My first post - Insurance denied :(

My name is Ann and I have been overweight my whole life. Like so many of you, I am the one with the "beautiful face." Like so many of you, I have tried countless diets and have even been successful at a few of them. By the time I was 18, I weighed around 230 lbs. By college, I was hovering around my "average" adult weight of 250 (at 5 ft 6 in, a BMI of 40). Back in 2001, I went on a diet with the help of a great nutritionist and worked so hard and managed to lose 65-70 lbs, going from my previous all time high of 273 to around 208. I felt so good - I was hovering around a size 16 and even managed to buy clothes in a few stores not called Lane Bryant or The Avenue. And I never thought I would gain the weight back. Well, I was wrong. As soon as I got to my all-time low, the weight started creeping up again. To make matters worse, I was now engaged to the most wonderful man, and needed to fit into my wedding dress. Despite going to the nutritionist and trying, I put back on between 30-40lbs for the wedding. I got into my dress but barely. That was November 2003. Afterwards the weight kept climbing. I was soon back up to 271 - and up from there. Last year I spent hundreds of dollars on Weigh****chers and LA Weight Loss - but was now over 300 lbs. I was so depressed. I tried but couldn't commit. I think because I had finally had a good success at a diet, and never thought I could gain it back, I was so devastated to find myself worse off then before. I had finally tasted what it felt like to feel good about yourself - and felt ashamed and humiliated that I had gotten to this point. And that's when the health issues started. I had always been heavy - but I had never really felt limited. Now my husband and I were buying our first house - a 3-story townhouse. Almost immediately I realized my knees and my ankles couldn't handle my weight and the stairs. And the first time I had to ask for a seat-belt extender - or was afraid to go to a play (theater is my greatest love) for fear of not fitting in the chair. And after 2 years of marriage, and now having a house, wanting to have a baby but being terrified of complications, gestational diabetes, - and how the hell could i keep up with a baby when I couldn't climb the stairs. And now I was afraid for my health. My father died at 46 in part due to diabetes. And my 33 year old brother just got diagnosed with Type II diabetes. And what was in store for me if I kept up like this? I never considered WLS until I got to that point. I saw Carnie Wilson on TV pregnant - and starting considering the option. I don't offically have any co-morbidities. Other than my knees, I am luckily pretty healthy. And I don't want to die young - and if I stay at this weight I fear I will. So I started looking into WLS. Before anything, I asked my OB-GYN about it - and she thought it was a wonderful idea. Since I was 30, she said to have surgery first and then work on the baby. Had I been 35 she would have said the opposite. I first explored a practice on Staten Island which was good, but then I ultimately decided on Dr. Marina Kurian in Manhattan. She said I was a good candidate for surgery and said to try and lose weight, but at least not to gain weight. I went for the psych consult to the Dr. recommended by my surgeon, the meeting even took place in the office. I started seeing my personal nutritionist again to have that support system in place - and she did my diet history and letter for me. I also the nutritionist at the office. I have managed to lose 15 lbs since the beginning of October. I was hoping for surgery in December and the insurance coordinator finally sent my application in last Monday. I have HealthNet. I called on Monday, only to receive the devastating news I was declined. I am still waiting for the whole story - but this is what I know- They wanted a 5-year weight history and a diet history. Only because I went on the most successful diet in my life was my BMI under 40 for a bit. It seems like they are holding this against me. Secondly - the damn psychologist I paid $250 cash to that was referred to me by the surgeon's office (who I thought was there to help me get approved) wrote her eval in a very unflattering way: that I had gained 100 lbs since my wedding (not true - I had put 30 - 40 kbs on prior) and that I eat due to stress (who on this board has never eaten when they were upset) and that I can graze. I mean I paid you because I thought you would try to get me approved. Not because you would paint a picture of me like a big fat slob with no will power. I am so upset. I know the surgery is not a magic pill. I will still have a long road ahead of me - and I will have to battle my demons. That is why I have started working already with my nutritionist and why I am looking for a therapist. Also why I started attending my surgeon's support group. Dr. Kurian has tried to contact the medical director at the insurance company and is waiting to hear back, I will probably need to appeal but I am just waiting to have more information. I am feeling devastated and a bit at a loss for what to do. I have thought about getting a lawyer to help with the appeal. I know many of you have been in the same position. I would really appreciate any help or advice you could give. Please. I need some support. Thanks so much. Ann

Sorry to hear you were denied Ann....I do remember what that feels like.....I was denied 3 times before I was finally approved....I also had no comorbidities.....now here is what you have to do you can never give up....and continue to fight.....send in your appeal.....and wait for the answer........then we will go on to the next step..... I understand how you feel...I was devastated when I was denied and denied and denied...I sometimes wanted to give up....but the wonderful people here on the board didn't allow me to and continued to cheer me on every step of the way....so now I tell you again....you can NEVER NEVER give up......this is your health and your life....so hang in there.... I do belive that things happen for a reason.....and maybe right now is not the time for you but I also belive that you will have your re-birth and be on the losing side.....but you will have to fight for it so hang in there we are here for you.... If you need to talk send me an e-mail and I'll give you my number... {{{{{{{hugs}}}}}} Christine

Ann, First off let me say welcome to the NY board, this will be a great place to learn, vent, cry and just chat. There are some really great people here. We try to offer support to each other and it can become part of your extended family. I know being denied is so hard, I was not denied but told I had to do a 6 month weight loss program before the Ins would even look at my case, so I did but know that what ever you have to go through you will make it ~Hugs~ Hang in there, fight for what you want and just keep trying to move forward. I know that is easier said then done. Just know that we are always here for you hun and also believe that when the time is right this will work out. Take care and my wishes are for what ever is the right thing for you.. Debra P

Ann 1st off. (((HUGS))) I am sorry you got bad news. I am sure its hard hearing the words you heard. BUT, Like Debra and Christine said up there...........Dont give up !! Sometimes we have to fight harder for the things that mean so much to us all, this being one of them. I am sure in time you will be accepted and will find yourself on the losers side with all of us, and when you do. it will make you embrace this journey all the more. Dont give up......... I will be keeping you in my thoughts and prayers Love 2 U Brenny