Frustrated...help? advice?

Hey guys. I haven't really been able to update on this messageboard too often because I'm working 40 hours, taking a full course load in college, and being a wife and mommy. Spare time is not easy to find! Anyways, I'm on my 4th month of supervised dieting. I'm on the journey to get the Lapband, and I'm a Dr. Steele patient. I've only lost 5lbs, which takes me to 265lbs (I'm 5'11). My primary care doctor is supportative of my surgery, but he wanted to make sure I was healthy and he put me thru a TON of tests. I had a sleep study, a stress echocardiogram, a ton of bloodwork, and my blood pressure was monitored. Turns out I no longer have high cholesterol, my blood pressure has stabilized to normal, and my heart is functioning perfectly. Although I'm glad to hear that I'm in great health, I now have NO co-morbidities! My BMI is 38. I have EHP and supposedly I need co-morbidities to get approved.  On the other hand, I have been diagnosed as a binge eater (DUH!). Dr. Steele seems to think since I have constant knee, back, and joint pain and that I should be approved through those symptoms. Also, my PCP is going to write me a letter of recommendation.  I'm feeling a little helpless now. I'm so scared that I won't be approved, and I have tried dieting on my own SO many times.  Has anyone else had any of my same issues or can someone offer me advice? Thank you, Melissa

hello trade, im going through all of the same tests that u r . kimberly steele is my sugeon too. i dont think i have lost a lb. lol. i see the heart doc on monday feb 25. and i have the sleep study on march 14. everything will work out for u.   i hope that i will be approve myself.   good luck, sweetheart59

I love Dr. Steele. And don't worry I didn't lose the 5lbs the easy way. I had the stomach flu!!!

I am sorry I don't have any advice. But I wanted to wish you the best. I am sure Dr. Steele had to deal with this before and she knows what to do to get your approval. Stay positive and I wish you nothing but the best.   

Thanks for the positive thoughts!

Melissa, what did the sleep study show? What about medical records on joint or back pain, osteoarthritis, carpel tunnel? any of theses things should do it.  I'd be concerned about the diagnosed binge eater though. Its been a while since I had to go through the process but my insurance required a psych eval to make sure there were no underlying psych issues related to my obesity. In other words, if you are obese due to a psychiatric reason, you'll need intense therapy, not surgery.  Surgery won't fix a psychologocal issue, so I'd be concerned that insurance will see that type of diagnosis as a reason to deny surgery. Just get some clarification from your surgeon on that issue and whether it will be a problem in getting you approved. 

I have recently read both of the entire website for the Johns Hopkins Bayview program where your surgeon is based, http://hopkinsbayview.org/bariatrics & http://www.smallscar.com/ and they say there that if a patient is diagnosed with binge eating disorder they will register them for their cognitive behavioral group therapy treatment program for several weeks.  Also, if there is any other mental illness such as depression or anxiety, it says that there needs to be documentation that it is being treated.  It's the untreated issues that would be a problem in getting approval I would think based on reading this.  As far as your other issue, the comorbidities, here is a list- Depression, Anxiety, Social Phobia, Cardiac problems, Congestive heart failure, coronary artery disease, GERD(Acid reflux disease), Edema, fatty liver, mobility limits, diabetes type 2-(even borderline type II insulin resistance counts), sleep apnea, hypertension, hypercholesterolemia, hyperlipidemia, asthma, arthritis, degenerative disc disease, Nerve damage/ neuropathy, fibromyalgia, stress urinary incontinence, menstrual problems, thyroid disease, plantar fascitis(heel spurs), carpal tunnel syndrome, and also skin conditions such as psoriasis and eczema.  Or, Maybe you have something on this list below which I copied and pasted from their website? 

List of Medical Diseases Associated with Obesity (only partial list)

Coronary (heart) artery disease Congestive heart failure Hypertension (high blood pressure) Pulmonary embolism (blood clot to lung) Sleep apnea syndrome (snore and gasp for air at night) Obesity hypoventalation syndrome Pre-eclampsia Necrotizing pancreatitis Necrotizing soft tissue infections Adult-onset diabetes (type 2) Breast, endometrial, and colon cancer Unrecognized peritonitis (infection in the abdomen) Cirrhosis (liver disease) Degenerative osteoarthritis Urinary stress incontinence Gastroesophageal reflux disease (heartburn) Venous stasis ulcers Deep venous thrombosis (blood clots in you leg veins) Dyslipidemia (high cholesterol) Pseudotumor cerebri Hernia Dysmenorrhea (irregular periods, infertility) Nephrotic syndrome (kidney disease) Wound infections Depression Cholelithiasis (gallstones)

Thank you for looking that up!  The cognitive therapy group is a great tool. I'm already signed up to do that. Binge eating is a factor for almost everyone if you think about it. Binge eating means you eat when you are not hungry. If you are eating past your stomach's capacity and you have already reached that "full point".   I think I am a good candidate for this surgery because I'm taking it very seriously. I don't think its the magic tool to lose weight without trying. I'm going to therapy to help with my issues, stemmed from depression mainly, and I'm learning how to change my way of thinking about food.  Thank you for your help! I know I have to take it one day at a time and stop stressing about the process of getting approved.