I gave up today!!!!

I have been experimenting with my protein powder and have found a really yummy breakfast that keeps my bottomless pit of a stomach full for about 4 hours. I do 1 scoop of the chocolate protein powder, 1 cup of milk, 1 whole banana, 4 ice cubes. Put it in the Magic Bullet and blend and YUMMY!!!! Chocolate Banana Smoothie that is less than 300 calories. I have two of those a day and then a high protein lunch that is about 400 calories and I am set for the day.I'm gonna make it!!!!! Thanks for the advice and your encouragement!!! People are so nice on this site!!

California patients with insurance plans regulated by the DMHC/Dept of Insurance (which is most of them, and ALL HMOs), do not have to do pre-op weight loss.

All you have to do is file a grievance with the DMHC and cite this review, and they will order the insurance company to waive the requirement  http://www.dmhc.ca.gov/aboutTheDMHC/org/boards/cap/Bariatric REV.pdf

Mandated weight loss prior to indicated bariatric surgery is without evidence-based support. Mandated weight loss prior to indicated bariatric surgery leaves the patient at increased risk from the patient’s comorbidities. Mandated weight loss prior to indicated bariatric surgery is not medically necessary. Mandated weight loss prior to indicated bariatric surgery would be deviant from the standard of care practiced in the United States and other published countries. The risks of delaying bariatric surgery, while not entirely known in the short-term, are real and can be measured. Any potential value of losing weight prior to bariatric surgery is theoretical and not supported by any data.

Thank you for the information. I will see if I can try to lose some more weight, I have to anyway, and if the weight loss is the only thing holding me back I will file a complaint. Is that what you did? My insurance through Kaiser and my doctor said that the insurance requires pre-op weight loss. I hate that they have so much control over us.

They can say whatever they want -- but the DMHC will FORCE them to waive the requirement as being unsubstantiated by evidenced-based medicine.

I didn't have to (I had Aetna and I had already qualifed with a program I did before I decided to go for my DS), but I have helped many people with Kaiser and other insurance companies with this ridiculous requirement get it waived.

Honestly, they're not really trying to control you.  The weight loss pre-op is to try to clear excess fat from your liver, which makes it much easier for the surgeon to do the lap procedure.

I recently watched a program which showed the lap surgery and there was a lot of plain old fat (looked like chunks of chicken fat) in the abdominal cavity where the work was being done.  If our pre-op diet makes their work easier, it makes our LIVES easier.

Hang in there, Pumpkin!!

I just read your response today. I don't how I missed it the first time around. I really do appreciate your kind words and reassurance I am just so tired of trying to lose weight. I feel like they don't look at each patient individually but pronounce a blanket requirement on the whole extremely obese population. I have lost hardly any weight on my own and I am exhausted! I've cut my calories, tried walking (very painful) and still cannot lose weight and keep it off. I have taken 3 semesters of nutrition and exercise while going to college just so I could learn about eating and walking to be healthy but it does no good when my stomach growls and aches from want and I stay awake all night from the pain of exercise. I wrote my doctor today to tell him I was frustrated and feeling like a number in the insurance world. I also took the advice from another patient to file a complaint for waiver of the 10% weight loss pre-op. I eat healthy and have very little fat in my diet so I'm pretty sure my liver is healthy enough. Actually, I really have never eaten alot of fat. My metabolism is slow and I lost the genetic lottery as far as being obese is concerned. Anyway....sorry to go on and on. I am inches away form a meltdown. Have you ever felt one coming on? That's me right now. I really feel like the doctors could care less if I have this surgery because at the end of the day they get paid. Too much stress...... I am trudging on because there is little else to do!
Please take care and good luck in your goals

Hi Diana,
I took your advice after suffering miserably to try and lose 25 pounds on my own. I think I am bulimic and yesterday was a wake up call when I realized I had downed 3 doses of laxatives, 1 after each meal. I am so discouraged with the "thou shalt lose 10% of your body weight" law. I e-mailed my Dr. to let him know how I felt and also that I was going to file a formal complaint with Kaiser, which I did today. I have a few questions for you, since you seem so knowledgeable about the issue. Have you ever known anyone to be denied the surgery after filing a complaint or have known anyone who was put at the bottom of the list or delayed from having the surgery for filing a complaint? I am really worried that I just screwed my chances for having the surgery altogether. Do you have any thoughts or words of wisdom?

I don't know for sure what happens to people who fight Kaiser on this issue alone -- most of the time, I am helping with this issue in conjunction with fighting Kaiser to get the DS too, and since they have to pay an outside surgeon for the DS, people don't go to the bottom of the list once they win their grievance.

But since they don't put you on the list until you make the 10% weight loss anyway, what's the harm in trying?  Yes, they will probably treat you somewhat more poorly, but if you can't lose the weight in the first place, you are no worse off.

With your metabolic issues, have you looked into the DS?  Note that Kaiser almost always loses the appeals where the patient wants a DS and in NorCal, pays Dr. Rabkin to do them -- he is one of the best DS surgeons in the world.

Diana,

Thank you for responding. I am pretty set on having the RNY because of the research that I have done. Each person knows what will work best for their body. I am already being treated poorly as far as I'm concerned. I do not appreciate being overlooked as an individual. Well I've already filed the complaint with Kaiser so it can't be undone. I guess I'll just have to accept whatever happens. In the meantime I am still trying to lose weight. Eventually I will lose the weight so eventually I will have the surgery.

Becky