PreOp, I cant stop eating - Does insurnce require u 2 lose weight 1st in order to be approved?

Since I have made the decision to pursue WLS. I can not stop eating. I feel like every meal is the last supper. I know it is my food addiction kicking and screaming that it wants to get the best of me. I wonder if this is uncommon? My insurance requires i have 4 months of nutrtionist consults before authorizing the surgery and i  dont think it is going to look good to be gaining weight instead of losing. i dont think i have really gained much but I have definitely not lost. I am wonderig if my insurance company which is Aetna will look unfavorably at this.  Has anyone had  this experience. I can't imiagine I am the only one. Would appreciate any feedback. Thanks!

Hi there Kevin!

As a requirement for most insurance companie they do require that you see a dietician/behaviorist for a certain period of time before surgery.  for the most part they do NOT require you to lose weight prior to surgery.  However, your surgeon may require you to lose a certain amount of weight before they will operate on you.  this is purely for safety reasons and ensuring that you will pull through surgery ok.  Also, some doctors like mine will make you go on a liquid diet for 2 weeks prior to surgery to shrink your liver as much as possible because they have maneuver around it to do the procedure.  If your liver is enlarged and fatty, then your chances of having an OPEN procedure increases rather than a laparoscopic procedure.   It is to your advantage to lose weight prior to surgery but for insurance purposes they just want to make sure that you are seeing your dietician/behaviorist for CONSECUTIVE months prior to surgery so they know that you will stick to the demanding regiment once you are post-op.

I hope that helps!

Hey Kevinax,   My insurance is also Aetna and I am going through the 4 month thing right now.  My first visit with my nutrisionist is on Thursday.   I'm pretty sure my weight is going to be up as well... I was told by my counselor that they wanted me to more or less maintain...not to gain, not to loose.  If I find out something different from my nutrisionist on Thursday, I'll post here again and let you know.   My surgery is scheduled for May 2009!

I think the consults with the nutriontist help because someone is watching you! It's like being graded at school. We had to keep a food journal and I'm sure you'll be doing the same. But my insurance didn't require we lost weight ...the surgeon did, and it was 5%.

I had Aetna (still do) and they didn't say anything about loosing. My surgeon wanted me to lose 14 pounds. It's to help you to know what to do after the fact. I know I was on the month maintnance diet my group has and lost like crazy. It helped me to see what I was in for. Well, as far as what I could and couldn't eat. Pre-op you die on the diet. Post-op I still can't eat everything.

Kevin, Almost all insurers require WLS patients to undergo some sort of diet and nutritional counseling. Call your 1-800 number for  the insurance company and ask for their WLS guidelines. It spells out a lot of the terms. I had Aetna and followed mine and made sure all my doctors and surgeons did too. There is most likely no cast in stone rule that you have to lose weight or punishment for gaining weight. Just remember to follow ALL the rules the insurer puts on you. It is the best way to make sure your claim goes though smoothly. In terms of your eating, it's emotional eating. Calm down, chat with folks on here, go to support groups, read up on the surgery. I think it gives a person comfort with the process. It should help you to understand where you need to be going and give you a push to get started. Best of Luck! -- Tom