Saxenda Injections After Gastric Bypass?

Hi there. i am trying my best. sleeved 4/4/17 lost about 40 lbs and then plateaued the last 6 months. I eat protein 3 meals a day and drink as much water as I can. infind that i can eat more than usual but stop when i am full. i cant eat a full meal but protein first veggies after if i can fit it. i find that i gain weight after i eat.

dr rec saxenda. what kind of diet do you do or follow? i also do hiit classes 4-5 times a week

I believe Nik had her surgery in 2009 and you had yours in 2016. That?s a huge difference. 10 years ago they didn?t have the supports and knowledge they have had in place the past few years. After about 2 years cravings come back and stronger and it is very challenging to stay on track. There is a 50% success rate with the sleeve. Now they recommend vitamins, there are pre and post op dieticians and counsellors on staff at hospitals and many other resources.
I am 4 years post op and see my dietician every 6 months, weigh myself every 2-3 weeks, take daily vitamins as recommended, eat a clean diet and still have cravings and it?s a daily fight. If there is a drug that can help then why not? As medical advances are made there will be new found solutions to obesity. I have PCOS which compounds my cravings and through great difficulty and unbelievable personal challenges I have only gained 15 lbs in 4 years. It?s important to have compassion and patience with others that are struggling especially those that had surgeries years ago. All the best to you.

That was 2 years ago...pretty much a moot point by now, dontcha think?

I would just hop back on the horse. your tool still works!

weigh and track everything, maybe use my fitness pal?

NIK - Did Medicaid PAY for your WLS? I'm curious as to if that is the reason, for the declination, for the injection. They didn't give you a reason, at all? I know you said you asked, but how can you know WHAT to appeal without a REASON? Insurance just boggles my brain (can you tell I'm a retired nurse, who puts the PATIENTS first????????)...

I am not familiar, with Saxenda, but would be very interested, with how your appeal turns out. I have a close friend, who has spoken, of the medication, and I'd like to share the info, with her. She had WLS, even before me. She is not particularly interested in "working her tool", which is HER choice, of course, and has always struggled. If this will help her, I'm 100%, in her corner.

I had different health insurance when I had surgery. They won't pay for it because I had Gastric Bypass. I've called and called asking for just a simple explanation as to why. Why are you denying a prescription because I had Gastric Bypass?!???!?!

NO ANSWER! No one knows why that is the issue.

I thought maybe if MCD had paid for it, it would fall under what some insurances call their "one bariatric treatment per customer rule" - like when they won't pay for revisions.

If they deny your appeal, surely they will send something in WRITING. I'm such a dreamer :)

Please keep us updated

If there is NO way you can get these injections, and need some "advice", with getting back on track, I urge you to come back here. Many of us have history with regain - substantial amounts - MYSELF, included, and have been successful in beating that demon - with daily work, of course.

I am taking Saxenda until the DS date, and I have just researched it for work. Part of the rejection is cost. The medication is about $1500/month, and so Medicaid is unlikely to approve it as medically necessary. Having a bypass, you basically already have permanent Saxenda, though, so to speak. From a medical perspective, an RNY is more powerful than the Saxenda, actually, so in theory someone with a bypass would not biologically need it. Insurance companies don't have to live with obesity though. At any rate, let me explain.

Part of why I am taking Saxenda, is because my weight loss plateaued. Even when I am medically monitored, I will stop losing weight unless I eat like 500 calories or less, which makes it hard to get my protein in unless all I have are protein drinks. Saxenda basically makes it so I can eat like a normal keto WLS patient instead of permanently on a liquid diet. However, I was also 750ish pounds at my highest weight, so a stall after over 450 pounds of loss is not surprising, either. My body is tired from the past few years.

Saxenda basically sort of mimics a bypass, as it is a GLP-1 inhibitor. GLP-1 is one of the incretins that can assist with weight loss. Having a bypass, you already had these receptors reset. For whatever reason, perhaps they became unreset, so the Saxenda should help with it (in theory).

However, it does not always help with weight loss. In my case, because I had the VSG and not the rest of the DS, I never gained the metabolic benefits the DS (and the RNY) both confer. The real reason those surgeries pack a weight los*****h is that they basically reset the enteroendocrine cells of the gut, and therefore, a good chunk of metabolism. Sadly, I've even seen some of my patients regain on Saxenda. It really depends what the cause of the regain is, and sometimes it can be a serious medical issue. And, some of us just need a DS, too. They might be more likely to approve a revision, though DS after-care is expensive monthly (the supplements).

The real question is what is causing the regain, though, and I would demand an answer from the doctor. You deserve an answer from him, not just him trying a prescription that might not get approved.

It is very frustrating, I am sure. I hope they are able to approve it for you.

DONNA - thank you, VERY much, for the fabulous tutorial - SINCERELY!!! You always bring things down, to MY grade level :)

So, the OP should push for answers as to WHY the regain? Like, be sure there is no MECHANICAL failure? Have an EGD? I ask, also, because the friend I mentioned (in my post to OP) is a 15 year post RNY, with significant regain, who has never had "her guts checked out". She just swears she has ALWAYS been able to eat more than me, and says her pouch is bigger than mine. I have learned not to argue.

While I appreciate the compliment, after working with nurses, I already am aware you know more than I will ever forget! I have so much respect for nurses in medicine.

Anyway, I think it's always better to figure out why. If we don't know why, all treatments are a band-aid at best. Even surgery will not help unless we figure out why. Doctors should also be able to justify their treatments. It cannot hurt to see why... I think even 10+ years out seeing a bariatric surgeon who is very experienced is a good idea. WLS stays with us forever. It isn't a "set it and forget it" type of thing.

Hernias, constrictions, etc...lots of stuff can happen. It never hurts to see if there is a mechanical issue at all, IMO, depending, but that's up to the surgeons, of course.