too skinny?

what do you consider the insured self pay patients?

Who is an insured (for WLS) patient who is also a self-pay?  Seriously?

Who pays out of pocket for something their insurance would cover?  WLS is to treat obesity and it;s related diseases and complications.  On what Planet is it considered cosmetic?  It is about the opposite of cosmetic when you see what a formerly obese person looks like naked after losing a large amount of weight!  

I have seen what they look like and its better than what they started with. Please note in my personal situation its not cosmetic but others ive seen paid for a "tool" to help them lose stubborn weight. Im my opinion its cosmetic because there is no medical necssecity 50lbs overweight isnt a medical necessity.

oh so your a doctor now? It is ignorant and presumptuous of you to say 50# over is not a medical necessity. You have no idea what that 50# might be doing to someone's health.

No i am not a dr but a registered nurse BSN. Not bragging just stating facts. I would assume being 50lbs over weight would be about a 35BMI - 37Bmi my insurance wouldnt deem it medical needy however self pay one  would

When I say i need to lose 80lbs People doubt my rationale when I talk about a fellow IG follower who did it with max of 50lbs to lose im playing DR

I can never win here

I am also a retired nurse and BMI also depends on ones height. 

Most insurance polices specify a BMI of 35 if the patient has two or more co-morbidities, or a BMI of 40---which you say you have---with no co-morbs. As for "50 pounds over" being a BMI of 35-37--- BMI is a relationship of weight to height. I know folks who've been covered by insurance who only needed to lose 50-60 pounds.

As for losing too much---about 1% of all WLs do indeed lose too much. ONE PER CENT. A much greater per centage fail to lose enough.

Thank you I find comfort in that 1% stastic . I guess my next question would be who are those 1% are they starting with a low BMI? Why cant they gain? are they trying to gain?

I understand bmi and the concept but the individuals appear to be average height.

According to my surgeon, there doesn't seem to be a correlation between starting BMI and excessive weight loss. No one knows exactly why these people wind up losing too much weight, and it most likely varies from person to person. Yes, most are trying to regain, but a few do suffer from psychological problems like body dysmorphia---they think they're still too fat. Or they're anorexic, or---I suppose there could be several things. Those trying to regain do things like up their carbs, take pancreatic enzymes, or, if they have a malabsorptive surgery, eventually have their surgery modified or reversed. The majority don't require the extreme of reversal.

And I'll be honest. A very, VERY few die. This is serious surgery, even the Sleeve.

My daughter was a self pay, insured, patient and she had to jump through all the hoops to her her surgery.  Her insurance just doesn't pay for WLS.