Weight loss before surgery

Hi everyone, I'm new. I've been reading forums and websites and watching videos and talking to insurance, etc., but I haven't started the process yet. I'm still researching, and waiting for my husband to get used to the idea :)

A couple questions about pre-op weight loss... first, why do they make you do it? Do most surgeons make everyone do it?

Second, have you ever heard of there being a problem with insurance coverage if someone dropped below the required BMI limit after pre-authorization but before surgery? My BMI is currently 41 and my insurance requires 40 or above if you don't have certain uncontrolled conditions (which I don't).

Thanks!

Celesteeel

Hi Celesteel,

     Obviously I don't know how every surgeon/insurance works but I had a similar situation, I actually gained weight to qualify, so my surgeon did not have me lose weight, in fact she asked me to not lose any weight until I was approved for the surgery but my insurance did not require the 6 month pre-op diet. I would find out from your insurance if they do require the pre-op diet.  

Best of luck!

Thanks, Beachy. I forgot to mention that my insurance does not require a pre-op diet. I've gone over their medical policy for Bariatric surgery and it's quite liberal. It looks like it went through some major revisions a couple years ago that should make it a lot less onerous to get approved. 

Okay so if your insurance doesn't require it, then it will be whatever your surgeon asks you to do.  Your office should be savvy on how to get your insurance approval for the surgery. Definitely ask them these same questions! 

A lot of insurance programs and surgeons require pre-surgery weight loss for different reasons. My surgeon wanted some weight loss because often the first area to lose fat is around the viscera, which makes their job easier. Also, losing fat in the liver reduces risk of injury during the surgery. 

Insurance companies can require a pre-surgery diet program or a past documented weight loss attempt. They are going to spend a lot of money and they want to make sure it's not going to be a waste. I had to do a 6 month diet and it was no big deal. Just another hoop to jump through!

As for the BMI question, I know most insurances will cover a BMI of 35 with co-morbidities such as diabetes and sleep apnea. I didn't think I had sleep apnea, but my surgeon sends everyone for a sleep test and I did indeed have it. You might too and not know it, so it's probably worth checking out if it will increase your chances of insurance coverage. 

Jen

Hi - Each insurance is different- mine required 6 month dr/dietitian supervised weight loss. Luckily the insurance said I could use the dietitian at the surgeons office so worked out great since I was already seeing him once a month. I'm in month 4 of the 6 and they can file the insurance after my Nov visit. My insurance goes based on starting weight before the start of the 6 month weight loss, so I don't need to worry about losing too much to disqualify in these 6 months. But each insurance have their own rules. I've lost about 22 pounds since June. the dr has been happy about it but more concerned that I know what and what not to eat and that I'm on the right track for this.

Cool, thanks, folks. Very helpful!