Has anyone else run into this problem?

Hey everyone!

I have a question. Another long one, please bear with! I was going to go through with the surgery last year, but I didn't because 1. I chickened out and 2. my doc formed a weight loss group that I was apart of and actually had a little success. Until I gained all of the weight back. Story of my life. But even still, my doc signed the forms needed to be sent to the surgeon giving her approval. This was approx this time last year. However, I went to see her today and told her that I was serious about the surgery this time and that I have an appt with my surgeon. Now suddenly, she wants to supervise my diet for another six months (my diet has not changed and she didn't supervise the last time she signed the papers!!!). She says that she won't sign the papers until I spend six months going back to the weight loss meetings are her newly opened "wellness center". She also says that she has seen too many patients fail after WLS and that one even died on the the table. I understand that some insurance companies want that 6 months, but that didn't stop her from signing them last year! She knows that I've tried everything (diets, therapy, OA, hypnosis, nutritionist, weight loss meetings, etc.) and how miserable that I am. My mom is her office manager and has also told her all of this!! She even mentioned that some people have switched doctors because of the six month wait. I wonder of she was sending me a subtle hint. I can't believe that she is flipping the script on me. I can't stand that thought of waiting another 6+ months in this misery! My primary before her practically begged me to get WLS! 

My question is: has this every happened to anyone? What did you do? Has anyone ever been approved without your primary being on board? A friend of mine is a nurse at the WLS clinic that I go to and I plan to ask her for advice. I'm just kinda freakin out right now. Thanks for listening. 

I did not have to get any kind of letter from my primary. I just went to a seminar and made my own appointment with the surgeon. The surgeon may want you to do their supervised weight loss program not your primary's. If you know what surgeon you are thinking of using, I would go to one of the seminars and see what they have to say. I don't see how the PCP can force you into her program. that doesn't seem ethical. I would call my insurance company too and see what they say.

Your primary does not believe you are ready for surgery.  You have the option to switch doctors if your present doctor is not comfortable with the surgery.  You will want a primary that is on board, so either do her program or look for another doctor.

I think the 6 month thing is kinda standard. sucks but it is what it is/

I could not even make an appointment with my surgeon until after 6 months of going to the weight loss doctor.

My insurance nor surgeon required an OK from my PCP. I would definitely go to a seminar of the surgeon you select to find if this is the case for them. I would also get the requirements from the insurance company. 

*Edited for spelling

Before you go any further, call your insurance company and ask them exactly what they require. 

If you have complete documentation of your participation in the program (and I bet your mom can get it for you if you didn't keep all receipts), you may have already completed any documented medically supervised dieting attempts they require.

Yes, I agree with Valerie!  You are ultimately in charge of your health, not your pcp. You've tried, like many of us, and not had long term success. You know when the time is right, and in my opinion, timing is of utmost importance. Weight loss clinics are big money makers, of course your doc wants some of that pie. I do not believe she has your best interest at heart, but rather that of her wallet. If it were me, I'd find a new doc and go to that seminar the others here are talking about. 

I agree get a outline from your insurance holder.  I used it as a checklist to make sure I had met every requirement.  Order copies of your medical records.....they usually send it out on a disk to you now days.  This should show all of your PCP notes and that you have been on a supervised diet and anyother health problems contributing to your weight.  Mine wanted 5 years record showing I had struggled with my weight.  All my records from the doctor's office showed I was morbid obese.