Dr. Oz Podcast - Dr. Michael Mosley Reverses Diabetes with Intermittent Fasting | Dr. Oz | S7 | Ep 148 | Full Episode Aired: 2026-04-08 Duration: 40:16 === The Biggest Weight Loss Myth (14:55) === [00:00:00] Weight loss breakthrough, you've been hoping for, but is it right for you? [00:00:04] This may be the biggest weight loss myth of all. [00:00:06] Meet the guy who says you've been dieting all wrong and how to fix it fast. [00:00:12] Then, what would you do if your child needed a life changing treatment and insurance won't pay for it? [00:00:18] They look at a bottom line when they pay your insurance policy, they put it under the loss column. [00:00:24] Montel sounds off coming up next. [00:00:32] save lives today. [00:00:37] You guys ready to get healthy? [00:00:51] The show, the weight loss breakthrough gaining massive steam across the globe. [00:00:56] For researchers and celebrities and MDs, all are singing the praises of intermittent fasting as the key to losing weight and living longer. [00:01:06] But is it right for you? [00:01:08] You're about to meet a doctor who's reached rock star status in Britain because of the results his take on intermittent fasting are said to deliver. [00:01:16] Find out why he says everything you've been told about weight loss is wrong. [00:01:21] Plus, which rapid weight loss fast is right for you? [00:01:24] Let me ask you this question. [00:01:25] What would you do, shifting gears here, if insurance won't pay for life changing treatment for you or your child? [00:01:31] Well, Montel Williams is back. [00:01:33] He's here fighting on your behalf. [00:01:35] But first, let's talk about the controversial approach to weight loss and the man who made it famous. [00:01:41] All month long, we are diet layering, giving you the best of the best from all the diet plans out there. [00:01:48] And it starts with a base layer our 28 day shrink your stomach challenge. [00:01:52] One of the biggest concepts in the challenge is a 12 hour fast, a modified Form of intermittent fasting, based on groundbreaking research showing fasting as the key to unlocking rapid and long term weight loss. [00:02:05] But more extreme versions of intermittent fasting are creating waves in the diet world because they actually instruct you to skip meals for a day or more at a time. [00:02:14] The theory behind this controversial diet during a fast, you severely restrict calories, forcing your body to burn through the fat it has stored up. [00:02:23] Critics claim the science is not strong enough to justify fasting, but new research suggests you can lose weight. [00:02:30] Improve blood sugar and reduce inflammation. [00:02:33] The man leading the charge, physician turned journalist, Dr. Michael Mosley. [00:02:38] Seeking to improve his own health, Dr. Mosley began researching and practicing intermittent fasting, writing about it in the international bestseller, The Fast Diet. [00:02:48] So is Mosley right? [00:02:49] Have you been dieting all wrong? [00:02:51] And is strict calorie restriction healthier than we ever believed? [00:02:55] Or is this just another fad starvation diet? [00:02:58] Today, Dr. Michael Mosley reveals why he says. [00:03:01] using his intermittent fasting plan can transform your health. [00:03:06] Dr. Mosley joins us. [00:03:09] How did your own personal health crisis catalyze you to become a leader in this movement? [00:03:14] Well, it was about four years ago, and I went off to see my doctor, and she took a blood sample, and she rang me up later to say, I have very bad news for you. [00:03:23] You are now a type 2 diabetic, and we need to start you on medication. [00:03:27] So I was advised to go on the standard, you know, low-fat diet and do more exercise, but it didn't make any difference. [00:03:34] And so I went out to find something that would really make a difference, and I came across intermittent fasting, which I had never heard of before. [00:03:42] But I discovered there was a huge body of research. [00:03:45] This is a part that's perplexing to me. [00:03:47] We don't learn about this in medical school as doctors. [00:03:50] Nutritionists are often taught in classes information that sometimes is outdated, and it's often hard to do these studies. [00:03:56] So when you actually have a personal problem, you become the world expert on it, at least for yourself. [00:04:00] All right, so come on over here. [00:04:02] I want you to show everybody the fundamental insight here. [00:04:05] And I think it partly explains your passion for fasting. [00:04:08] So I built two bodies here. [00:04:10] This is the fasting body. [00:04:11] You'll cover that in one second. [00:04:13] I'm going to start with the feasting body, which is actually what we do normally when we live our lives. [00:04:17] Your body operates completely differently when it is feasting versus when it's fasting. [00:04:22] This red represents the fat that you want to lose. [00:04:25] You don't want any red. [00:04:27] Most of you in this room, most people watching at home, don't want all the red they have in their body. [00:04:32] This represents the meal that you're about to eat. [00:04:36] The meal that you're about to eat, the meal you just ate, changes everything inside your body. [00:04:41] So I'm feasting. [00:04:43] The meal that I just ate goes into my body, and notice what happens. [00:04:48] It begins quickly to become the first line of calorie consumption. [00:04:53] So, if I begin to exercise and I start to get rid of some calories, I burn away the blue before I get to the red that I wanted to get rid of. [00:05:01] Sometimes I don't get rid of it all. [00:05:03] You know, I'm always amazed when I see people working out at the gym, they're so dutiful about it, but they've got some energy drink next to them that has, you know, 300 calories in it, right? [00:05:10] They'll never burn through those calories to ever get anywhere past. [00:05:14] Now, you argue. [00:05:15] When you fast and you don't eat anything