BMI TOO HIGH 79.4 FOR SURGERY?? INSURANCE CHANGING!!

Okay! So, im 23, and i have a BMI of 79.4  I have BCBSNC and as of sept 10th our insurance will be changing to where those interested in weight loss surgery will have to first start a weight loss program or see a physician for a combined total of 6 months without missing a month in order to be approved for surgery. What the hell??  Upset that this is changing it seems AS SOON AS I GET THE PLAN! 

anyway,

I have finished my 3 appointments nutrition/psych/and surgeon consult. I will be doing my lab work.chest xray and ekg this week. My physician will then schedule my egd there is only one problem

a hugh problem.

While seeing the Doctor yesterday at Duke hospital I was informed that i would not be able to have the surgery in september because my BMI was too high, that i needed to lose weight beforehand i was not given an amount of weight to lose but just that i needed to lose weight. Well if i could lose weight on my own i wouldnt be in your office sir! I was so dissapointed and right now i feel like my world has crashed. I am at my breaking point this weight is taking a complete toll on me and i cant stand another second being this weight and im just so ugh.

Has anyone with a BMI as high as myself had weight loss surgery? should i find another physician that can try to fit me in before my insurance changes in september? Or should i just attempt to lose weight in the 6 months! Is having the surgery in september a great risk to me! Im relatively healthy besides the fact that i am EXTREMELY OVER WEIGHT ! Sigh What do you guys think? I need some advice here. 

Hi radiantrealm,

 

Though I am not a heavyweight myself, I can really sympathize with your frustration. I also had some very frustrating interactions with doctors and insurance companies before getting approved for Weight Loss Surgery. Nothing like being told you need the surgery so much that you are not a candidate to get the surgery!

Anyway I wanted to answer you because I was just reading some posts on the VSG board from Watson. His highest BMI ever was 94 quite a few years ago, but when he had surgery in 2010 his BMI was almost identical to yours--79.3. He has been very successful and is currently at a BMI of 26.5. He could be a really good resource for you.

Is it possible that some of the doctor's reluctance to operate was because he or she simply does not have a lot of experience with patients of your size?  Or maybe doctor does not feel comfortable with RNY for you now? ( I noticed your profile seemed focused on gastric bypass.)  You might try posting on the DS board. Some surgeons feel that doing a DS in 2 stages is the safest approach for larger patients. 

I am sure that someone with more experience will be along soon with more info, but I just wanted you to know you are not alone. Persevere and keep asking questions.

Good luck in your journey,

Katy 

It is frustrating. I think there are a lot of unnecessary roadblocks to WLS BUT 

 

This is coming from my heart - I started out with a BMI of 60+. My first thought was "why the hell would I have to lose weight to get WLS"

But, for me. I had a soul searching day where I really thought about it. I was young. I was considering a very drastic life changing surgery. I decided for me I needded to commit to a year of changing my habits before I could consider WLS because I was scared - terrified of surgery. I did my research and its shows that people with BMI over 50 are at increased risk for complications during surgery - co-morbs or not. So, that was my goal for a year before surgery. Reduce my risk. It was that important to me. i didnt want to do such a drastic thing if I wsnt fully committed. 

I lost 85 lbs before surgery. In retrospect - compared to post op life- it was pretty freaking easy. Not the emotional part of having to deal with those mental issues that drove me to eat. But we have such a big benefit with high BMIs - our bodies can lose weight at much higher calories levels. I did 1500-2200 cals/day - no low carb BS or nothing, and i steadily lost weight. I did it in baby steps but i cleaned up my diet, helped heal damage to my body, got active, and the WL just came...it was absolutely the b est thing I haev done for myself. When I laid down on the OR table, I knew I was ready. (and being ready for surgery is something that needs to relaly be explored more deeply - desperation does not equal being ready)

So Id suggest just trying to keep an open mind about the requirements - take advntage of this period, and time will fly - i promise.

 

I hope you stick around and post often for support - we are here for you, and weve all been there, and even those of us at several years post op still struggle with issues, so we can all relate. 

I have to agree with acbrown - this is a good thing.

Surgery on us obese folk is already risky. Being super morbidly obese makes it riskier still. There may also be equipment concerns - a BMI as high as yours may not be suited for laparoscopic surgery, and open surgery is REALLY risky. This is MAJOR surgery, after all.

