Even though I'm 20 months out,  I think I might have a possible answer for you.  While I was doing my 6 month waiting period,  I did Weigh****chers for losing weight, support, and learning to how to handle eating right before and for when I could go to regular food (I had an  RNY) afterwards.  I also wanted to get the additional support that I was getting from other people on how to handle nutrition, people, social, emotional, and psychological areas that we all deal must deal with.  I also started walking.  The only thing that I didn't do was tell them that I was going to have bariatric surgery.  That's a big no-no with them.  At one point, I did go back to them to get the rest of my weight off.  When that happens, I will be eligible for free maintenance to keep me honest and accountable.  I don't know if this helps but it's worth a shot.  I was able to lose 40 lbs before surgery when the surgeon required only 10.

I read that you need to lose 40 pounds b4 surgery. That is a walk in the park. I lost 148 pounds in 8 months to get cleared for surgery. I am not looking for a pat on the back...just want to let you know that YOU CAN DO THIS. You just need to take charge and go for it !!!!!!

I need to lose atleast 80 lbs to discuss possible surgery.Your weight loss is very interesting,would love to know if you put in a workout routine and or a diet plan.

WHY do you need to lose weight first??  What POSSIBLE need can there be??

You too should check out the DS.  Dr. Rabkin in SF has done a lap DS on an 800 lb man.  You are African Amercian and older (based on your picture) and apparently VERY heavy (or you wouldn't "need" to lose 80 lbs pre-op) - the RNY is likely to fail you and restrictive only procedures are going to be utterly inadequate.

If your insurance company is making you lose weight pre-op, read my advice to the OP - you can get that overturned by the CA DMHC.  If it is your surgeon - you need another surgeon, one with compassion, skills and the ability to perform a proper bariatric surgery on you.

You don't have to lose an ounce.  You live in CA, and the CA DMHC will ORDER Kaiser to waive the pre-op weight loss requirement, which has NO basis in evidence based medicine.

What you need to do is to tell Kaiser you don't WANT to do the pre-op weight loss, and if they will not let you progress in the bariatric program without it, you want it in writing.  They know this - they are just ********  The DMHC has done a study and has a position paper:
http://www.dmhc.ca.gov/aboutTheDMHC/org/boards/cap/Bariatric REV.pdf

"Mandated weight loss prior to indicated bariatric surgery is without evidence-based support. Mandated weight loss prior to indicated bariatric surgery leaves the patient at increased risk from the patient’s comorbidities. Mandated weight loss prior to indicated bariatric surgery is not medically necessary. Mandated weight loss prior to indicated bariatric surgery would be deviant from the standard of care practiced in the United States and other published countries. The risks of delaying bariatric surgery, while not entirely known in the short-term, are real and can be measured. Any potential value of losing weight prior to bariatric surgery is theoretical and not supported by any data."

What you need to do is to contact the DMHC after Kaiser refuses your direct request to waive the requirement (www.dmhc.ca.gov) and file a grievance against them - you can even do it by phone.  EVERY TIME the DMHC will order Kaiser to waive the requirement.

You should be looking into the DS as a surgical option by the way.  Kaiser says they don't cover it - but the DMHC will FORCE them to cover it.  You just have to appeal.  You are VERY fortunate to be in CA, which has a very strong, pro-patient Department of Insurance.

SAMPLE MEAL PLAN ....would like to compare food plans given to those trying to lose weight Mark as Unread | Print  

diet plan

 

Each meal should include: Breakfast: 3 proteins, 1 fruit, 1 dairy, 1 carbohydrate, 1 fat Lunch:3 proteins, 2 vegetables, 1 fruit,1 carbohydrate, 1 fat Dinner: 3 proteins, 2 vegetables,1 dairy, 1 carbohydrate, 1 fat Beverages You are strongly encouraged to drink water as your primary beverage. All beverages should have less than 20 calories per 8-ounce serving. They should also be caffeine-free and non-carbonated.     SAMPLE MEALS BREAKFAST-3/4 cup egg substitute (3 proteins),3/4 cup fresh blackberries (1 fruit),1/2 cup grits (1 carbohydrate),1 tablespoon reduced fat margarine (1 fat).   LUNCH-3 ounces skinless chicken (3 proteins),1 cup green beans (2 veg),1 small apple (1 fruit),1 small potato (1 carbohydrate),1 tablespoon reduced fat margarine (1 fat).