before you exercise, what goes on? [00:05:19] That can be just, say, 12 hours. [00:05:21] What happens is that you've no longer got food in your system, so you instead basically burn through the fat. [00:05:29] Fat is like money in the bank account. [00:05:31] Your body doesn't use it. [00:05:32] If you've got money in your wallet, you'll use that instead. [00:05:35] But when you have all that fat stores, they do not get burnt until you've kind of got rid of the other stuff. [00:05:41] So remember this you want to look like this, or do you want to look like this? [00:05:46] That's the basic equation that Dr. Moses is arguing for. [00:05:49] Come on over here. [00:05:50] Absolutely. [00:05:51] Now, in your quest and your passion for this, you've turned a lot of conventional medical wisdom on its head. [00:05:56] Yes. [00:05:56] And I'm going to talk, if I can, with you about three arguments you have picked with the medical establishment three areas where you just think we don't have it right with dieting. [00:06:05] And we've actually talked about it on the show, some of these things. [00:06:08] The first point you argue is that when we say you got to eat breakfast to lose weight, y'all, who's heard that before, right? [00:06:15] I mean, literally everybody. [00:06:16] in the audience said that. [00:06:17] So why do you think that is wrong? [00:06:19] It's really strange because there was an article in the New England Journal of Medicine, which is the most prestigious medical journal in the world, and they got hold of the US's top obesity specialists and they said, what are the myths? [00:06:32] And number one myth was you have to eat breakfast to lose weight. [00:06:36] They said it is a myth. [00:06:37] What they did is they took a large group of people, some of whom ate breakfast, some of whom didn't, and they got them to swap habits. [00:06:44] So the people who didn't eat breakfast started eating breakfast the other way around, and it made absolutely no difference whatsoever to weight loss. [00:06:51] This is really important because it's the foundation of one of the fasting plans we're going to talk about a little later. [00:06:56] Second big myth if you eat too little, your body will go into starvation mode and slow down your metabolism, so you will plateau. [00:07:03] This may be the biggest weight loss myth of all. [00:07:06] Yes, it is an absolute myth, and it's based on a study done in the US in the 1940s where they got people to live on potato and turnips for about six months, and when their body fat went down really low, then they went into starvation mode. [00:07:19] But they did a study recently where they got people to live in a metabolic chamber where they could measure exactly what was happening to their metabolic rate. [00:07:26] And they found that when they put them on a water diet for five days, their metabolic rates increased. [00:07:32] Increased. [00:07:33] They were burning more calories when they were not eating than when they had been eating. [00:07:37] Well, why would that be? [00:07:38] Why would the body not try to protect itself? [00:07:39] Well, one of the reasons is that, and they measured it, was that their bodies were producing more adrenaline. [00:07:44] And adrenaline burns fat. [00:07:46] And we know that. [00:07:47] If you go exercising, one of the things that happens is it pumps up your adrenaline levels. [00:07:50] That helps burn fat. [00:07:51] But adrenaline, noradrenaline, you call it epinephrine. [00:07:54] Epinephrine, yeah. [00:07:55] Basically, it's a hormone your body produces, and it is a real fat burner. [00:07:59] And it is exacerbated by fasting, because fasting is slightly stressful. [00:08:03] It's like exercise is a bit stressful, you know, you're going to feel it. [00:08:06] But as I said, your body responds by really digging into those fat stores. [00:08:10] It's interesting, if you think about it, if a thousand years ago we were starving, your body would tell you to get out there and get some food. [00:08:16] Absolutely. [00:08:16] So it might stimulate your metabolism, so you'd have the energy to go find some prey so you wouldn't keep starving. [00:08:21] It's completely bonkers, isn't it, when you think of it? [00:08:23] If you're in a cave, And you haven't got any food, if your metabolic rate slows down and you just sort of lie on the floor and you wait for pizza to be delivered, you're going to go extinct. [00:08:31] That's when you have to be really active and smart and clever, is when you don't have calories. [00:08:36] You've got to go out there and search for them. [00:08:37] All right, so we're giving you a little bit of a foundation of rapid weight loss fasting, but which of these plans is right for you? [00:08:43] Because there's so many out there right now. [00:08:44] We're going to go through the three biggest types of fasts out there and help you decide. [00:08:49] Stay with us. [00:08:54] Next, with tons of fasting programs out there, how do you know which one is right for you? [00:08:59] Dr. Mosey has three different approaches. [00:09:01] All of them provide benefits which go beyond simply weight loss. [00:09:04] Find out which one best suits you and your lifestyle. [00:09:07] It is worth miracles. [00:09:09] Duped by diet ice cream? [00:09:11] This is the diet one here. [00:09:12] This is the regular one. [00:09:13] There's only 10 calorie difference between those two. [00:09:16] 10? [00:09:17] Fooled by Froyo? [00:09:18] Do you think these diet ice creams are really just Franken foods? [00:09:22] See what's in them that may be keeping you fat. [00:09:25] And shrink your stomach in just 28 days. [00:09:28] This is what a lot of bodybuilders and actresses use. [00:09:30] We have the step-by-step plan to get your body be shredded. [00:09:34] All nuance. [00:09:35] That's coming up tomorrow. [00:09:39] All month long, we're giving you a brand new approach to weight loss. [00:09:42] We pulled apart the best of the best from the latest research