Hi New and have ???

Im new and have been through all avenues I can take and I am ready for taking the step to surgery and not sure where to look and my family doctor and not a positive influence. Did anyone go to a clinic without a referal? What kind of tests do you have to go through? What kind of bad health do you have to have before they will allow you to have surgery? I am sorry I want a different life and I really have put all my effort into trying on my own and with drugs and with exercise and have even injured myself in exercise and my doctor doesn't seem to get it. Can someone give me their insight. 
Thank you.

Hi Dani,

You don't have to have a referral to go see a bariatric surgeon. It helps enormously to have a supportive PCP because you'll need their help and support pre-op and post-op, but you don't have to have their blessing or referral to see a surgeon. 

Each insurer may have specific guidelines that are particular to your policy, but here's the high level stuff that's common to most: 

* Body Mass Index (BMI) of 40 or more qualifies you for surgery without any comorbidities.

* BMI of 35 or more with one or more comorbidity. There are a number of comorbidities, but the most common are Type 2 Diabetes, high blood pressure, high cholesteral, sleep apnea, GERD (Gastro Esophgeal Reflux Disease). Things like arthritis and lymphedema are positively impacted but not usually considered a comorbidity that qualifies you for surgery. 

Most programs want a history of your weight loss attempts, what, when, where, how much... I just created a list (and was astounded as I looked at it). 

Many, but not all programs require a medically supervised diet attempt. If you are even contemplating a WLS program, contact your PCP and let them know that you want them to help you do a medically supervised diet. You want them to document your vital signs, including weight, height, BP. You want to have them document what you plan to do for the following areas: Nutrition/Diet, Exercise, and Behavior Modification. For example you might join Weigh****chers or go on the South Beach diet. Plan to walk 20 mins a day every day. See a counselor about eating issues or join a support group. You should go see the Dr at least once each month to have them document your progress and make whatever changes might be necessary to your plan. You don't have to lose weight while doing this, but an honest effort needs to be documented.

I did this and lost weight prior to submission to my insurance company. I also continued to lose weight prior to my surgery.Know that you are embarking on your journey to change your life now, not when you get your surgery. It is one of many tools you will lose to get as much of your excess weight off as possible, but it is just one in your arsenal.

I have a some books that have been enormously helpful. One is 'Eat it Up' by Connie Stapleton and the other is the 'Beck Diet Solution' by Judith Beck. I use them to this day. They are about changing your view of yourself and your relationship to food. 

I would look at all of the surgery types available. There are basically two main types of WLS: restrictive only and restrictive/malabsorbtive. There are pros and cons to all of the surgeries. You will need look at your own issues with food, the strengths and weaknesses to each surgery and determine which is best for you. There are a number of variables to consider.

I would also suggest that you attend informational seminars at 3 or more programs if at all possible. You will gain a lot of information and different perspectives. I would strongly suggest having your surgery through an ASMBS Center of Excellence if at all possible because these programs are fully faceted and have a great deal of experience. You need a program that has great psychological support and nutritional/dietary support as you make your way. 

I hope this helps.

Thank you,
I am over 40 BMI :(
I have attempted many weight loss solutions with and with out my PCP.
I am going today to talk to him again with my husband to see if he will assist me in this decision. If not there is another PCP in his practice who might.
I am concerned about the Upper GI, and the pysch eval. I am not sure what to think about a tube going down my throat and yes, I am depressed about my weight. Isn't that why I am wanting this? I am also determined to change my life I am just sure I have tried everything I am able with out the surgery and I can not do it with out help. I am sure I will try to keep the life changes after the surgery as I want to be able to sit in a plane next to my husband comfortably, walk and play with my kids, not cry when i get dressed, enjoy making love to my husband again. Sorry
I have found a ASMBS in Concord, it seems to be the closest to me as well.  I am also not sure as to the surgery in paticular I am comfrotable with.
Thank you and I am sure I will have more questions.
Hugsss

I went straight to the baraitric surgeon.  My PCP didn't know until I asked for my weight records.  But you should look into a more positive PCP.

Kelly

My PCP was a bit ambivilant about having the surgery but she gave me the referal anyway and now is very happy with my results so far. Once you get started into the process your PCP may end up coming around especially when they see how well you are doing.

 Thank you, my PCP was still not for it but it is a practice where I am comfortable with two of the Drs there and I spoke to his colleage and he is happy with my decision and will support it. 
During my PCP appt my blood pressure was found to be thru the roof. It has be under lots of stress. Making me want the surgery more and more. I want to work hard at getting this weight off.
I have a simple question about Lap Band, I understand the concept but the tube the add and can remove saline thru, does that come out of your body? how does that work?
I guess my next step is setting my appointment at a seminar!!!! 
I am excited nervous and overwhelmed
Please shoot all the info you can at me, things you think I should ask, please