Hi New Here
Hi All,
Been lurking around these boards for a while now and thought I would stop in and join. I am curently doing WW for the 5th or 6th time. I have been overweight my entire adult life (I still blame my kids for that :)) and have tried every diet and meal plan out there. I have had good results a couple of times only to gain it all back and then some. I started WW so I could have 6 months on a doctor's plan for the insurance company. I have a BMI of 35.6 and need to loose about 90 lbs. I also have many co-morbidities such as diabetes, GERD, hiatal hernia, and the list goes on and on, not to mention a family histroy of obesity.
I have researched for the last year or so about WLS and specifically the VSG. I discussed this with my PCP (who was in favor of a more permanent solution) and my family and decided that this was the surgery for me. Unfortunately my insurance does not cover the sleeve, only the RNY and lap band. I have a cousin that had the RNY surgery several years ago and has had wonderful results and is healthy and off all her medications . The surgery itself does not scare me one bit, but I believe the VSG is a better fit for me. I have seen first hand how my cousin has to monitor her vitamins, her bloodwork, any malabsorbtion issues and dumping (although she has only dumped once or twice). I don't have a problem with sweets and such and I was looking for a more restrictive solution which is why I chose the VSG. I am not interested in the Lap Band at all.
I intend to give my all to WW and try again to lose this without surgery, BUT I have to wonder if I should start the process of trying to get approval for RNY anyway. I have even thought about going to Mexico to have the sleeve done, but my husband is appalled that I would even consider it. My PCP is wonderful and has seen/documented all my struggles to shed this weight over the past 20 years and is willing to help me in obtaining WLS.
I have already made some real changes in my eating based on what my cousin has had to do to maintain her weight. I have cut all "white" things out of my food plan and have upped the protein and fruit and veggies. I have been eating more raw and whole foods and have nothing tempting in my home to sabotage me. So far in 4 weeks I have lost 10.5 lbs. This is wonderful, but in the back of my mind I keep thinking about how this too will fail and I will be that much farther behind in obtaining lifesaving WLS. Oh and to add another wrinkle, I have a job that is not really stable because of the economy and there is always the chance that I will not have insurance coverage when/if I do decide on the surgery.
My husband and family will back any decision I make. I am just wondering if I am wasting time not starting the process now since I know how long it takes. Does this time on WW fulfill my requirement for a 6 months supervised plan?
And my biggest question: Where/how do I begin all this?
Sorry this is so long. Thanks for listening.
JC
Been lurking around these boards for a while now and thought I would stop in and join. I am curently doing WW for the 5th or 6th time. I have been overweight my entire adult life (I still blame my kids for that :)) and have tried every diet and meal plan out there. I have had good results a couple of times only to gain it all back and then some. I started WW so I could have 6 months on a doctor's plan for the insurance company. I have a BMI of 35.6 and need to loose about 90 lbs. I also have many co-morbidities such as diabetes, GERD, hiatal hernia, and the list goes on and on, not to mention a family histroy of obesity.
I have researched for the last year or so about WLS and specifically the VSG. I discussed this with my PCP (who was in favor of a more permanent solution) and my family and decided that this was the surgery for me. Unfortunately my insurance does not cover the sleeve, only the RNY and lap band. I have a cousin that had the RNY surgery several years ago and has had wonderful results and is healthy and off all her medications . The surgery itself does not scare me one bit, but I believe the VSG is a better fit for me. I have seen first hand how my cousin has to monitor her vitamins, her bloodwork, any malabsorbtion issues and dumping (although she has only dumped once or twice). I don't have a problem with sweets and such and I was looking for a more restrictive solution which is why I chose the VSG. I am not interested in the Lap Band at all.
I intend to give my all to WW and try again to lose this without surgery, BUT I have to wonder if I should start the process of trying to get approval for RNY anyway. I have even thought about going to Mexico to have the sleeve done, but my husband is appalled that I would even consider it. My PCP is wonderful and has seen/documented all my struggles to shed this weight over the past 20 years and is willing to help me in obtaining WLS.
I have already made some real changes in my eating based on what my cousin has had to do to maintain her weight. I have cut all "white" things out of my food plan and have upped the protein and fruit and veggies. I have been eating more raw and whole foods and have nothing tempting in my home to sabotage me. So far in 4 weeks I have lost 10.5 lbs. This is wonderful, but in the back of my mind I keep thinking about how this too will fail and I will be that much farther behind in obtaining lifesaving WLS. Oh and to add another wrinkle, I have a job that is not really stable because of the economy and there is always the chance that I will not have insurance coverage when/if I do decide on the surgery.