and diet plans out there and broke them down to just the essentials. [00:09:50] It's called diet layering, and it allows you to mix and match just what works for you. [00:09:55] It's a game changer for all of you looking for real solutions that fit into your real life. [00:10:00] When you're watching the show over the next month, if you see this, it means we're giving you one more layer to add to your overall weight loss plan. [00:10:08] This is about you tailoring a weight loss plan for you. [00:10:14] Fasting, it might be the diet layer that you're looking for. [00:10:17] It's one of the biggest and most controversial concepts that hit the diet world in the last decade. [00:10:22] But with tons of fasting programs out there, how do you know which one is right for you? [00:10:26] And how far could you and should you safely go? [00:10:29] Dr. Michael Mosey's back. [00:10:31] Fasting programs. [00:10:33] I mean, they all sort of have to do with cutting back food beyond what you're comfortable doing. [00:10:37] Are they all the same? [00:10:38] They all have different benefits. [00:10:40] All of them provide benefits which go beyond simply weight loss. [00:10:43] There are improvements in things like your insulin levels, reduce your risk of breast cancer, reduce your risk of developing diabetes, which go beyond simply the weight loss. [00:10:51] But it really matters critically which one you can stick to. [00:10:55] You can try a range of them. [00:10:57] Pretty well, all of them. [00:10:58] And I've settled on one I find comfortable, but everybody's different. [00:11:02] So you want to try something and see which works for you. [00:11:04] So let's present three different types of fasts to see which one is right for you. [00:11:08] So we're going to start with the first weight loss fast. [00:11:10] It is the 12 hour fast. [00:11:12] You do this every day. [00:11:14] The details here are important. [00:11:15] Now, we include this as a key component in our 28 day shrink your stomach challenge base plan, which I know a lot of viewers are right in the middle of right now, getting a lot of feedback on it. [00:11:23] And this type of fast is time restricted, not the amount of food, but when you can eat it. [00:11:28] When you take your last bite of food at night, you are not allowed to eat again until 12 hours later. [00:11:33] Let's do the math. [00:11:34] You finish eating at 8 o'clock, right? [00:11:37] At night, you don't get to eat again until 8 in the morning. [00:11:39] Let's say you go out to dinner, have a good time with your buddies, you don't finish till 9. [00:11:42] Guess what? [00:11:42] You're not eating until 9 in the morning. [00:11:44] So why does this work? [00:11:46] It works because you're actually allowing your body a period of time when it's doing what's called spring cleaning, where it got on with essential repairs. [00:11:55] Because if you're just sort of feeding your body all the time, it's rather like driving a car. [00:11:58] If you drive the car all the time with your foot on the accelerator, it's going to break down. [00:12:02] You need to take it into the garage for repairs. [00:12:05] And that's effectively what you're doing with an overnight fast. [00:12:07] You're spending 12, maybe 14 hours without putting food in your system, and it allows your body to do lots of essential things. [00:12:15] This is the program I sort of use, everybody. [00:12:17] And I actually heard about it from Hugh Jackman, who's a friend, but he's been on the show a couple times. [00:12:22] And he would use these when he's becoming Wolverine, big and strong. [00:12:25] He'd have to go up and down in his weight a lot. [00:12:27] And I was curious how that happened. [00:12:28] He said this time restriction, he does it for longer than 12 hours. [00:12:32] But that was actually what took him. [00:12:33] Jimmy Kimmel has used this. [00:12:34] There have been other folks you all know about who have lost weight and attributed it to this. [00:12:38] Okay. [00:12:38] Dr. Mose, I'll be back with you in a minute. [00:12:40] But first, I want to meet Patricia. [00:12:41] She's here. [00:12:42] She's been on the 28 day shrink your stomach challenge. [00:12:45] Using a 12 hour fasting window. [00:12:47] How are you? [00:12:48] Hello, Dr. Oz. [00:12:49] So, how does the 12 hour fasting work for you? [00:12:51] It has worked miracles. [00:12:53] I'm so happy to report I've lost eight pounds. [00:12:57] Have you really? [00:12:57] Yes. [00:12:58] Congratulations. [00:12:59] Thank you. [00:13:00] So, walk us through a typical day. [00:13:02] Obviously, 12 hours fasting, I know that part. [00:13:04] But what do you eat when you can't eat? [00:13:06] Sure. [00:13:06] So, in the morning, the first thing I do is I'll cut up half an avocado on toast. [00:13:12] I'll serve myself a cup of coffee and I use almond milk. [00:13:16] Okay. [00:13:17] Then later in the morning, more like my towards 11 o'clock, I'll have my green juice and a handful of nuts, of peanuts. [00:13:26] And then for lunch, what I'll do is I'll roast some Brussels sprouts with a half an apple or a full apple, and it's very, very filling. [00:13:36] I was actually really happy about that. [00:13:38] And then my peanut snack, I'll have a spoonful of almond butter. [00:13:43] Delicious, which I was very excited to. [00:13:45] You like almonds, I guess. [00:13:47] Yeah, I love. [00:13:48] Love. [00:13:48] And then for dinner, I'll have half a plate of non starchy vegetables with some quinoa and chicken. [00:13:54] So it's a lot of food, actually. [00:13:56] It is. [00:13:57] Some of the things that might seem as vices, like a coffee or snacks, you incorporate it. [00:14:01] Yes. [00:14:01] And are you ever hungry during the day? [00:14:03] No. [00:14:04] I actually feel really good. [00:14:06] If I get a little hungry, I'll have a glass of water. [00:14:08] But for the most part, I felt great. [00:14:10] I felt really good. [00:14:11] Thank you, Patricia. [00:14:12] Thank