getting approved.

Mr.C., Glad to see you've stooped down to my level with your post to me I have no right to respond in the manner I have?? Seems like you are the one who thinks they are all high and mighty... Who the hell are you to tell me what my rights are? Keep my MONTH shut?? What the hell does that mean? Go join whomever you want........BYE!!!!! P.S. Do you need bus money? *sigh* Oh the drama of the internet...lol Tracy

OK Elizabeth, Here's the thing..you post this same kind of question nearly every day. You get the same responses...i.e. call Walter Lindstrom, etc...and the next day you post the question again. I dont know what you expect from us, really. Gaining is an option, of course, but there is no guarantee that you will be covered, then you have an extra 22lbs to carry around. Bad idea. (notice I didnt say viable option) I feel for you, I really do. I do think you can fight this with legal help.

I would be very hesitant on gaining in order to qualify for surgery. My insurance wanted proof that I had a BMI of >40 for the past 5 yrs just to prove that I didn't gain weight in order to be approved for surgery. With your co-morbities the rule is generally BMIof 35 is acceptable, >40 w/o co-morbities. good luck Kristi

Elizabeth, I just looked at your profile and see that you have BCBS of IL. They are now starting to get sticky with the 1 yr of a diet try with a doctor before you are approved. I would not recommend that you gain weight in order to have WLS, you are really setting yourself up for more serious weight issue problems. Talk to your PCP to find out what some of your options may be. I would highly recommend Weigh****chers. They have two great programs for loosing weight and they are a really sound program and they really have a great support system with their meetings especially if you go to a meeting that has a lot of feed back at it with the members in the audience. I agree with some of the others about your insurance company would not look favorably with you having a recent weight gain, they really look closely at your recent weight history when they are considering an approval. Keep us posted on this board and I also say not to post on the Main board, they can be real bruttle(sp?) with their responses.

hi, my pcp wrote a letter stating a 2 year supervised diet plan, to no avail. I have tried everything. I have degenerative disc disease, and depression, so all I have to do to keep gaining weight is, keep taking my anti depressants, for they make you gain a ton, that is how I got obese, I would go on and off of them, hoping the weight would come off, I would try the ones that are not suppose to cause sooo much weight gain, they did not work, I would get more depressed, so now at this point I will stay on them, and see what happens, and I know what will happen. I have gained 40 pounds in the last year, along with losing my job, and not getting that much activity. Because of the degenerative disc disease, I can't do much exercising, or walking cause my back hurts sooo much, I even purchased a treadmill and gazelle. My BMI is at around 35.5. I have alot of documentation on my depression, but not on my degenerative disc disease, because I thought the only thing the doctor can do is prescribe pain pills, and I don't want any. But I did see a chiropractor, and that made everything hurt worse. Sooooooo, any suggestions? thanks to all!!!

Elizabeth, most insurance companies require that the co-morbids be "life threatening", that means diabetes, high blood pressure, some heart conditions and I think high cholestorol. I am not real sure on this last one but am positive on the first three. Are the depression and degenerative disc disease life threatening? You may want to consider to self pay or attempt to obtain some type of financing to have the surgery IF a doctor would take you with a bmi of 35.5. Which by the way means that your are just VERY OVERWEIGHT, NOT OBESE.You and your doctor are going to have to put on your thinking caps to figure out a way to help you loose some weight. You the patient has to be their own advocate, you should start doing some research on line for other drugs that will help you with your degenerative disease, something that will not cause a weight gain and then turn this info over to your doctor and see what he says. I did that with my bowel disease before my WLS. I am not really sure a chiropractor is the best avenue for your disc disease, try an orthopedic doctor. I gave you the suggestion of Weigh****chers as did another person in this question that you posted. We have all come to a dead end with suggestions for you, I am not sure what else to suggest to you. Sometimes WLS JUST is not for everyone, not everyone qualifies for it either by the insurance road block that you have met or with other problems that arise. I myself was denied by one doctor because I have irritable bowel disease. That one doctor thought it was not the right thing for me at that time. I did eventually find another doctor that thought it was safe to go ahead and do RNY on me. I like you was devastated at that time when I could not have WLS. I am sure you are the same way. You will just have to try another avenue for yourself. While I can sympathize with you on this I think that you need to move on and put every effort into trying to loose weight on your own. I cannot see anywhere in your profile where you say that you have tried a gazzilion different diets. It makes me wonder if you are just wanting WLS to loose weight the easy way. Let me tell you WLS is not easy to live with. I would rather do anything else than constantly keep in mind to eat protein first, do my exercising, drink my water, taking 3 bites of food first for every bad bite of food that I want to eat. I have recently learned this rule of eating, 3 good for 1 bad, you fill up on the good food first ie: protein - so therefore you do not have room for the bad foods. THE WLS LIFESTYLE IS NOT EASY AS MANY PEOPLE THINK. Christine