Newbie & Weighing Options

Hi Everyone,

My name is Nadia and I'm new here to this forum.  I've been struggling the past year with gaining back 30 of the 40 lbs I've lost.  I used to work out consistently, I drank wheat grass and did green smoothies all the time (less fruits over time), monitored my portion control, and tried to get my hormones in check.  To  no avail, I don't know why I keep gaining weight.  It could be I lost my dad and got married all in several months time from each other and I was stressed, I have no clue.  In November I went to a weight loss clinic and got phentermine and b12 shots, then I stopped taking them (was put on antibotics for a root canal) and I've gained 7 of the 11lbs I did lose in 3 weeks.

I'm interested in getting WLS but I wanted to give this phentermine & work outs one more try.  The thing is though, if I'm considering WLS don't I have to document my prior efforts?  My doctor (which I rarely get sick so I don't have a fantastic repore - nor do they prescribe phen) would send me to their non-medicated weightloss program before even considering a referall to a WLS.  What should I do??  I'd like to go a to a doctor that understands what I'm going through verses someone that can only help me with part of the issue (nutrition).  I'm in Chicago, 5'5" and 234lb.  Looking for any insight that you can offer.

Regards!

Welcome!

The first thing you should do is contact your insurance and ask them if the surgery is covered under your policy and what the requirements are. They will tell you if you have to have a supervised diet. If you do, then you can start now. I didn't need my primary Dr.'s referral. I found a Surgeon and scheduled a consult.  

Just want to add that I didn't need a referral, either.

I'm sorry you are struggling.  First thing first, here.  Call your insurance.  See if they even cover WLS.  If they do, ask the requirements.

Some insurance companies require the diet study for six months, a sleep study, psyche evaluation, etc.  Some don't.  Here's what mine required:

BMI of 40+ or BMI of 35-39 with co-morbidities (i.e. diabetes, HTN, etc.), psyche evaluation  THAT WAS IT!!!

So, I did my research on surgeons in a 180 mile radius of my home.  Found one I was comfortable, scheduled an appointment.  

Surgeon required first consult, an endoscopy, psyche evaluation, informational class, second consult.  It moved pretty quickly.  

Consult 9/7

Psyche eval 9/17

Endoscopy 9/21

Class 9/23

Second Consult 10/5

That was it...all info went to insurance, was approved with first request around 10/19

They wanted to schedule surgery on 10/31, but I postponed due to my schedule, sons' birthdays, etc.  Finally had RNY on 11/28.  Best decision I've ever made regarding my health.

Best of luck to you!

You have mail  

Regards,

Kathy

ObesityHelp

Here's the contrarian view.  Just go to a few public seminars of WLS drs in your area. You may decide that it is/is not for you.  Forget about starting with your insurance company and putting too much faith in what you are told over the phone. (Read you policy, OK, but go to a public meeting before you make a final decision based on what the insurance co told you).  Many of the people at the insurance co do not know the requirements as well as the insurance expert in the surgeons' offices.  

At the end of the meeting, their staff will be there and tell you if they work with your insurance and what the requirements are.  You need education and this is the way to get it from the surgeons themselves.  The seminars are free.  Invest in your education. 

Many WLS also supervise non-surgical weight loss programs.  Although most surgeons are familiar with the stats - that only 3-5% of people take off and keep off more than 50 pounds without surgery and the  75% of people who have WLS take AND KEEP off more that 50 pounds, 5 years out. 

Have you had a heart-to-hear talk with yourself - is there reason to believe that you are one of the lucky 3-5% who will take and keep it off without surgery. 

Since phen only works when you take it, why do you think that you will keep the weight off when you stop taking it?  I'm not sure why you think that longterm phen is safer than surgery. 

Good luck with your WL journey.  Take time to really understand the options.