you. [00:14:12] All right. [00:14:13] The next weight loss fast is to fast for two days each week. [00:14:16] So, Dr. Mosey, what are the rules for this fast? [00:14:18] So this is one I came up with when I discovered that I was a type 2 diabetic. [00:14:22] And on this diet, I lost 20 pounds of fat in eight weeks. [00:14:27] And I reversed my diabetes, and I've been completely free of diabetes for the last four years. [00:14:31] Oh, my. [00:14:33] All right, so let's go through the details. [00:14:35] So five days you eat normal, two days you fast. [00:14:37] And what days of the week do you fast? [00:14:39] You can do consecutive days, Monday, Tuesday. [00:14:42] I chose Mondays and Thursdays because you have a kind of a weekend. [00:14:45] And as I said, it's not really fasting. [00:14:47] What you're doing is just cutting your calories down. [00:14:50] I cut them down to a quarter for these two days. [00:14:53] So around 600. [00:14:54] I was on 2,400 calories. === Reversing Diabetes in Days (06:49) === [00:14:56] If you're on 2,000 calories, average intake for a woman, you go down to 500 calories and you do that two days a week. [00:15:01] Drink lots of water because that will also keep you kind of fuller. [00:15:06] and stop getting constipated. [00:15:07] But you can have it as three mini meals a day, you can have it as two meals, it kind of depends on you. [00:15:13] But the great thing about it is people say to me, you're only dieting for two days a week. [00:15:18] So there are the other five days you kind of, in a way you can eat what you want, but actually most people find they don't. [00:15:24] They actually stick to eating pretty healthily on the other five days and that's what I would recommend. [00:15:28] All right, so let's meet two women who lost weight on the five too fast. [00:15:33] I've been doing it since maybe like six weeks and I've lost 14 pounds. [00:15:39] It is not a challenging diet to be on because for me, it took about three days for my body to be adjusted to the fact that it wasn't going to eat a full course meal for two days. [00:15:49] As you can see by my handy dandy green smoothie over here, today is my calorie restriction day. [00:15:56] And thanks to my secret weapon here and also tons of vegetables and lean protein, I'm not hungry at all my days of calorie restriction. [00:16:06] So thank you so much. [00:16:09] 17 pounds down, still shrinking and halfway to my fitness goal. [00:16:15] We'll be right back. [00:16:21] Next, Dr. Moby's third and newest diet that promises the fastest results. [00:16:26] One woman lost 70 pounds in eight weeks. [00:16:27] It might be controversial, but he'll tell us why it works. [00:16:30] It is fantastically effective, and how it can even help reverse disease. [00:16:34] Next, Marie Osmond on bulimia, postpartum depression, and why she almost drove off a cliff. [00:16:42] I'm sorry. [00:16:43] Then the Cleveland kidnapping survivors speak out all nuance. [00:16:48] That's coming up Friday. [00:16:55] Dr. Mosley is a doctor who is credited with revolutionizing fasting to lose weight. [00:17:00] Now, he's given you three different types of fasts to see which one is right for you. [00:17:04] Now, his newest and most controversial diet that promises the fastest results. [00:17:09] But are they too fast? [00:17:10] It's 800 calories a day for eight weeks. [00:17:16] Now, the broad medical communities, there are many of them out there, recommend to avoid diets with less than 1,000 calories per day. [00:17:22] I hear this all the time. [00:17:23] Dr. Mosley, this flies in the face of that conventional wisdom. [00:17:27] How is it safe? [00:17:28] It's safe because it's been tested on hundreds of people. [00:17:30] It's been tested at the University of Newcastle by some of the world's leading experts, Oxford University, Melbourne University. [00:17:37] I could list you dozens of academic institutions that have tested this 800 calories, and it is fine. [00:17:43] It's at the lower level. [00:17:45] 1,000 to 800 calories is kind of low level of low-carry diet, but it's not very low. [00:17:50] When you go below 800, you're in the realms of stuff which is perhaps a little bit more iffy. [00:17:55] But I'm very confident that this is safe. [00:17:58] Spend a second on that. [00:17:58] So what happens if you get less than 800 calories? [00:18:01] The biggest danger is that if you don't have the right amount of protein in your diet and your body doesn't store protein, it stores fat, it stores sugar, but the protein, it will then go for your muscle because it has to get the protein from somewhere. [00:18:12] It needs the protein not to fuel you but to provide all the things like your blood cells and things like that. [00:18:18] So what happens then is that your body will start to cannibalize itself and it will start to take stuff from your heart, from your muscles. [00:18:26] And that's why a very low calorie diet, particularly one which is not properly done, which is not properly medically supervised, is not a wise thing to do. [00:18:35] So, if you do have an 800 calorie diet and you're having enough protein, and I know you can have recipes and you offer some of yourself in the book that are pretty clear about this, you can avoid the muscle wasting and get faster weight loss. [00:18:48] So, how fast is the weight loss? [00:18:50] In the trials, on average, there was 33 pounds weight loss over eight weeks. [00:18:54] That's the average. [00:18:55] Some people lost a lot more than that. [00:18:56] One woman lost 70 pounds in eight weeks. [00:19:00] That's unbelievable. [00:19:00] Average weight loss, 33 pounds. [00:19:02] Yep. [00:19:03] And yet you argue that's not the biggest benefit. [00:19:05] No. [00:19:06] For me, the reason I wrote the book was because I was a type 2 diabetic. [00:19:09] My father was type 2 diabetic. [00:19:10] He died of that. [00:19:12] Blood glucose levels, blood sugar levels are a huge problem in the US and the UK. [00:19:16] Probably