Hey there, I’ve been having some real issues with lifestyle and health in general and want to get a second opinion. I’ve recently been on sequence to see about weight loss meds. I’m 27 years old, 260 lbs with a 43.5” waist which definitely meets the criteria for obesity. I submitted a claim to my insurance company for Wegovy and it was denied. Despite the initial barrier, I was able to see my psychiatrist today for some symptoms of low mood/energy/poor diet/poor lifestyle. I am currently taking Fluvoxamine 250mg and Risperidone 0.25 mg once at night. He recommended Wellbutrin to help with mood/depression and Topamax to help with appetite. I don’t know the dosage of those two new meds, but he said it would be a low dose.
I went to get my meds and the copay was over $200, and I’m not sure the other one was even accepted. I’m going to see if there is another option via my psychiatrist and the sequence team, but would you recommend getting a general lipid profile done via LabCorp or another outlet to increase my odds of getting covered? I’m having issues getting covered for this and it is really affecting my health. Since I have strong cravings for calorie-dense foods, it seems to cause low energy, which makes it hard to focus, get quality sleep, exercise, or do anything else. I’ve been sleeping more than 12 hours a day, I basically sleep until I have to go to work in the evening. I’ve tried many different things to manage stress as well. Therapy, meds, lifestyle, etc. but nothing seems to work as I keep having a poor diet and low energy.
I’ve listened to a lot of podcasts of BBM about behavior change and how a lot of decisions made aren’t necessarily conscious or chosen freely. At this point, I seem ready to say, what’s the point? It’s all too complicated to be healthy and I’ve had too many issues to stay consistent with it. What would be your recommendation? Should I just keep trying for the biological piece to fix the appetite and satiety issues? Or just “try harder” with the lifestyle stuff? I understand this is a complex problem, but I appreciate the responses you guys have on here, thanks.