,000,000, you should just go without any protection for her and the kids?
We can successfully get offers all day long for those who can’t get it somewhere else due to build, but we can’t change that all or nothing mentality.
Bottom line. Keep in mind that I have never had a widow call me and gripe that their husband left too little behind. The only time I hear complaints is when they find quotes or application paperwork that was never followed through with. Don’t break the bank. Get what you can afford and your family will be glad you did.
November 30th, 2009
There is a common misconception, especially among those who have pretty extreme weight issues, that life insurance simply isn’t available. With most, but not all, companies they would be right.
Obesity carries with it a lot of mortality baggage that most insurance companies would really rather not deal with. They see the glass as half empty so to speak. When they see an application for someone, say 5′10″ and 370#, even in the absence of any other health issues they can’t seem to get past the fact that obesity is in fact a risk factor for a lot of problems such has high blood pressure, heart disease, cancer and stroke.
Some companies can’t get past that and see their way to an approval. That is not to say that the companies that will approve a policy on a severe weight issue are ignoring the potential consequences, but they are giving some leeway for the fact that those problems haven’t shown up yet. This gives some advantage to younger applicants as, just like diabetes, obesity tends to wear your body down over time. You are far less likely to have been impacted by obesity in your 30’s and 40’s than later in life.
The good news whether you are in your 30’s or in your 50’s or older is that if you have managed to maintain good health, other than your weight, reasonable rates are available. Some companies, like Prudential, even bump their build scale up after age 65 sort of acknowledging that not all of us can hold our stomach in forever.
Bottom line. There are times when you really won’t qualify for traditional insurance based on height and weight, but in most cases that isn’t true. A good independent agent can guide you to the right company for your build.
October 30th, 2009
I had a client just recently who works for State Farm as a claims adjuster and was declined for life insurance by to them due to his obesity. He’s 6′1, 415 pounds.
I shouldn’t get down on State Farm over this since by most life insurance company underwriting guidelines he has stretched well past the breaking point. But dang! The guy does work for them.
Well, whining not being the point since we got his approval and his new policy is in force with Prudential, I just wanted to share some of the upper limits of what Prudential will consider assuming no truly egregious risk factors. The risk factor thing is worth mentioning because it is highly unlikely that someone approaching these limits with diabetes is going to get an approval, but the client that I just mentioned did have well controlled blood pressure and that didn’t impact his approval.
So, if you’re this high……….and weigh this or less……..
5′2 303#
5′3 313#
5′4 323#
5′5 333#
5′6 344#
5′7 354#
5′8 365#
5′9 378#
5′10 387#
5′11 398#
6′0 409#
6′1 421#
6′2 432#
6′3 444#
6′4 456#
6′5 468#
and so on. These are the upper limits of approval period. These are well above the approval limit of almost all companies so don’t be thinking you can take this post down to your local Allstate agent and say, “look, you should be able to get me approved because Ed said so”. He will wish that he could. He will look for every way he can to get er done, but it isn’t happening.
Bottom line. You need to find an independent agent that understands obesity and knows how to help. You need to be talking to someone who is savvy enough to be able to tell you where you stand right up front without dragging you through an underwriting and application process. You need someone with a track record of helping those with the same issue succeed for their families.
September 22nd, 2009
Obesity is a complete show stopper with most life insurance companies. Each company has their own build chart and most of them are relatively comparable up through the standard rate class.
Where companies rapidly peel off and get out of the game is when people are heavier than what fits into their standard rate class. It’s at that point that it’s apparent, at least to me, that most companies really aren’t sure what to do with build or aren’t sure how to address mortality assumptions based on out of the ordinary height/weight situations.
Let’s start with what most companies can agree on, the approximate height/weight ratios they want to see for their best rate classes. Below is a build chart from Banner Life Insurance, kind of a middle of the road guideline. These show the maximum for each rate class, the first two groups being for preferred plus rates and divided as many companies do into maximums for male and female. Some companies keep the sexes separate all the way through to standard. In Banner’s case as the continued weights show for preferred, standard and standard plus rates they go to a unisex guideline.
