Will Insurance Pay For Removal Of My Fat Deposits That Have Occurred From My HIV?

Q: Dr. Eppley,  I have HIV and my cdf is about 350 and i am non-detectable. I have developed a small hump in my back and large fat sacks on my legs in certain areas and excess fat in my stomach. I am always unconfortable from the extra weight. I cannot not afford to have this procedure done. I had a price for about eight thousand. I don’t unsterstand why insurance will not cover this.  Do you know of anyone who might put extra effort in to help you getting it covered by insurance.I i have medicare. M y knees hurt terribly from the extra weight. The weight is not from my eating habits. I just can’t get these areas down in spite of all the diets I try. It can be very depressing at times as I have so many people ask if i am pregnant because of the weight gain. Can you help?

A: The fat collections or lipodystrophy that you describe are  classic areas of collection due to the medications used to treat HIV.  They are not going to be removed by diet and exercise although doing both of those is always good. The reason that fat grows in thsese areas is due to a specific hormonal stimulation effect of the medications, not due to excess calories or food intake.  When it comes to insurance coverage for liposuction, the simple answer is that it is never going to be covered as it is considered a cosmetic issue regardless of what caused the fat to appear. Much of your stomach fat is actually not treatable by liposuction anyway since it is in an intraperitoneal location (around the organs) and not between the skin and the abdominal wall (subcutaneous layer) which liposuction can reach.

Dr. Barry Eppley

Indianapolis, Indiana