about half the adult population in the US either have prediabetes, which means their blood glucose levels are raised, or diabetic. [00:19:25] And as you get older, the risk goes up and up. [00:19:27] And it is a horrible disease to have because it massively increases your risk of heart disease, dementia, and things like that. [00:19:33] And you believe this diet is the best way to rapidly turn that around? [00:19:36] Yes. [00:19:37] Now, what is interesting is we have known for 20 years that if you have bypass surgery, weight loss surgery, you can reverse type 2 diabetes in days. [00:19:46] Literally, your blood glucose levels go right down, and as long as you keep the weight off, you are fine 20 years later. [00:19:52] What this guy, Professor Roy Taylor, who is one of the UK's leading diabetes specialists, said was if you can do it with surgery, why don't you just do it with weight loss? [00:20:01] And he's the guy who has pioneered this. [00:20:03] 800 calorie diet for eight weeks. [00:20:05] And he has done loads of studies, lots of science behind this. [00:20:09] He says it is absolutely safe and it is fantastically effective at doing something which doctors will claim is not possible, which is to reverse diabetes through diet. [00:20:19] So let's take a look exactly what 800 calories a day of food looks like and if it's enough to give your body the energy it needs. [00:20:25] Take a look. [00:20:26] Think 800 calories won't fill you up? [00:20:29] Take a look. [00:20:30] For breakfast, you can start your day with an easy to make blueberry and green tea smoothie. [00:20:35] For lunch, a pepper with jeweled feta, and then dinner, eggplant with lamb and pomegranate, or tri apple and goji berries with almond butter for breakfast, halloumi salad for lunch, and spicy chicken and lentils for dinner. [00:20:49] With options like these, it just may be possible to make 800 calories taste and just as important, feel like a full day's worth of food. [00:20:59] It actually looks like more food than I expected. [00:21:01] It is a load of food, and most people report within a few days. [00:21:05] when they're on the eight-week blood sugar diet that they feel fine. [00:21:08] They said, I expected to feel starving. [00:21:10] I actually feel perfectly okay. [00:21:12] These recipes were created by one of the UK's leading dietitians called Dr. Sarah Shrinker, and they have all the right balance of nutrients, and it's kind of the Mediterraneanized diet. [00:21:22] So there are vegetables, there is lots of nice, good, rich, tasty protein, lots of olive oil, occasional treats, bits of dark chocolate, you know, a little bit of alcohol. [00:21:30] He knows how to wet her appetite. [00:21:33] Exactly. [00:21:33] So for this complete plan, the recipes, you can check out Dr. Mosey's new book, and it's very well done, The Eight-Week Blood Sugar Diet. [00:21:39] We'll be right back. === Insurance Denies Life-Saving Therapy (12:29) === [00:21:45] Next, we are switching gears to a reality facing millions of Americans. [00:21:49] What would you do if your health coverage won't pay for a life-changing treatment for you or your family? [00:21:55] It happened to these guests. [00:21:56] Look at their records at the end of the year. [00:21:57] They put it under the loss column. [00:21:59] Coming up next. [00:22:01] You think diet ice cream and fro-yo are healthy. [00:22:04] See what's in them that may be keeping you fat. [00:22:07] And shrink your stomach in just 28 days. [00:22:11] All nuance. [00:22:13] That's coming up tomorrow. [00:22:16] What would you do if your insurance wouldn't pay for life changing treatment for you or worse, your child? [00:22:23] It's a reality for millions of patients and it could happen to you. [00:22:28] As a doctor, the question takes me back to one of my earliest days in medicine. [00:22:32] Montel Williams has the story. [00:22:36] For patients, it can be a disaster. [00:22:38] The news that their medical insurance claim is denied or that a life changing procedure will not be covered. [00:22:43] Every year, insurance companies initially reject at least 200 million claims. [00:22:48] Sometimes the reasons are technical, like improper filing of paperwork. [00:22:52] But at other times, the denial of coverage for doctor-prescribed treatments, drugs, or devices falls into a gray area. [00:22:58] The doctor argues the treatment is critical, often a matter of life and death. [00:23:02] The insurance company maintains the treatment is experimental, risky, medically unnecessary, or unproven. [00:23:11] All around the country, doctors and patients are fighting what often looks like a battle between David and Goliath. [00:23:17] Some desperate families even resort to crowdfunding when insurance refuses to pay. [00:23:21] One woman even took her struggle on behalf of her daughter to YouTube. [00:23:25] If a doctor deems it medically necessary, who are they to go against the doctors? [00:23:33] You legalize it with your big fancy words, but let me tell you, I am a mother who's fed up. [00:23:39] The stakes couldn't be higher, as Dr. Oz himself knows all too well. [00:23:44] I was a young surgeon, and I was called from another hospital in the area about a patient that was dying. [00:23:50] He just had emergency heart surgery, and when he came over, To me, it was a pretty straightforward decision. [00:23:56] He was critically ill, but he needed a new technology that was already FDA approved called an LVAT. [00:24:01] It's a piggyback mechanical heart to allow him to survive long enough to get a heart transplant. [00:24:08] And as I was about to open his chest to do this life-saving operation, we got a phone call, never forget it, and it was the insurance company. [00:24:15] The insurance company representative on the phone said, we're not going to pay for this life-saving operation because even though it's FDA approved, it's not widely used. [00:24:25] So it's an experiment. [00:24:26] So now I'm in this incredible