Mandated Pre-Op Weight Loss: ASMBS SAYS NO!

 Thanks for posting this!  I remember reading one of the studies referred to here, which showed that the pre-op process makes no difference in the success of the patient post-op.  I am so glad I did not have to go through that process (my insurance didn't cover the surgery I wanted so I was self-pay).  I like what Kaiser is doing now... only a few weeks "options class" is requied, and although DS is not an option at least the VSG IS (blue shield said it's investigational).

First, you should know that Kaiser NorCal and SoCal have different requirements - but both have a form of mandated classes/weight loss which = delay.

Second, Kaiser has been forced repeatedly to pay for the DS if the patient wants it.  You just have to appeal, appeal again, then go to the DMHC which orders them to pay.  In fact, Kaiser SoCal has a surgeon in their bariatric program who has performed a few DSs, so SoCal patients who appeal for a DS get one from him - Dr. Belzberg in Harbor City.  Something for you to keep in mind.

Personally, I would not have wanted to go with such an inexperienced DS surgeon, but he's done a couple on patients I and Larra have helped with their appeals, and they seem to be doing fine.

By the way, the "few weeks of Options classes" are not that minor a delay, when it often takes months to get into one, and have to attend without a miss or have to start over.  They are just trying to delay and obstruct, in my opinion.

Good to know! I do not have Kaiser but I do go to a support group meeting at a Kaiser in So Cal once a month. I was told the options class went from being months long to merely a few weeks long... no one ever said they had to wait a long time to get into options but I believe it. It seems to me that WLS is becoming more and more "acceptable" of an option to people desperate to lose weight.

The meetings always start with asking who has what (by raise of hands). It's mostly RNY, with a very rapidly growing number of VSGs, honestly seems VSG is becoming the most popular choice for pre-ops. Once in a blue moon there will be a banster but really, they are very rare. Never once saw anyone with a DS there... but good to know... because Pre-Ops go there and if the opportunity ever arises I will tell them about this surgeon you mentioned and that the option is there! I don't get the impression that the option of a DS is common knowledge there. Thanks for writing me back to let me know this! :)

Here in NorCal, it's not the Options classes that are the big delay. It's the mandated 10% weight loss. Then, once you actually lose it, it can take months to get on the schedule and you better not gain any weight during that time.

It makes me so mad and I don't even have Kaiser.

BUT - the CA DMHC is VERY willing to order Kaiser to drop both requirements - IF you know to ask.  You just file a grievance with the DMHC after getting instructed to do the weight loss or classes, citing this document: http://www.dmhc.ca.gov/aboutTheDMHC/org/boards/cap/Bariatric REV.pdf

The DMHC is pretty good about this - they are not supportive of delays in referral to surgery.  Too bad they are too toothless to order Kaiser to stop doing it.

 I was a part of this community, so I did know I could appeal... I soaked up all I could on OH and youtube and the WLS board at lowcarbfriends.  Sure there was misinformation out there, but any information at all set me down the path toward finding out real reliable information.  I am so grateful for the WLS community as a whole.  

I knew I could appeal for a VSG, but I chose not to waste any more precious time struggling and get on with it.  I took out some from savings, a bit from 401K and the rest was debt in order to self-pay.  I think it was worth it.  Not everyone would or could do that but bottom line, I totally get that it's cruel to delay surgery for the weight loss requirement, it would have been pretty devistating for me.

Thanks again for posting, I hope this helps some pre-ops and allows we post-ops that read this to retain this information for future discussions with pre-ops :)

 Ouch!  with the metabolic issues I had, I was totally stuck without being able to get under 275 for a year before surgery.  I did lose from 355 down to 275 but I did not see a doctor before I got stuck.  I for sure would have gained on their options class guidelines (burritos?! lol) and I didn't lose on 1,000 calories low carb... I was on metformin with very high insulin and cortisol levels out of whack.  I was worried that even surgery would not work (I was on about 500 cals for a while and extended the phases)

I for sure would have felt screwed if I had to lose 10% before surgery.

I was supposed to be on that horrible Optifast for 2 weeks.  I lasted about a day.  That stuff is loaded with sugar and I was starving!!  I called my Drs office and the nutritionist said I could do low carb, which I did.  It was very healthy.  Mainly steamed fish, chicken and veggies.  But I cheated some too.  I am not very disciplined and even more so when I am being forced into something.

I lost 10 lbs, which was a good thing.  I ate normal healthy food though.  I can see how keeping someone on a liquid diet for 2 or more weeks before surgery is counterproductive to a good surgery and recovery.

I really hope ins cos. will drop that 6 mo. nonsense.  If someone is to a weight where they qualify for WLS it is obvious that they can't do it on their own no matter how many attempts they have made.

Are you seriously saying that the reason you FAILED at your first surgery is because you didn't have to do a 2 week liquid diet before surgery??  Are you freaking KIDDING me?  Or trying to justify the torture you are currently undergoing?

If you want to suffer, be my guest.  However, it should NOT be mandated or forced on anyone, since THERE IS NO MEDICAL EVIDENCE THAT THIS TORTURE DOES THE PATIENT ANY GOOD WHATSOEVER!

I don't hate you for this post - I feel sorry for you, for the self-loathing that apparently drives your belief that you need and deserve to be tortured.