Male Preferred Plus
Build Chart
Height
5′ 0″ 144
5′ 1″ 148
5′ 2″ 153
5′ 3″ 158
5′ 4″ 163
5′ 5″ 168
5′ 6″ 174
5′ 7″ 179
5′ 8″ 185
5′ 9″ 190
5′ 10″ 196
5′ 11″ 201
6′ 0″ 207
6′ 1″ 213
6′ 2″ 219
6′ 3″ 225
6′ 4″ 230
6′ 5″ 237
6′ 6″ 243
6′ 7″ 249
6′ 8″ 256
6′ 9″ 262
6′ 10″ 268
6′ 11″ 276
PPNT Preferred Plus Non-Tobacco
Female Preferred Plus
Build Chart
Height PPNT
5′ 0″ 135
5′ 1″ 138
5′ 2″ 140
5′ 3″ 143
5′ 4″ 145
5′ 5″ 148
5′ 6″ 150
5′ 7″ 155
5′ 8″ 160
5′ 9″ 165
5′ 10″ 170
5′ 11″ 175
6′ 0″ 180
6′ 1″ 184
6′ 2″ 188
6′ 3″ 193
6′ 4″ 197
6′ 5″ 201
6′ 6″ 205
6′ 7″ 209
6′ 8″ 214
6′ 9″ 218
6′ 10″ 222
6′ 11″ 226
Male/Female Build Chart
Height PNT SNT SPNT
5′ 0″ 158 172 166
5′ 1″ 163 178 172
5′ 2″ 168 183 175
5′ 3″ 174 190 182
5′ 4″ 179 195 188
5′ 5″ 185 202 194
5′ 6″ 191 208 200
5′ 7″ 197 215 206
5′ 8″ 203 221 212
5′ 9″ 209 228 219
5′ 10″ 215 234 226
5′ 11″ 221 241 231
6′ 0″ 228 249 240
6′ 1″ 234 255 245
6′ 2″ 241 263 253
6′ 3″ 247 269 259
6′ 4″ 253 276 265
6′ 5″ 260 283 272
6′ 6″ 267 291 280
6′ 7″ 274 299 287
6′ 8″ 281 306 294
6′ 9″ 288 314 302
6′ 10″ 295 322 309
6′ 11″ 303 330 317
Please be advised; the build data listed for Standard Non-Tobacco also applies to Standard Tobacco and Preferred Non-Tobacco also applies to Preferred Tobacco.
So, using a current client, a young man in his 30’s who is 6′1 and 415#’s, what would Banner’s stance be? He already knows that State Farm considers him not insurable since they declined his application of a few months ago. Banner, and frankly most companies would come to the same conclusion.
We applied for a policy through Prudential and his policy for $250,000 of 20 year term was approved, albeit highly rated, still approved at a rate of about $91 a month. Certainly the average person his age might consider that an outrageous price, but for him it’s a chance to provide the coverage for his family and it’s within his budget.
Bottom line. Obesity presents plenty of challenges in life, but with life insurance it doesn’t have to if you choose an independent agent with access to the right companies.
August 25th, 2009
I’ve written before about the dramatic and often amazing results that extremely overweight people have see in regards to their diabetes when they undergo gastric bypass surgery.
Gastric bypass is a procedure that essentially creates a dramatically smaller stomach by stapling off the majority of the stomach and leaving just a “pouch” for the food to pass through. With this much smaller stomach a person gets full quicker, and that combined with eating the right things, a healthy diet, creates rapid weight loss and in many cases an almost instant reversal or cure of type 2 diabetes.
Such is the case in an interview posted by TuDiabetes today. The story tells about a woman whose diabetes was really poorly controlled even on medication and within a week of the bypass she was able to come off of medications completely and her glucose levels were lower than they had been in years.
The decision to have gastric bypass surgery is not to be taken lightly and has risks that need to be considered, but for many those risks pale in comparison to the risks face by continued obesity and out of control diabetes. There really is no soft way to explain how damaging the combination is and how it can lead quickly to a loss of the quality of life, if not the loss of life itself.
Life insurance underwriters view gastric bypass carefully knowing that there are risks from the surgery and the dramatic weight loss for the first year or so, but within a few years the weight loss and improved overall health often lead to much better rates than a person would have received prior to the surgery, if they were insurable at all at that point.
Bottom line. Gastric bypass has always had a stigma attached, just as obesity has. To put it bluntly, there are a lot of people who probably say under their breath that it’s just a case of a fat person taking the easy way out. But let’s be real. There isn’t anything easy about the situation they are in and when they choose the surgery there’s nothing easy about the way out…..and it saved and changed their lives.
May 29th, 2009
Guilty as charged. I am one of those recovering saltaholics that grabs the salt shaker and tops off a meal before I’ve even taken a bite to see if it needs it. I love salt and although I am getting better about at least giving something a taste first, the truth is, well, I’m still recovering and fall off the wagon occasionally.
A high salt/low potassium diet is a pretty reliable ticket to the land of high blood pressure, stroke and some types of asthma. A topic of considerable attention lately has been the unbelievable amounts of sodium found in some of the most popular dishes in some of the most popular restaurants most of go to at least occasionally. Sometimes it seems to me that restaurants offerings are kind of self defeating. They make meals taste good by adding large amounts of salt and it often tastes so good that people are driven to eat every last bite, which unchecked leads to obesity.
Now perspective is a good thing. No reason to freak out if there really isn’t a reason, right? They (whoever they are) say that the maximum sodium intake for an adult should be about one teaspoon daily. I am an admitted saltaholic and if I were presented with a salt free day’s worth of meals, I doubt that I would add an entire teaspoon over the course of a day. That’s a lot of salt!