dilemma. [00:24:29] I have my Hippocratic oath as a doctor that I will always protect my patient. [00:24:33] And I knew this device could save his life. [00:24:35] And yet the insurance company, very loudly on the call with everyone to hear, is telling me I don't have the right to put it in. [00:24:41] No one's going to pay for it. [00:24:43] What would you do? [00:24:45] Whoa, what did you do? [00:24:48] What would you all do? [00:24:51] What? [00:24:53] Put it in. [00:24:54] Do the surgery. [00:24:54] What did you do, sir? [00:24:55] I put it in. [00:24:56] There you go. [00:24:57] And I'll tell you, I put it in because that's the oath I took when I finished medical school, and then I got sued by the insurance company. [00:25:06] What? [00:25:07] Because the insurance company said, and this is actually logical, it's crazy sounding, but it's logical. [00:25:11] They said, if you hadn't saved this man's life, he wouldn't have survived to need the transplant and cost us all that money. [00:25:18] So you created an expense for us. [00:25:20] Crazily, the better he did, the more I was on the hook. [00:25:24] Well, see, one of the things that people don't understand, and this is what I think this show is so important for, and why I'm glad you're doing it. [00:25:30] Because people have to understand, insurance companies don't look at you really as a patient. [00:25:34] As much as you think they do, they don't. [00:25:36] They look at a bottom line. [00:25:37] It's a corporation. [00:25:38] They have profits and they have losses. [00:25:41] When they pay your insurance policy, when you look at their records at the end of the year, they put it under the loss column. [00:25:48] That's what they think of us a loss, not the fact that you've been paying them all along to cover what you've asked them to cover. [00:25:54] And here's the part that's most perplexing. [00:25:57] There are some technologies that are FDA approved, but they're not widely used. [00:26:03] They're not standard procedure. [00:26:05] And it's in the best interest, of course, of people to think that they're not widely used because that way they're not widely paid for. [00:26:11] And that's the slippery slope, my friends. [00:26:13] That's when the patient and the doctor have to team up to fight back. [00:26:16] So I want you to take a look at the story of a young woman caught between her insurance company and a life saving treatment. [00:26:23] At 27 years old, Lindsay was happily engaged to the love of her life and excited to be in the middle of her surgical residency. [00:26:30] When she was given a devastating diagnosis, liver cancer. [00:26:35] Lindsay was originally treated with chemotherapy, but her cancer metastasized, so her current oncologist wants her to try a different approach proton therapy. [00:26:46] Proton therapy is much more focused than traditional radiation and decreases radiation exposure to surrounding organs, which in turn decreases Lindsay's risk of developing cancer later in life. [00:26:58] But Lindsay's insurance company is denying her claim. [00:27:02] Preventing her from receiving a potentially life saving procedure. [00:27:06] Now, just two weeks away from her wedding, Lindsay finds herself in a fight of her life with her insurance company for the treatment she desperately needs. [00:27:15] Lindsay is here with her fiance. [00:27:17] Ernest, thank you for being here. [00:27:18] I know it's a busy time. [00:27:20] You're getting married? [00:27:20] Yes, 10 days. [00:27:22] 10 days. [00:27:22] Great. [00:27:23] How are you feeling? [00:27:26] So, overall, it's a little overwhelming right now in my life. [00:27:31] We're getting married in 10 days, so that's a little overwhelming. [00:27:34] I'm in residency right now, and that's Definitely overwhelming, and in addition, I'm dealing with cancer, so between everything, it's just an overwhelming time in my life. [00:27:45] How difficult was it going through chemotherapy for this diagnosis? [00:27:50] That was one of the hardest things I've ever done, for sure. [00:27:58] It's just a difficult time in your life. [00:28:00] Take your time. [00:28:03] But I was fortunate in having a lot of great friends, great family, a lot of support from other people. [00:28:11] But it's a very difficult time, for sure. [00:28:14] Doc, you know, it's very interesting. [00:28:16] Lindsay said it quickly, and people don't think caught on it. [00:28:18] She's in residency, she's training to be a doctor. [00:28:22] So when a doctor finds out that a doctor is ill and has to go through it, first off, I know you're going to survive this, so I would love to have you as my doctor if it ever happens to me. [00:28:31] It goes for all of us. [00:28:32] But you understand a little bit more about treatment, about insurance, and about things like that. [00:28:37] Yes. [00:28:38] And again, Monto mentioned, and I'm going to highlight it, you're a doctor. [00:28:41] So if a patient came to you and needed a treatment you knew they'd benefit from, and it was declined by an insurance company, how would you react? [00:28:48] I would be angry. [00:28:50] I would be angry for sure. [00:28:51] It makes you fight more for your patients. [00:28:54] Every time you walk into a room and you're with a patient and something like that has occurred, it just makes you angry. [00:29:00] You know, when Doc, but see, here's the problem. [00:29:02] The treatment that she could have made available to her is one that's never been tested on her type of cancer because her cancer is so rare. [00:29:09] So they'll never have an opportunity to test it. [00:29:12] But instead, they're saying, nah, since we've never used it on a person like her before, nah, let her just suffer through the other kinds. [00:29:18] Let me, if I can, I just want to make sure we're all on the same page here what we're dealing with. [00:29:21] If a better technology exists, right, a patient should have the right to receive it. [00:29:25] That's what we all think up