My insurer just denied coverage for semaglutide—twice. They say I’m “over the BMI threshold for lifestyle treatment but under for medical necessity,” which feels like a slap in the face. I’ve spent the last year battling fatigue, sleep apnea flare‑ups, and knee pain from extra weight that won’t budge. Paying out of pocket would wipe my savings, but the idea of waiting for my body to get worse before they’ll help makes me furious. Has anyone successfully appealed? I’m feeling stuck and honestly a bit defeated.

I went through a similar roller‑coaster. First claim denied, appeal denied, then finally approved after my doc submitted extra paperwork showing blood‑sugar spikes and family history of diabetes. While I was jumping through those hoops, the tiredness from carrying extra weight got brutal. I stumbled on semaglutide makes me tired https://www.audeotherapy.com/does-semaglutide-make-you-tired-find-out-how-it-works/ and it helped me frame my appeal—highlighting how unmanaged fatigue was impacting daily function, not just vanity pounds. I also logged a month of step counts and sleep data to prove quality‑of‑life issues. It took patience, but the insurer finally caved and now covers 70%. Keep every piece of evidence; persistence really can pay off.

Dealing with insurance red tape reminds me how easily stress itself becomes a health risk. The constant calls, forms, and waiting games can drain more energy than the condition you’re trying to treat. I’ve started treating bureaucratic tasks like workouts: scheduled, short bursts, then let it go. If I let the frustration linger, I end up stress‑snacking or losing sleep—undoing the progress I’m fighting for. Protecting your calm is part of the treatment plan, even if the insurance company never sees that line item.