Pre surgery diet disqualifying surgery?

SharonLL
on 4/12/17 1:42 pm

My BMI is 40 with no health issues. I'm concerned with the liquid pre-diet. If I drop below BMI 40 and have no health issues will I be disqualified from WLS?

Vegbeth
on 4/12/17 1:46 pm - Boston , MA
VSG on 12/28/16

I would ask your surgeon or their team about this but I would think not. I was told it really is a matter of your weight going into that first consult. That is the weight they use to determine your insurance eligibility. Personally it took about 9 months from my first consult till surgery. In that time I lost a significant amount of weight, dropping my bmi to the low 30's and it was not a problem. My insurance covered it all and I feel like I went into surgery with a huge advantage. I'm hoping to be at goal weight by my 6 month follow up.

SharonLL
on 4/12/17 1:49 pm

Thank you

Gwen M.
on 4/12/17 1:51 pm
VSG on 03/13/14

This is definitely a question for your insurance company.

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

Erin T.
on 4/12/17 1:56 pm
VSG on 01/17/17

In my case I needed to stay at a 35 BMI or higher and yes, if any of my weigh in's prior to Pre-Op liquid diet fell below that I would be disqualified. My Bari Center didn't put me on a Pre-Op diet before the 9 day liquid. I actually gained 7lbs (hello, maintaining is hard!). Then I lost quite a bit during the liquid. On surgery day I had a 35.1 BMI.

VSG: 1/17/17

5'7" HW: 283 SW: 229 CW: 135-140 GW: 145

Pre-op: 53 M1: 22 M2: 12 M3: 12 M4: 8 M5: 10 M6: 11 M7: 5 M8: 6 M9-M13: 15-ish

LBL/BL w/ Fat Transfer 1/29/18

Sparklekitty, Science-Loving Derby Hag
on 4/12/17 3:53 pm
RNY on 08/05/19

Every insurance plan is different in their requirements. Call the phone number on the back of your insurance card and ask.

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

Liz WantsHealthForAll
on 4/13/17 3:03 am - Cape Cod, MA
VSG on 03/28/16

I was the same as VegBeth, and dropped to the low 30's in BMI prior to surgery. My insurance required 6 months of supervised WL visits prior to surgery. They said they wouldn't penalize me for losing and would use my starting weight. However my surgeons office didn't officially take my weight at surgery (when I had dropped so low), but used the last taken prior weight just to make sure there were no insurance snafus (they did unofficially weigh me on surgery day for anesthesia purposes).

Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-125 CW: 121

(deactivated member)
on 4/16/17 8:49 pm

My surgeon said that the starting weight when I first went in is the weight for qualification. Check with your surgeon, I'll bet it is the same.

(deactivated member)
on 4/22/17 4:03 pm - Eugene , OR
VSG on 04/17/17

Funny that this just happened to me. I'm 5 days post op. I had my pre-op on the 13th of April and Surgery on the 17th. I was supposed to begin my pre-op liquid diet 7 days prior to surgery. I go to pre-op and I did this with a couple other ladies that had surgery dates on the 24th as well. The teacher said "There is one person in the class that doesn't need to do the pre-op diet". The ladies in my class were older than me. I assumed it was the gal with many medical problems and diabetes. I looked down at my paper... mine was scribbled out. I raised my hand and said wait.. are we sure this is mine with my chart label on it. She said yes! I was first off I've been on the pre-op diet since like almost 5 days ago, and why wasn't I told this. She said you didn't get told. I said NO! She says stop the pre-op and continue as normal. If your BMI gets to low your insurance can deny you if we submit anything. I was baffled and confused. I said okay nice to know know because my body is freaking out! She apologized and the other ladies weren't happy about that. Let's just say when class was done... I headed straight for a burger and fries! I had a migraine for 3 days straight and was pissed off. Let's say my migraine went away about 30 minutes after getting food into my system! I lost just 3 lbs in those few days anyways... I'm sure I gained some back after I was told I didn't have to pre-op diet. ??

So yes, even though I was already approved by insurance I guess you can still be denied.

NCMTNEER13
on 4/5/18 10:53 am
VSG on 11/26/18

With a starting BMI of 43.5 my surgeon and I weren't concerned about qualifying for insurance coverage. But I'm only 2 months (out of 6) into my required weight loss program and have already lost 19 lbs., which puts my BMI at 40.8. I can qualify at a BMI of 40 without any comorbidities. I'm scared if I keep losing I will fall to the 35-40 BMI range and will require 2 comorbidities. I'm very likely to be diagnosed with sleep apnea soon (doing the sleep study soon, but I'm very confident that I already have it), but I'm not sure if I'll qualify for a 2nd comorbidity, especially if I keep losing weight.

The idea of giving up on my diet/exercise so I can qualify for WLS seems absolutely counterintuitive and frankly insane. For the last 2 months I have taken the approach that I should eat and exercise for the 6 months, the way I'll need to eat/exercise after surgery. I have been so happy with my weight loss, but when I realized my BMI as already at 40.8, I am beginning to panic.

Any advice from anyone that has had this happen to them? What should I do?

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