beginning the process

Hi, I've had my consult and have chosen RNY.  Now I'm at the beginning of the insurance approval process (Aetna) which requires the 3 month surgical prep, doctor supervised weight loss program with a dietician.  Any advice on how to navigate this part of the process would be appreciated.

I have Aetna and originally had the roux-en-y planned and pre approved but things changed while undergoing surgery (I knew ahead of time via my surgeon).  Follow through with every appointment and requirement.  Document when you complete each requirement and/or make sure that the N.P., Program Director or whoever you report to knows that each is completed and documents as well. I was given a check list. In my program, they relayed the completion dates to the insurance coordinator. Mine went super smooth, no hiccups.  After I completed all of the steps I was told not to call to see if I had received insurance approval. 2 weeks later I received a call from the surgical scheduler and had my surgery date. When I went into surgery, the surgeon's staff contacted Aetna while I was on the table to verify they would cover the sleeve instead of the roux-en-y. 

Don't gain any weight during the weight loss program. I am sure your program has told you that too because Aetna won't cover or the process will be delayed. 

A lot can vary with programs, etc.  This is how mine went.  Hope all goes well with yours.

Take advantage of this pre-surgery time to gain clarity on why you are having WLS.

This is the time to ask yourself - how significant is my weight problem? - I don't know for you, you could be at 175 and unhappy or you could be a 400 pounds with many health issues.

So, you ask yourself - how hard are you willing to work at this?  You have one best chance with WLS, so if you are not ready to make permanent changes, I might suggest waiting until you are.  Even after surgery, expect to measure your portions, track your calories, avoid snacking and too much drinking, give up smoking, and working through the emotional issues that cause you to make unwise choices. 

Then, ask yourself what you will gain - for me I avoided knee surgery because I've lost 145 pounds and distanced myself from diabetes because my A1C is back down. 

About GERD - I discovered I had a hiatal hernia which was repaired during my RNY surgery - IT HAS BEEN HEAVEN without the constant heartburn. Again, that is a risk that might tip in the other direction for you.

Me personally, I ask WHAT THE F&^% was I waiting for?  I am at 25 months post-op,I have been maintaining for about 1 year, but I worked to get down to and stay at a 'normal' BMI, and a size 6-8 from a 22/24.  I in 10,000 steps most days and will be back with my trainer soon- that is very different from my pre-WLS behaviors.  The WLS gave me enough help, that I could do the rest of the work, but WLS does not do it all.  I could not still be a cream-pie guzzling couch potato and keep the weight off.  

Best wishes for your weight loss journey.

If you are working with an experienced weight loss center, they will know what to do to meet insurance requirements so follow their lead in addition to what Soho has suggested.  Whether you can lose some weight during pre-op may depend on your starting weight - again your weight loss center will know what is appropriate.