I been denied surgery by my insurance and can't lose weight normally.

T Hagalicious Rebel
Brown

on 9/11/18 8:12 am - Brooklyn
VSG on 04/25/14

Your insurance sounds very strict & it seems odd to me that with your weight that they'd demand a co morbity to go along with it. Especially when in time you'll probably get those illnesses. Is it written that way in your policy? Do you have a copy of it?

I'm guessing if you've been denied 7 times then you appealed their decision at 1 point & was still denied. You might have to look into getting the surgery out of the country, but I'd switch to another insurance that covered it if you can swing it.

No one surgery is better than the other, what works for one may not work for another. T-Rebel

https://fivedaymeattest.com/

Notaboutperfect
on 9/12/18 3:06 pm
VSG on 11/08/16

I was also denied by my insurance due to lack of co-morbidity(ies). I had a short period of feeling pretty defeated and depressed.

The WORST feeling was the disappointment I felt because I didn't have diabetes, or sleep apnea, or joint issues, or......!! What a mind-screw.

Once I accepted the truth of it, I began investigating self-pay options. As mentioned above there are options in Mexico, but I stayed in the US. There are centers of excellence that are very decently priced.

Aside from the price, there are pros and cons to self pay. Once you get past the rejection I hope you'll find a renewed sense of purpose and look into it.

Ultimately, I feel it was worth every penny. Best to you.

sweetpotato1959
on 9/14/18 12:05 am

Did your doctor do a metabolism study? Ours did and that made the difference in getting approved. o do t hat you do a complete diet diary for 2 weeks... and turn it in for evaluation. It must include calorie countt carb protein and fa intake of every item you put in your mouth. They usually do a weight before you begin and at end of 2 weeks

Here are two big alternaive..thing to try...

..I would /did try this, it worked for a while and i lost inches. as you loose inches then are able to exercise. muscle uses more calories than fat.This was several years before my blood sugar went wonky. it was a diet based on one...called "calories don't count". stayed on it for 6 months.

basics of the diet: It was a high "healthy fat"(.ie coconut, real butter, and olive oil only.). diet and high protein. but lean meats only- no pork fat and no bacon and no sausage unless first boiled then browned in skillet and pressed to remove all fats posssible

. eggs could be fried in butter. or olive oil,.... Idea was to provide vegetable oils for entire fats in diet...that required he body to use stored animal fat reserves for those type of fats.

green leafys were free as many as desired, so were string beans and tomatoes.

a minimum of 10- 8 oz glasses of filtered water every day. lemn juice added from organic lemon ok. another alternative to that would be add 2 drops of esential lemon oil.

No "diet" products and no sugar. stevia pyure brand is ok,( produced with out chemicals.)

all carb based veggies were strictly off limits. Carb veggies were limited to ONE ADA serving per week. this includes corn ,sweet peas, butter beans, pintos, potatoes of all kinds.

CUT out ALL breads.

No cereals.

No fruit except 1/2 banana 2x wk. .

with that kind of exercise program you were building some muscle. I still cant do that much exercise , even in 10 years.! You may have had some fluid retention as well . it sounds like you over did it on exercise and it messed with weight loss.

another alternative would be to try ddpy as an exercise plan... with sensible portions. his is closest to what i am on now..(..I am on 90 grams protein and 25-50 grams carbs.. unlimited fat/but have a low tolerance/ost op).

. cut carbs to as near zero as possible. first 3 days will be bad. Boost your vitamin B complex in a sublingual to 2 cc a day for 3 days, then daily one cc. per bottle.. that will help with cravings. avail at dollar general and wal mart.

and since you are male you would probably need 120+ grams of protein. do not use diet products . the low fat ones have added sugar and the low fat ones have hidden sugars.

read labels avoid corn syrup in all forms .. it now is advertized an listed in many different ways. be a label reader. cut the condiments, except mustard is free.( all you want.)

eat a lot of raw veggies... check out enzymes and probiotics to keep your gastric health. there are some vegan ones that are high protein and add lots of flavor.

do a liver clanse with milk thistle 2 caps every day for 2 weeks, and repeat each 6 weeks one bottle =under 6$. will last sevral months.

diane S.
on 9/15/18 10:56 am

I can't help much without a review of your insurance policy but I can refer you to my blog here on OH which has a copy of my insurance appeal letter which won. Don't know if it will help you but take a look. Don't give up. Diane S


      
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CerealKiller Kat71
on 9/16/18 6:23 am
RNY on 12/31/13

I would draft a formal appeal to my insurance for the sole reason that your BMI more than qualifies if your insurance covers weight loss surgery. I've never heard of a co-morbidity clause with that high of a weight.

Also, there's no way to know if you actually suffer NASH (non-alcoholic liver disease) without preforming a liver biopsy. Your blood results can be completely normal, yet you have early stages of damage. I did.

Also, if you've not had a formal sleep study -- only an at-home monitor, I would demand a real study. It's highly likely that you do have it at your weight.

Finally, as others have already stated, your diet is mostly sugar/carbs. Rice, corn, bread are all foods that will pile on weight.

"What you eat in private, you wear in public." --- Kat

(deactivated member)
on 9/16/18 11:55 am

I am so sorry for all you have been going through. Stinks you are getting road blocks. Not fair but so many things in life can be that way.

In the meantime I highly suggest Weigh****chers the new freestyle program for 2018 is really good. I was really struggling with some regain (I am over 10 years out from Gastric Bypass) I am down 16 lbs in 6 weeks without exercise. It is slow and steady but a great program. The support is wonderful too. I know I need to add exercise but currently facing some other woman health issues and have not felt up to it. I joined for 3 months so only $8 something a week.

Stay positive and let people help you get your mind in the right place. Read here.... If you join WW go to meetings, go online to their connect online community. You can do it.

best to you,

megan

dreamer1234
on 10/12/18 6:11 pm

have you thought about going on disability? i know that medicare covers the surgery, so does medicaid. just a thought.

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