here, right? [00:29:26] I think everyone in this audience feels that way. [00:29:28] Proton therapy is FDA approved, and it's important for Lindsay to get it for her treatment because we can stop growth. [00:29:36] That won't kill you directly except over time. [00:29:39] So, if this therapy, without damaging surrounding tissues, can take care of this one little problem, we can take your life to decades more of fruitful existence. [00:29:48] You can make family. [00:29:49] Who knows what cures we'll find in the future? [00:29:51] So, this is, I think, especially important, Montel, for a rare problem like you have because we know enough to know it's really going to help you. [00:29:57] So, Montel and my med unit, well, they took on Dindsay's case. [00:30:01] I want you to find out what happened when we come back. [00:30:12] Next, Lindsay continues to fight. [00:30:14] Can she get the cutting edge cancer treatment that could prolong her life? [00:30:18] Montel Williams goes straight to the source. [00:30:20] We were just wondering if we can convince the insurance company to change their mind about covering this. [00:30:25] Will she get the help she needs? [00:30:27] Next. [00:30:28] We are bringing a healthy back this season and want you to bring it too. [00:30:32] Grab your prescription pad for fun and sign up for free tickets today. [00:30:35] You can go to drodders.com slash tickets and sign up. [00:30:43] We are back with Lindsay and her fiance, Ernest, who are just days away from their wedding, but they're busy fighting their insurance company for a cutting edge cancer treatment that could prolong Lindsay's life. [00:30:53] And Lindsay's doctor, Alan Meek, is here. [00:30:55] You've been a radiation specialist for years. [00:30:57] I just want to hear from an expert. [00:30:59] Do you think this therapy will make a difference in your patient's life and compare it to traditional radiation? [00:31:05] Yes, definitely. [00:31:06] Lindsay has a very rare kind of liver tumor that has spread to her spine at about the level of the shoulder blades. [00:31:13] And if this tumor continues to grow in that location, eventually she will be paralyzed from that level downward. [00:31:19] So we have to do something about that. [00:31:21] Radiation is one option, and proton beam is the most targeted form of radiation. [00:31:27] So this is the best treatment for her. [00:31:30] It sounds to me, and as a doctor, you know this, that this is clearly what should happen. [00:31:34] So Montel Williams and my medical unit have been taking on the case with your insurance company. [00:31:39] Let's take a look at what happened. [00:31:41] Please leave a message, and I'll call you back as soon as I can. [00:31:44] On our first attempt reaching out to Lindsay's insurance provider, our medical team found it difficult to get through and difficult to get answers. [00:31:50] We finally reached an insurance company physician. [00:31:55] We were just wondering if, you know, there's something that we can do to see if we can convince insurance company to change their mind about covering this treatment. [00:32:03] The oncologist that we've been talking to has stated that he thinks that because of where it's metastasized near her spine, that the other form of radiation might not be the best course of action because the proton beam Could be a little bit more direct, not interfering with surrounding tissue, and possibly fare better in a long term prognosis. [00:32:26] We want to do what is ever going to be best for it, but we need to administer the benefit plan that you have. [00:32:32] And the benefit plan says we can't cover procedures that are experimental, investigational, or unproven. [00:32:39] And there's just a lack of data showing that proton beam is useful for this kind of tumor. [00:32:46] But that's the exact problem. [00:32:47] It's a rare type of tumor, so it's very difficult to gather evidence for this. [00:32:51] Everybody we've spoken to so far has said IMRT or conventional radiotherapy is the appropriate treatment to use. [00:32:58] It's hard for us to say it's anything other than an unproven technology for the treatment of her particular condition. [00:33:06] Okay, so just for the record, you're still denying Lindsay's claim? [00:33:14] The denial still stands right. [00:33:17] So, despite our efforts, including that call, Lindsay's request. [00:33:21] Is still denied until she goes through an appeal process. [00:33:24] Unfortunately, you all have lived this. [00:33:25] The responsibility falls ultimately to the patient to navigate these waters, and that takes a lot of time. [00:33:31] And time is not our ally when we're racing cancer. [00:33:35] And frankly, I think, unfortunately, and this happens a lot red tape and medicine don't mix. [00:33:41] And we are forcing them into the same bucket. [00:33:44] I know that's frustrating. [00:33:45] I know it's frustrating. [00:33:47] But I do believe, even though the insurance companies push them back, that we have a solution for you. [00:33:55] We have found an anonymous donor who has agreed kindly to pay for all the proton therapy treatments at the Provision Center for Proton Therapy. [00:34:07] Wish you the best of luck. [00:34:09] Give up, keep tightening. [00:34:10] Thank you very much. [00:34:11] We'll be following your story. [00:34:12] You're going to send us pictures for the wedding? [00:34:13] We do. [00:34:14] All right. === Fighting the Insurance Giant (02:54) === [00:34:15] Up next parents who took on the insurance company and they won. [00:34:24] Next, if you were denied insurance for a life saving procedure that could help your child, what would you do? [00:34:30] Meet a determined mother who wouldn't take no for an answer. [00:34:34] They didn't know who they were messing with, how she fought the system and won. [00:34:38] Next. [00:34:40] You think diet ice cream and fro yo are healthy. [00:34:43] See what's in them that may be keeping you fat. [00:34:46] And shrink your stomach