Can't get the surgery if over 50+ BMI

sarah_durso
on 12/22/11 7:59 am
 Hi All , 
   I'm planning on getting WLS in April.  Although, I was reading through tricare ( my insurance)  rules and it says if your BMI is 50 + they won't do surgery.  Have any of you had the WLS using tricare insurance?  

            

        
(deactivated member)
on 12/22/11 8:06 am
I do not know about your insurance but I do know that some plans and surgeons place their WLS patients on medifast or similar shakes to drop your BMI before surgery.  It really reduces the risk of morbidity and complications from surgery. 
MsBatt
on 12/22/11 11:01 am
That's stupid---the fatter you are, the more you need WLS.

(deactivated member)
on 12/22/11 8:28 am
What Ms.Batt is probably referring to is that there are some members out there that will recommend you filing a grievance/appeal against your plan with your state DOI. Personally, before taking out the bigs guns, it is always wise to investigate this with your plan and a bariatric surgeon.  Just because you may be able to appeal doesn't mean it is within your best interest.  It may pose a significantly reduced risk of morbidity by reducing your BMI before surgery. 

Now is the time to go slow, and methodically and get therapy.  Find out the reasons you became obese, and start dealing with that. No surgery fixes your eating habits.  While some surgeries may be more forgiving of what you eat, the fact remains that addiction is addiction.  If not treated, you'll be thinner and unhappy.  I know plenty of miserbable people that remain so after weight loss surgery. 

Wishing you the best,
Judi J.
on 12/22/11 8:53 am - MN
Obviously you have been very successful and want to help but don't you think it is presumptious for you to try to interpret what you think others have said or will say? why don't you just speak for yourself

this strikes me as a dig personally
(deactivated member)
on 12/22/11 8:57 am
I am sorry you see it that way.  There are many WONDERFUL and talented  people here and to suggest they should go elsewhere for advice was the real dig.  I meant nothing but support for the poster.  Isn't that what it's about?
Judi J.
on 12/22/11 9:01 am - MN
yes it's support but to presume you know what others will tell her is presumptious!


sarah_durso
on 12/22/11 8:59 pm
 I appreciate ALL advise. Thank you ! 
Sharyn S.
on 12/23/11 2:08 am - Bastrop, TX
RNY on 08/19/04 with
Most of the WONDERFUL and talented people have been run off, leaving the rainbows & unicorn brigade.

Sharyn, RN

RIP, MOM ~ 5/31/1944 - 5/11/2010
RIP, DADDY ~ 9/2/1934 - 1/25/2012

RosieSweetie21
on 12/22/11 9:38 am
Chris- I think your advise is right on. No one gets MO because they just "like food". My BMI was over 55 and I had high ALT and AST levels( liver enzymes) when I went to my WLS surgeon. He told me-I will not do surgery unless your bring BMI down and reduce your liver. Do high protein, low carb- use protein shakes. Stop all the junk. When I did this, I realized I used food for many more reasons than hunger, particularly stress. I realized I need to reduce my stress levels by changing my attitude and exercising more. ( I even bought a sauna at Costco). I also realized I  have a really big sugar addiction. My Dr required  psychological testing- my ins co did not.  First I thought it was stupid and I didn't think I needed it and I didn't want to go. Again the Dr said, these are my rules, if you want the surgery, these are my requirements, so I went. I'm glad I did because  talking with a therapist, who does mostly bariatric patients was very helpful to identify issues for me. After I did the pre surgery diet (losing  well over 40 lbs), I got sleeved. Not only was the surgery easier for the doctor, but I find it easier to follow the post op diet because I was already using protein shakes, and I was already working on my food as love, food as fun, food as stress relief,etc.  I do not think it is presumptuous or anything else to suggest someone go to therapy.  Some obese people are still looking for the magic cure.  There is none- or I would have found it! You have to go into this surgery with your eyes wide open and you have to be able to make a committment or you will be unhappy.  No matter what, once you get sleeved you will lose some weight, but to really be successful, you need to change your thinking, attitude and lifestyle. Lucky for me, I found a great Dr who I respected (he has done over 700 sleeves and has over 20 years of weight loss surgery, with thousands of RNY), and I was willing to listen to him. Occassionally I thought I knew better, but I listened to him anyway, because I wanted the surgery. (I was desperate enough to get out of my own way!) I think you were wonderful and courageous to give the great advise that you did. 
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