My husband and family will back any decision I make. I am just wondering if I am wasting time not starting the process now since I know how long it takes. Does this time on WW fulfill my requirement for a 6 months supervised plan?
And my biggest question: Where/how do I begin all this?
Sorry this is so long. Thanks for listening.
JC
Hello and welcome!
I think many of us have struggled like you. Years of dieting and regaining is so frustrating. I'm glad you've decided to seriously consider wls!
To start you can identify institutions in your area which offer wls. Barix Clinics and St. Mary's Hospital are the only two I can think of off the top of my head but there are several more. They'll probably want you to sign up for an informational meeting/session which will be a good opportunity for you to get some questions answered.
I don't know if the time on WW will count or not. That will have a lot to do with your insurance company and their requirements.
I can also tell you that there are some amazing women in this forum that know a lot more than I do about all this. I'm sure they'll get back to you with some even better answers soon!
I think many of us have struggled like you. Years of dieting and regaining is so frustrating. I'm glad you've decided to seriously consider wls!
To start you can identify institutions in your area which offer wls. Barix Clinics and St. Mary's Hospital are the only two I can think of off the top of my head but there are several more. They'll probably want you to sign up for an informational meeting/session which will be a good opportunity for you to get some questions answered.
I don't know if the time on WW will count or not. That will have a lot to do with your insurance company and their requirements.
I can also tell you that there are some amazing women in this forum that know a lot more than I do about all this. I'm sure they'll get back to you with some even better answers soon!
The first thing I would recommend is checking with your insurance company and finding out what their requirements are, the requirements vary by ins co.
I doubt any insurance company would approve wls on a hx of WW only, even multiple WW hx's. Most require a physician supervised weight loss program of some type. You can do WW simultaneously, it would definitely help. I sent my WW notes w/ my approval request, anything you can give them when you go for approval helps.
As far as the 'type' of surgery, that's an individual decision. I choose RNY because it's the only one that my ins. approved too and I didn't have the money or trust in Mexico.... again a personal decision.
Personally, I am very happy I did this, I lost 115 lbs and have regained about 10 and I'm 2.5 years out. When I left the hospital I left my diabetes and hbp meds behind. My GERD is gone, but I'm still taking Previcid as a preventative (most of us do). Beyond that for me it's just vit's and I can live with that!
Stick around, ask questions, go to the surgery specific boards ask them questions..... Ultimately make the decision you can live with, because this is your life and your body thus your decision.
Good luck,
Edie
I doubt any insurance company would approve wls on a hx of WW only, even multiple WW hx's. Most require a physician supervised weight loss program of some type. You can do WW simultaneously, it would definitely help. I sent my WW notes w/ my approval request, anything you can give them when you go for approval helps.
As far as the 'type' of surgery, that's an individual decision. I choose RNY because it's the only one that my ins. approved too and I didn't have the money or trust in Mexico.... again a personal decision.
Personally, I am very happy I did this, I lost 115 lbs and have regained about 10 and I'm 2.5 years out. When I left the hospital I left my diabetes and hbp meds behind. My GERD is gone, but I'm still taking Previcid as a preventative (most of us do). Beyond that for me it's just vit's and I can live with that!
Stick around, ask questions, go to the surgery specific boards ask them questions..... Ultimately make the decision you can live with, because this is your life and your body thus your decision.
Good luck,
Edie
You don't have to have a lump to have breast cancer!
Inflammatory Breast Cancer
www.ibcresearch.org
The Sleeve is considered "exploritory" and you can see if they will cover it for you. Also pending on your insurance I have BCBS and they covered me on just speaking to my dr on different times about weightloss nutrition etc also they do accept ww or any other 6 months proof gym membership history etc. So find out from your insurance company exactly ask them to mail your the requirements and do a consult w/ a surgeon they will give you the most accurate information. Best of luck to you!
i am not trying to make you nervous but the lowest bmi that wight loss surgerys are approved for is 35. i would definatly get connected with a clinic that does weight loss surgerys and go to orietations soon. im also afraid ww may not be used for your 6 month it has to be doctor surpervised..what area of the state are you from i went through grand health partners here in grand rapids . but there is also mmpc and there is grand health partners in k zoo. im afraid if you go under 35 bmi you will have a big struggle getting approved for any wls,
vsg is still considered experimental by some insurance but many are coming around.my suregry was listed as a 2 part deodoonal so that my insurance would cover it . i had the vsg and can choose to never have th 2cnd part .or i can follow up and have the second. i doubt i will i really love my sleeve. please also enjoy the surgery forum for vsg very informative.
