America should promote health and wellbeing for its citizens and reward efforts made to improve health and reduce risks. If an individual has the determination to lose a massive amount of weight they should be able to obtain the support needed from insurance companies to remove excess skin that hinders their ability to live a normal and healthy life. This should not be classified as cosmetic (and so denied coverage) as it certainly has the potential for real and harmful effects on the physical health of the individual as well as their morale moving forward after significant weight loss.