in just 28 days. [00:34:50] All nuance. [00:34:52] That's coming up tomorrow. [00:34:58] We're back asking the question, what would you do if insurance won't pay for life-changing treatment for you or your child? [00:35:05] Well, one mother refused to take no for an answer. [00:35:09] Take a look. [00:35:10] Our daughter, Aria, was born with multiple congenital heart defects, and her condition was very serious. [00:35:17] The good news was that the medical technology existed that could save her life. [00:35:20] When Aria was about one year old, we began making arrangements for her open heart surgery, and then just a few days before the operation was scheduled, the insurance. [00:35:29] Company informed us they wouldn't cover the procedure. [00:35:32] They said that both the doctor and the facility were out of network. [00:35:36] This was really unexpected because they didn't let us know that in the months leading up to the operation. [00:35:41] We were devastated, of course, but we knew we wouldn't give in. [00:35:45] This was the doctor in the hospital that could save our daughter's life. [00:35:48] We knew it and we were ready to fight for her life. [00:35:52] Bridget, Johan, and Aria are here with Montel. [00:35:56] It has been four months since Aria's surgery. [00:35:59] So, how's she doing? [00:36:00] How's she changed? [00:36:01] She's doing really good. [00:36:03] She. [00:36:04] Has changed quite a bit in her ability to be running around and vocally everything. [00:36:14] I can see she's enthralled. [00:36:16] Was she as beautiful before the operation as she is now? [00:36:19] Yes. [00:36:20] And did she still have her little doggy here before the operation? [00:36:24] That's your doggy, yeah. [00:36:27] Roger, why was it so important for you to be here today? [00:36:30] And why was it important for Aria to see the heart surgeon that you had picked out? [00:36:35] We felt that they were the ones that knew her, knew all of her conditions, and were best suited to handle her situation. [00:36:45] There are lots of reasons that I find patients pick one doctor over another. [00:36:50] They get along better, they feel the qualities better, the experience they feel more comfortable with. [00:36:55] All these, by the way, are important issues. [00:36:57] But you're just one mom, one little old mom, fighting against this big insurance company. [00:37:02] What gave you the belief that you'd even make a dent into this process? [00:37:06] Well, I am pretty ornery. === A Mom's Media Blitz (03:06) === [00:37:09] And I told them when they told us no that they didn't know who they were messing with, that I was pretty fierce, and that I wouldn't stop until we got what we needed. [00:37:29] I, in fact, said over my dead body, would we go to the other surgeon or hospital that had never seen her? [00:37:37] And, Mimet, you know, what people have to understand again. [00:37:39] The insurance company sends you to a doctor, the specialist, to do all the workup. [00:37:45] Then, a week or two before the surgery, you say, Oh, by the way, you're not going to let him, he's not going to operate. [00:37:49] I'm going to take you over to guy B that you've never seen before, your child has no relationship with at all, and this is the guy who's going to do the surgery, and I don't know, we think he's as good. [00:37:59] You can't do that in the middle of this. [00:38:01] It takes this kind of voracious mom to say, No, enough, you're not going to do this. [00:38:06] And the fact that she said it made them go, Ooh, wait a minute, wait a minute, because the squeaky wheel does get all the grease, period. [00:38:14] So they finally relent. [00:38:19] They didn't. [00:38:20] No. [00:38:20] And what happened? [00:38:21] We had to keep fighting. [00:38:23] So. [00:38:24] What was your strategy? [00:38:25] How did you get them to finally say, we give up? [00:38:28] Well, our strategy was I told them, I know lots of people. [00:38:33] I'm a hairdresser, so. [00:38:36] I'll whisper in everybody's ear. [00:38:37] But she's like, I got it. [00:38:39] Yeah, I'm going to say, that's true. [00:38:41] We all have a lot of power. [00:38:42] We don't think about it, but we do. [00:38:43] And I went and found their Facebook page, was the first thing, because I couldn't sleep the night that we were told no. [00:38:50] And I tagged every single one of my friends and one of my clients and wrote across their whole page. [00:38:56] They shut it down for about 48 hours. [00:38:59] And I told them by tomorrow we will have a media blitz going. [00:39:04] And by 12 o'clock the next day, we had every news channel in town at our house. [00:39:11] Now, I understand you also called, every state has an office that sort of monitors this. [00:39:17] You did everything. [00:39:18] So we had to keep appealing, and that was the process. [00:39:21] And then we appealed. [00:39:22] To the California Medical State Board review, and they stated that it had to be with our original plan. [00:39:33] And, Johan, what happened when you found out that your wife had finally won? [00:39:38] I was actually driving, and I had to pull over on the side of the road because it was such a tremendous experience. [00:39:46] It was stressful. [00:39:48] We did so many different things. [00:39:49] I broke down. [00:39:49] I just broke down and started praying and called just about everybody I could think of. [00:39:54] So it was tremendous. [00:39:57] Oh, Johan, Bridget, congratulations. [00:39:58] Aria, stay beautiful. [00:40:00] Give them a hard time now. [00:40:01] And you see. [00:40:01] Pay them back. [00:40:02] The main point, though, they didn't give up. [00:40:04] You didn't stop. [00:40:05] You didn't take no. [00:40:06] You kept digging and kept fighting. [00:40:08] And that's what we're all supposed to do for our loved ones, our family members, our children to fight. [00:40:12] Fight to the last drop. [00:40:13] Thank you for fighting for all of us, Montana. [00:40:15] I appreciate it.