Thanks for all the great advice. I still have a few (thousand) questions.
First of all, what is a doctor supervised weight loss plan consist of? Are we talking weighing in/documenting losses/gains each month with my PCP? Is it a nutrionist? Is it going on a plan like Medical Weight Loss or Optifast shakes? I am not sure what it is.
I also am losing on WW. Struggling, but losing. Very shortly I will not qualify for WLS anymore. I am afraid that WW will fail and I will gain again like I have every single time in the past. Don't get me wrong, I would do anything not to have my insides rearraged in order to be healthy again, but history is history and I know what will happen.
Has this happened to anyone else? Where they lost pounds and didn't qualify after the 6 month supervised plan?
I also wonder if after finding out what is required to qualify under HAP-HMO, should I just not try to lose anymore with WW and just maintain to get surgery? I am at a loss. I guess what I am saying is: I don't want to waste any more time. I have finally made the decision to become healthy and live a longer life and if WLS is the means to do it, I don't want to pass up the opportunity.
Thanks again.
JC
First of all, what is a doctor supervised weight loss plan consist of? Are we talking weighing in/documenting losses/gains each month with my PCP? Is it a nutrionist? Is it going on a plan like Medical Weight Loss or Optifast shakes? I am not sure what it is.
I also am losing on WW. Struggling, but losing. Very shortly I will not qualify for WLS anymore. I am afraid that WW will fail and I will gain again like I have every single time in the past. Don't get me wrong, I would do anything not to have my insides rearraged in order to be healthy again, but history is history and I know what will happen.
Has this happened to anyone else? Where they lost pounds and didn't qualify after the 6 month supervised plan?
I also wonder if after finding out what is required to qualify under HAP-HMO, should I just not try to lose anymore with WW and just maintain to get surgery? I am at a loss. I guess what I am saying is: I don't want to waste any more time. I have finally made the decision to become healthy and live a longer life and if WLS is the means to do it, I don't want to pass up the opportunity.
Thanks again.
JC
JC,
I can't tell you how many times I've read that over the last 3 years, the whole I'm going to loose to much to qualify for surgery issue. That's such a toughie for me, I TOTALLY understand where you are coming from, I think most of us on here do. How you handle it is your decision. It was never an issue for me, I had WAY to much to loose before I would not qualify.
First things first, your question on what is a "physician's supervised" diet....that depends on your ins. Call them, only they can answer that question.
Personally I found a physicians office that specialized in weight loss. They had you follow a Mediterranean diet plan... protein, vege's, fruits and some breads. They started you out doing vege soup, protein shakes and some salads daily. It worked very well for me, I think I lost about 25 lbs in 2 months, but I was going to kill someone because of the deprivation :). Anyways, I continued at that office with a more realistic diet for 1.5 years, because I was never going to have the surgery.....I could do this on my one you know! Plus I had been on WW during that last 6 mo's or so. So by the time I decided to give in (yes that's the way I saw it) and have the surgery I had enough documentation for 3 people LOL!!!
Keep asking away,
Edie
I can't tell you how many times I've read that over the last 3 years, the whole I'm going to loose to much to qualify for surgery issue. That's such a toughie for me, I TOTALLY understand where you are coming from, I think most of us on here do. How you handle it is your decision. It was never an issue for me, I had WAY to much to loose before I would not qualify.
First things first, your question on what is a "physician's supervised" diet....that depends on your ins. Call them, only they can answer that question.
Personally I found a physicians office that specialized in weight loss. They had you follow a Mediterranean diet plan... protein, vege's, fruits and some breads. They started you out doing vege soup, protein shakes and some salads daily. It worked very well for me, I think I lost about 25 lbs in 2 months, but I was going to kill someone because of the deprivation :). Anyways, I continued at that office with a more realistic diet for 1.5 years, because I was never going to have the surgery.....I could do this on my one you know! Plus I had been on WW during that last 6 mo's or so. So by the time I decided to give in (yes that's the way I saw it) and have the surgery I had enough documentation for 3 people LOL!!!
Keep asking away,
Edie
You don't have to have a lump to have breast cancer!
Inflammatory Breast Cancer
www.ibcresearch.org
Most Active
Recent Topics