Hi-you've come to a great place here on OH,wish you the best in your journey, positive thoughts,keep your mind on your journey,you will do good, believe in yourself!!

Hi Bigcoop,
Welcome to OH. I'm pre-op also and I have chosen RNY. The type of surgery is a personal choice that will work for you. There is some great advice from other posters on this thread that will help you alot.

I am not on a pre-op weight loss program at this time, but will need to eat clean the week or two before my surgery. This is to help reduce my liver size and make it easier for the surgeon to access my stomach during surgery. Whether or not it works, I'm willing to do it. In anticipation of my wls, I am getting my heart, mind, and body ready for the changes in eating habits. I am consciously making better food choices. I know I would fail miserably if I just kept eating the junk up til the day I have surgery, then expect to go cold turkey.

While the surgeons will be operating on our bodies and providing us with the tools we need to help us lose the weight, we have to operate on our psychological behaviors to modify our way of thinking. This is a permanent change of lifestyle and one we must be ready to embrace.

Everything I am reading says Protein, Water, Walk. The 3 best things we can do to start getting ourselves ready. As we lose the weight, our energy will increase, our desire to do more strenuous activities will help us lose more weight. It's a glorious circle!

You can add me as a friend. I'll be happy to send you encouragement and even tough love...if you need it : )

Kristi

Dear friend Ted,

 Let me say this, Although I understand what Denise is saying, Dr fisher knows what he's doing. Like I told you before Im a Surgical Tech and have done many many Rny's.. Never a sleeve or band. But when youre a heavier individual its very very difficult to perform surgery on us.. No matter what kind of surgery, its EXTREMELY difficult. I believe what Kaiser is doing is for the benefit of everyone involved. Ive been apart of many surgerys where the DRs are standing on stools, having issues seeing the anatomy due to the fatty liver and visceral organs, we dont want mistakes during surgery, especially when youre already high risk.. When you have a top notch Dr who introduced Bariatrics to N Cali, trust in him. Youre Blessed to have the Best of the Best (at Kaiser) he's NEVER lost a PT or had any major complications from any surgery he has ever performed. He is cut n dry, but please trust that its for YOUR benefit, not his. He is compassionate, He does laugh on occasion but he takes weight loss very seriously. He also wants to see how bad you want it. When you lose that first 40 email him, If you hit a slump email your diet plan and he will respond within a day,and tell you what to do next. Remember, you want the best care possible, and he will give it with very few recovery issues, from my understanding (other pt's) . Also, I wouldnt force a DR to give you a surgery thats not specialized at that paticular facility, theres a reason for it not being offered. Just ask him and he will be very blunt with you. Good luck my Friend. 

I agree with Denise when she says a restrictive surgery is def not for you. Id go with bypass, did Fisher give you that option or was it your personal decision? You have plenty of time to think about it Ted, Just weigh all options , ask all questions and if you feel you need to bypass the weight loss use the helpful links Denise put up. :) I can assure you though, theyre not doing it to be "********".lol

Fisher is an arrogant piece of work.  He continues to put roadblocks in the path of Kaiser patients getting fully informed consent regarding the DS procedure.

But, most importantly, when NorCal Kaiser patients fight him - and essentially ALWAYS win - to get the DS, Fisher doesn't do them - the patients are sent to Dr. Rabkin in SF, who is one of if not THE TOP DS surgeons in the world.  Paid for 100% by Kaiser.  An utterly fantastic outcome.

Interestingly, since Larra and I have been helping people prepare their appeals against Kaiser for the DS, and our nearly 100% winning record against them, NorCal Kaiser has recently been starting to send some patients directly to Rabkin after only one or two denials, without forcing them to go to the DMHC.  Of course, that could be explained by an intent to foist off their fattest, oldest and sickest patients on Rabkin (who is HAPPY to take them!), and thereby reduce the Kaiser failure rates.

We stay in touch with the patients who have had Kaiser and who have won their appeals and received the DS from Rabkin.  They are ALL doing well.  But Fisher steadfastly maintains his warped view that the DS is a bad surgery - I'm guessing because he doesn't have the skills to perform it, and because he is the sort who, once he has taken a position, will not back down in the face of monumental amounts of evidence to the contrary.