Don't want to do the pre-op diet/10% weight loss/other stalling requirement? The DMHC can...

"Did you READ the DMHC report? "

I'm going to guess no.

It is not easy for some people to lose 10% of their body weight and there are people who have died waiting for WLS because they couldn't get down to some magic number their surgeon required before they could have surgery. What is the point of making some weight for a life-saving operation until they meet some arbitrary criteria?

Sure, lose as much weight as you can pre-op. Do as much exercise as you can to improve your cardio-vascular health pre-op. But there is nothing magical about 10% or any other number. Any weight lost is helpful and not losing anything (or gaining) doesn't necessarily make things worse.

There is a surgeon in my area who wants people to lose 10% of their body weight and, if that ends up being 20 lb. and you show up for your pre-op appointment and have only lost 19.5, she cancels your surgery. How lame is that? There is no way you can justify that medically, IMO. It's about being a control freak and nothing else.

Whaddya know -- we're on the same side for a change!

Foster's 10% weight loss requirement was one of the things that pushed me to find some other surgeon, which is how I found the DS.

Not having a weight loss requirement is NOT a free pass to going on a Final Tour de Food.  Especially not with the DS.  But a mandated requirement is utterly ridiculous, and completely unsupported by research or clinical experience. 

I think it is just fatty-hating bariatric surgeons and insurance companies who want their patients to be punished for their gluttony; who want to deter the weakest ones (who probably need the surgery the most) to keep their costs down and their stats up; and who think that by making the patient feel guilty and humble from the git-go, they will be more likely to be "compliant."  There is no evidence in support of ANY of these reasons.

We're on the same side a lot of the time, actually.

Thanks for spreading the word!  I have Kaiser and fought for years to get the surgery before I stumbled across the DMHC.  I filed a grievance and within a month had a surgery date at Kaiser.  I had my surgery March 10 - the best day of my life!  I am close to -70 lbs to date and am happier than I can express.

Amanda

Thanks for spreading the word!  I did exactly that after fighting with Kaiser for years to get the surgery.  Within a  month of filing the grievance with the DMHC I had a surgery date.  I had my surgery (lLAP RNY) on March 10, 2009 and am down 70 lbs so far.

Amanda

Good for you!!

Kaiser uses stall tactics. They have a 5 month waiting period just to get into their Options program which is another 5 months long. Not to mention their criteria to have WLS is different (more strict) from the NIH's criteria. Those who say otherwise, really don't know what they are talking about.

I'd assumed it was up to the surgeon.  If he has approval from insurance for surgery, the rest is up to him, isn't it?  My surgeon didn't require any weightloss.  I actually gained prior to surgery.  How would the insurance company even know of weightgain?  Why would he be in contact with them once approval came in?

Diana,

Thanks for posting this. I really wish that this info was more available. I have a friend in the Chicago area with Type 2 Diabetes who would like WLS, but he doesn't qualify because he is able to loose weight on the 6 month mandated pre-op diet, or something like that. Whatever it was that kept him from qualifying, it didn't really make sense to me and seemed like a way for the insurance company to get out of paying.

It's really good that you bring up info like this--thank you!

Best,

Most insurance companies take the STARTING weight as the official weight, and only look at the diet (whatever their REAL motives) as a means of delaying the surgery date and making people give up.  There must be some other reason.  If he can lose weight on the diet, they should not hold it against him.