Newbie 6 month diet question

Shellbell82
on 4/27/16 10:18 pm

Hello. This is the second time I have been on this journey. I contemplated WLS a few years ago and didn't do it. My kids are getting older and I'm missing so much that I am doing it now for sure. My surgeon's office sent me to do the weight loss trail before my 1st appointment. I am required to do the trial for 6 months. I went today and he said over the 6 months I should get down to 200 pounds. I am 5 ft 1 and 236 pounds currently so my BMI is 44. Won't this mess up my insurance if I get down to 200 and my bmi gets under 40? While I would LOVE to be able to drop 30 pounds just like that, after I hit about 200, it's not quite so easy to lose. If I get to 200 and 40 bmi I will be thinner than I am now but I won't be able to lose any more than that. 2 years of dieting has proven to me I get to 200 and stall. So, will this trial disqualify me from surgery and I just have to be happy at 200? If I don't lose weight though I mess up the trial. I just don't know what I need to do. 

Amy R.
on 4/27/16 10:39 pm

I would start by reading my health insurance policy and then if needed calling my insurance.  Unless you are paying cash, they are the ones who set those seemingly arbitrary weight/BMI numbers.  They can tell you exactly what their own requirements are.  Some insurances even have different weight "requirements" for those with comorbidities and those without any.

All we can give you is are own experience which is likely completely unrelated.  Even those with the same insurance have different policies written.  Some cover WLS, some don't at all, some you can petition for exceptions.  Some have weight/BMI requirements.  Cash patients may have requirements driven by their surgeon's parameters; although paying cash can give you (and your surgeon) a little more wiggle room.

Honestly?  As kind and helpful as most people are here on OH, I would never, ever take the opinion of an internet forum on an issue like this.  You must be your own advocate during this very personal journey and your question here is a great place to start.

Good luck and congratulations on making a beginning!  =)

H.A.L.A B.
on 4/28/16 4:36 am

I would not risk going under 40 BMI if I plan to have insurance approve me for surgery. I would get close...

Before WLS I lost weight every time really really work on it...except I always gained it back and then some. 

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

Kathyjs
on 4/28/16 6:18 am

I so understand. I got just below 40 on my 6 month diet and was worried sick but it turns out they went by my original weight. Good luck.

Sparklekitty, Science-Loving Derby Hag
on 4/28/16 6:35 am
RNY on 08/05/19

 Every insurance plan is different. Call the customer service number on the back of your card and ask about the requirements.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

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