Too small for weight loss surgery?

Hello, noob here. I have been overweight most of my life, from about 3rd grade (34 now) but have always seemed to manage and maintain around 260. At that weight I was mobile and happy. I was very active, worked a fast paced job and loved it. Although no eating plan or exercise resulted in a lower number, I was in a good place for me, and gave up trying SO hard. Fast forward to 3 kids later, and currently 12 weeks pregnant with my 4th, and I'm tipping the scale at 310. I'm 5'8", at the end of my last pregnancy I had been issued a handicap parking pass because the weight was putting so much strain on my nerves my legs would go numb after walking too far. Breathing also suffered. After birth of my second, I joined a fitness center, changed eating habits, was truly faithful to change, 2 years, and nothing. I managed to lose 5 pounds in about a years time, then plateau hit and left me at 300 pounds. I even managed to keep up my workouts through my 5th month of pregnancy before it became too laborsome to breathe. I recently started seeing a new doctor and asked about possibly looking into a weight loss surgery after I've recovered from this pregnancy. I want to be around to watch my kids grow up, and he flat out told me that I wasn't fat enough. Is that true? Or should I get another opinion?

At 5'8" with 300 pounds, your BMI is 45 which puts you in the morbidly obese category. Your doctor is lying to you - he is perhaps anti-WLS. I would recommend finding a new doctor!

Also, call your insurance company and find out what their requirements are for WLS. That will help get you going in the right direction.

Welcome to OH!

Plenty of people on here have had surgery starting at less than you are, I'd say get a second opinion, or eliminate the middle man, if you can. My PCP was reluctant to refer me for WLS, so I first checked with my insurance, and discovered that by their weight standards, I met the requirements for coverage, so I contacted the bariatric team here in my town on my own. They sent me a bunch of information, including monthly evaluation forms, since my insurance requires six monthly evaluations from my doctor. So I made an appointment with my PCP and TOLD her I was having surgery, and could we go over what was required for these evals? There are forms that I take to the doctor's office each month, they weigh me, discuss my nutrition/exercise/behavior goals, and fax the paper to the bariatric team. I don't think she was necessarily against WLS, and is now helping me do what I have to do, but I don't think it's really any PCP's first choice, since many don't specialize in weight loss or seem to know much about bariatric surgeries.

I'm glad your PCP has changed their stance and is now working with you. However, I would caution those reading this that they want to make sure their PCP is on board or be willing to change doctors.

Most postops switch their bariatric care onto their PCP. Not only is it easier, you don't have to worry about comminication issues if a problem arises. A PCP not on board with WLS may not order labs, refuse to order all the labs necessary, not follow the trends of your labs, or not take any bariatric issue seriously. Many against WLS are not up to date on nutritional requirements or basic follow up care. They could even drop you as a patient if they felt manipulated or ignored.

Going around your PCP can make aftercare difficult. My opinion, for what it's worth, is to not take this advice.

I did say to get a second opinion. My doctor wasn't against it, she just didn't seem to want to talk about it as an option for me. I did the legwork to get more information, and now she is in support.

Also, my Bariatric team does its own followups, labs, etc, so I'll have regular appointments with them for years to come

You advised her to "eliminate the middle man," i.e., her PCP.

I'm happy your situation worked out for you. However, it's bad advice to give others, as going against your doctor's wishes can have consequences.

I stand by my post.

I suppose I was fortunate. When I decided to seriously look into having WLS, I called my insurance company first, and asked which bariatric surgeons were in my network. I also asked if I would need a referral from my primary. The answer was no. I was able to initiate things without involving a referring doctor.

There have been some horror stories on here over the years of doctors *****fuse to do the most basic of aftercare, as well as patients who go out of country and don't make sure they have a doctor to manage postop life. To assume all doctors are willing to take on postop WLS care is a mistake.

I see your point, especially for those who have surgery in another country! I am very pleased with my surgeon and his center, and the care I am receiving thus far. In my case, my old PCP had previously suggested WLS to me, however, I was uninsured at the time. When I did become insured (thank you ACA!), my old PCP was not in network. I absolutely appreciate being able to access specialized care without always first going through a primary.