HELP: Need opinions/info

Hello All!
I have been lurking and reading for a week or so now (love the board). I am 5 foot 1.5 inches and about 202 pounds and I have been considering the Lap band for a year now. I am just starting to do more reasearch about it (2 friends that love the tool) and I am already frustrated.
I have Aetna and called an office in PA (Crozer Med. Ctr) they are awesome there and really nice but I found out that my BMI is borderline (I think around 38-39) and it needs to be 40 to be considered. If less I need co-morbidities (which I do not currently have).
This is my problem, my entire family is morb. obese (I am the smallest of my entire family). My oldest brother had gastric byp and did great, my youngest brother is TOO big for surgery of any kind now, my father is a diabatic (along with being obese and many other things) and now my mother just found out she is borderline high cholestrol and diabatic. Ok having said that as you can imagine I know that I am on a slippery slop. I just want to take action now so I dont get to where my family is now.  My question, if I actally try to gain a few pounds so I make the 40 BMI (crazy I know) what happens if I do the mandatory 3 month nutrition program and loose a few pounds (brining me to below that %). Would they then not accept me for the procedure (even if I am still over weights). I have struggled SOO long with my weight (8 years) and I nervous about the future. HElp....Paula

Hi Paula - you certainly do have a bit of struggle with this. I had Aetna and had to do the 3 month diet/exercise regime prior to surgery - even without really trying I lost 33 lbs - granted I weighed much more than you do, so I'm sure that factored in. I was afraid Aetna would come back and tell me if I could do it that way then I didn't need the surgery, but they didn't - they approved me once all of my paperwork was submitted.

Crozer is really up and coming with their Weight Loss Center - I recently attended one of their support group meetings and was very impressed, even tho I had my surgery at Barix (which I love, but can't get to their support group meetings). I would talk to them and to your insurance company - I found a great lady at Aetna when i called who sent me the entire policy and package on WLS.

I'm sure the thoughts of gaining weight just to have the lapband done does seem strange - I'm not sure what I would do - but considering the history of your family I think you're smart for trying to get it under control now before you show up with additional health issues.

Best of luck to you - Kathy

Paula,

I'm glad you like the boards.

You certainly do have legitimate concerns.  Just out of curiosity - are you sure you don't have any comorbid factors?  Think a little outside the box - things like joint pain, depression (not necessarily requiring medications) etc count.  When was the last time you had blood work drawn?  For all you know your cholesterol may already be high and your sugar levels borderline abnormal.  Also - a sleep study test - perhaps you have mild sleep apnea without even knowing it.  My blood pressure was consistently 130-138/86-90 range.  Granted - not hypertension as it is generally defined - but my primary doctor put down "borderline hypertension" as a comorbid factor.

Ok - let's say you don't have any of those things (which is a "good" thing in most ways!!)  I believe if you gain weight for the surgery and then have to do their supervised plan - there's a few things to consider.  One, I don't believe your ending weight has anything to do with it.  I'm not sure.  Secondly - nobody said you have to lose weight on that plan.  Perhaps just be a little "cautious" with how much you lose, etc.  Read between the lines here if you get my point.

Stay in touch- I'm curious as to how this works out for you.  You certainly do have a strong family/genetic history which points towards a very daunting slope.

Pam

HI,
I had to go a 6 month diet and actually ended up gaining after the 6 months. I didn't do it on purpose but was in therapy every other week and for some reason it made me eat more. They called it a therapy burst. I was approved in 1 day. I have Highmark so I am not sure how Aetna works but I'm sure you can ask them.

GOod luck,
Tracy

HI, I was also borderline but was "fortunate " enough to have high bp.  But I was told by my surgeon that once I was weighed in the beginning of the process that was the only weight the insurance company would see!  I agree get creative with comorbidities, gain a few lbs, or just shrink by a bout 1 inch. LOL

Hello all!
It is me again, I just wanted to say "thanks" for all your replies and info that were all helpfull. I am actually going to attend a seminar next Sat and get more info and hopefully be inspiried. I think I only need to gain 4 pounds to be at a 40BMI and I think someone mentioned that was "do it" as they say (cant remember if I needed another co-mor with that).
And I will my dr. do all new blood work as it has been over a year or so since my last one and who knows what changes?
I am sure I will talk to you all soon.
Regards
Paula

Are you attending the seminar at Brinton Lake ? They just started post op support after the info seminars so I may see you there if you stay for that.  I had my surgery( RNY)  at Crozer ( before Dr. Katz) but he did my hernia surgery and I have been following up with him now. Pat is a great lady, she will help if she can.
As far as comorbs...do you have trouble sleeping ? Snoring ? Back problems, arthritis . I think these are also considered. I myself had a BMI of 52 to start so I didn't have to worry about meeting the criteria.
Good Luck and if you have questions I'll help if I can.
Sandy

You can also "shrink" a little as someone suggested.  Or even put some weight on by literally carrying money with you.  I have also read of people who have drank a lo****er, ate chinese food, and wore weights just to get the scale to slip to the 40 BMI or 35 BMI.  "Food" for thought.

Abby