My downfall comes when I eat dinner out at a restaurant that knows two things for sure. 1. We, as a nation, love salt and want it on most everything we eat and 2. The more salt we eat the more beverages we tend to drink. Chili’s restaurants are one of the most consistent abusers of sodium out there. That one teaspoon is roughly equal to 2300 mg. Just a few of Chili’s sodium busting treats are their boneless buffalo chicken salad which sounds healthy but has 4400 mg of sodium, about twice what you should take in on a daily basis. Then there is their Southern Smokehouse Bacon Big Mouth Burger which tops the sodium scale at 4150 mg.
PF Changs has proven to be the king of salt. Their Hot and Sour Soup Bowl tips the scales at an amazing 6878 mg. 3 times the daily recommended maximum in one bowl of soup. I’m wondering if that soup really, really tastes bad and they hope that enough salt will cover it up.
Given the kind of abuse your body goes through at these restaurants, it’s a wonder that life insurance applications don’t ask where and how often you eat meals out. While hypertension and even a stroke can be underwritten at good rates, if a person is hanging out at the who’s who of salty foods, they have to present a higher mortality risk than those who actually monitor their salt intake at almost any level.
Bottom line. Eating right is simply not part of the American way of life and our habit of ignoring how food is prepared, especially the salt and fat that is used, is a recipe for obesity, type 2 diabetes, high blood pressure and stroke. It may be time to ask for sodium confessions before we order a meal.
May 18th, 2009
There was a time when I had a whole different view of obesity and gastric bypass. I think the majority of folks still look at the whole thing through somewhat jaded and certainly uneducated eyes.
I will just be right up front and ask to be forgiven for the way I felt about the issue. I truly had no idea back then just how hard it can be to break the cycle of obesity and I truly had no idea just how at risk of premature death someone could be if they were extremely overweight. I just thought of it as a control problem and a gastric bypass as an easy way out.
After years of study I have a much different view of obesity and just how difficult it is to make meaningful changes in your weight and I also had a much greater appreciation for just how much danger a person was in the longer the weight stayed on. The risk of high blood pressure and stroke, diabetes and heart disease are not things that can be taken lightly and certainly aren’t health issues that, if a person has a way of stopping them, should be put off or ignored.
The studied truth is that for those whose health is at risk due to obesity, gastric bypass is starting to not just be seen as measure of last resort, but as a prudent medical decision. Studies have shown that most people being treated for hypertension or type 2 diabetes can be off of medication completely within just a few weeks of having the surgery. In the truest sense the bypass surgery isn’t just a treatment, but a cure.
From a life insurance standpoint, gastric bypass is viewed cautiously until the weight loss has stabilized. This usually takes about a year. It’s during this year that complications can still crop up. Then, most of the companies that are good with obesity issues will want to see a year of stability before they will approve at standard or better rates.
Bottom line. Gastric bypass surgery is not just an obesity easy button. It’s a measured decision that can help save a person’s life.
May 11th, 2009
Sleep apnea is one of those health issues that can elicit anything from a best rate class approval to a decline depending on two things, which company’s underwriter was involved and if you are truly treating the issue seriously.
A layman’s sleep apnea definition might give the wrong impression of why underwriters are concerned. Apnea is actually a period during sleep when a person quits breathing. It is almost always, when they start breathing again, followed by a loud snore or gasping. Sleep apnea is not a mortality issue in the sense that people quit breathing and don’t start again. Think of it as a more severe instance like those when you have been reading or something relaxing and you just haven’t been breathing deeply, and you suddenly have the need for a good deep breath.
So the issue isn’t about whether a person will forget to start breathing or not. Our body takes care of that quite well, albeit a bit loudly. The real issues have to do with the stress put on your body by two things. First, especially in more severe apnea where a person can quit breathing up to 50 times per hour, there is an issue with a lack of oxygen during sleeping hours. The other is that sleep apnea simply disrupts normal sleep patterns and makes for a tired, sleep deprived person the next day.
So the real mortality issues become sleep deprivation and the possibility of a higher rate of accidents, and the oxygen deprivation causing high blood pressure, heart disease and stroke. The other less talked about mortality issue is that your spouse may cause you substantial harm because of your snoring.
So, what do underwriters want to see for optimal results? A good sleep study that defines the problem as mild, moderate or severe. Mild or moderate bring the best results from a rate class standpoint. Probably the biggest issue for an underwriter is what you do about the apnea and how compliant you are with whatever treatment is chosen. If you have a sleep study with a cpap on that shows the cpap reduces your instances of apnea to almost nothing, but you then only use the cpap once in a while, or half the night, compliance is poor and control isn’t good. You aren’t going to win any underwriter points. Surgically corrected obstructive sleep apnea, if success is documented by a study, can put you back into best rate class running barring any other risk factors, such as obesity.
Bottom line. There are real reasons for underwriter caution with sleep apnea, but if you are serious about your approach to treatment there’s no reason you can’t walk away paying very reasonable rates.
May 1st, 2009
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