Looking for input...on letter to include in approval submittal packet

 I snore when I sleep on my back, but I mostly sleep on my stomach..well until my hips started bothering me..so sometimes I ahve to sleep on back.  Hmmmm...in the last  months to a year I ahve noticed having to wake up mmore between 3 and 4 am to pee.....interesting.  No acid reflux...more of a pear shape but in the past few years have a lot more in my stomach...hmmmm....off I go to the doc..problem is my PCP is useless, need to find a new one all the way around becuase I simply do not trust this one....not a good thing...

Thanks for the advice.

I took three approaches in my letter.  I emphasized that I was 40 years old and that due to age my metaboism was going to drop making it even harder to lose weight.  I said that I had always been heavy throughout my childhood and almost all of my adult life.  I indicated that I had lost weight in the past merely to regain it.  I stressed that I had tried diets coming and going.  And, I'd had a hysterectomy and I mentioned that as a possible issue with regard to being able to lose weight and keep it off (insinuating due to hormonal changes ...  although I kept everything that produces hormones).  I said that the easy days for losing weight were over and that even they kicked my ass.  What was my future going to be like in terms of dealing with my weight?

Secondly, I included a picture of me standing next to my "normal" sized parents and brother.  My goal there was to show that there was something different about me, that I was heavy and had always struggled with weight issues even as a young child even though weight had not been the same issue for them.  If your parents and siblings are heavy, you could take a similar approach of showing that there is a genetic predisposition of being heavy.  

And finally, I tried to connect on an emotional level to whoeer was going to be reading my letter.  I told them that they would be saving my life and allowing me to transform myself into someone who was living life versus someone simply being a bystander.  I talked to them about the pain my body was in (physically, literally).  And the social barriers my size created, the way it interferred with my ability to be comfortable in my own skin in a social setting with "normal" sized people.  I literally pleaded with them to approve the surgery.  I knew it was a matter of saving my life in every way imaginable.  

 Since I am submmitting this with my original submittal, I did want to emphasize the personal and connect on the emotional level.  I am 40 with small children....I want to enjoy their childhood. 

I really like the photo Idea...I can even relate it to stories of my mom and her immobility....this is already formulating in my mind, and conenct that to the fact that she was over 10 years younger than me when she started having babies, I was a 17 year old in college when my mom turned 40...I have a 7 year old...gosh...wow...that puts things in persepctive for me regarding her mobility or lack there of at 40.  

THanks for the suggestions!


Edited for spelling

Another thing you can emphasize, and I did this, was the cost of future health issues...  hip replacement, knee replacement, back issues....  I talked about it on a cost level and how it would be saving them money in the long run.  I didn't go into any big cost analysis.  I just said these issues are in my near future but with your help (wls), they could be pushed off for a long time - possibliy indefinitely.