Pre-op weight loss requirements also give you the time to learn to do this RIGHT. Adopting healthy post-op habits in the pre-op period is a huge indicator of future success. A longer pre-op period is a gift, and IMO should be a requirement. It's hard to learn all new behaviours & coping skills after surgery...and you NEED those new behaviours & skills.

if you've already started seeing your doctor monthly, just keep it up.  My BCBS carefirst required 6 months worth of attempts within the past 2 years.  either two stints of 3 months consecutively or 6 months in a row.  They accepted 4 months of Nutrisystem in a row and 3 months of weighing in with my doctor.  plus, after my surgeon submitted for approval, BC Care first told them "she doesnt techically need approval since her insurance is "PPO"...."   hang in there.  one way or another, it will work out. 

my starting bmi was 74 my surgeons limit was 70 but he said that he would make an exception for me since I lost 25 lb before seeing him, I had to lose 12% of my extra weight , normally he requires 10%, I needed to do 6 months with the nut

 took 9 months till I got the surgery my bmi was in the mid 60's at the time the surgery went great I was told that most of my fat was on the outside so it did not effect my surgery much , I was up and walking in 2 hours

 start tracking your food on myfitnesspal.com and try to stay under 1200 cal , you will lose the weight , I said the same thing to the surgeon about not being able to lose it

 you will have to learn to control your eating or the surgery will not work it is only a tool to help you control portion sizes

my surgeon prefers to do vsg on heavy weights finds it much safer than rny or ds with about the same results , he has done thousands of sleeves and rny

lissome to you surgeon if you don't trust what he says talk to a different one you need to trust him/her

I can imagine how frustrated you are.  I had a BMI of 60 when I started the process, and I was told I needed to lose 50 pound before they would allow surgery.  I made the commitment and was able to do it, and I'm really glad I did.

For me, I know that eating carbs trigger my cravings, and the only way I can succeed is if I keep my carbs really low (under 20 grams a day).  If I eat carbs, the cravings are unrelenting and always win in the end. 

I'd suggest going low carb.  the first three days will take great will-power, but after that it becomes much easier. Its worth giving it a try because it was a life-saver for me. 

My thoughts will be with you.  Please let me know if the low carb helps.

Carol

 

 I just recently had my first consult with my surgeon as well. My BMI was 72 (AFTER I had lost the 5% current weight that my insurance required). I was told that while it would be best if I was able to get my BMI down to 70 or under prior to surgery (for a safer surgery) my current BMI would not prohibit me from having surgery.

If I were you I would just follow your insurance requirements of the 6 month diet and you will most likely lose enough for your surgeon to be happy as well.

The surgery won't fix your relationship with food. That is mostly all in your head and the surgery doesn't fix your head. Part of the reason that insurance requires the 6 month diet ahead of time is to get your head ready for the changes that it needs to make with it's relationship with food. Don't take it for granted - it's an important part of the process. It sucks waiting but the time is going to pass anyways so just learn as much as you can in the mean time, learn your body, how it reacts to certain foods, and what to expect after surgery.

Good Luck!

Hi there,

I was told the same....my BMI was the devil...66.6  lol  and my surgeon told me that I needed to lose weight, without telling me how much but I wanted this SO bad that I decided to start, we all have to start somewhere, the question is:  How bad do you want this?  even if you lose 20lbs, at least it shows you want this.

My choice of food was chocolate, I probably had 6 to 10 candy bars per night and soda consumption was crazy as well.  So what I did was lose the chocolate and the soda..I was never a breakfast person so what I did was 1 protein shake for breakfast, salade for lunch and stir fry for dinner.....I did NOT concentrate on portion sizes cuz in my head, salad and stir fry was WAY better then candy bars and soda.  So find something you love and eat that for a few months....and what also motivated me, was that I went to a nutrionist, here in Ontario, Canada, I can see one for free, not sure how it works in the Sates but I went and saw her, told her that I didn't want to be told what to do or not to do, I needed her to weight me in every single Monday and with time, I might ask for advice and pointers on food but for now, all I wanted to do was concentrate on one thing and one thing only, change my food choices, one item at a time.

Just start somewhere, you can do this and I promise, it will be the best choice you made in your life.  Life at 174lbs is UNIMAGINABLE but I can scream every second to show how much I'm happy!

Hope you can see the good side of their decision and just baby steps and you will see too that you can do this!

If you want to, talk to me everyday to tell me what whatever you wish to say.  Looks silly but having someone to talk to is like letting go of our issues!

Ok, enough, I'm starting a novel over here lmao

Have a beautiful day!  and don't forget, we are all here for you!

Nathalie

I have a BMI of 65 and I have to do a 6 month diet as well. I see this as a good thing actually. I want to take that time to lose some weight and change my bad habits. I know this will not only lower my risks during and after surgery, but it will also help me be more successful post-op.

I think you should see the good in this and really put the effort in. It will benefit you in the long run...