Appeal help-5 yr requirement morbid obesity

I am in the middle of writing my first appeal letter and need inspiration! BC/BS Horizon NJ-Direct Access required psych eval, pt eval, pcp letter of medical necessity, nut val and 6 month supervised diet.  All completed. My bmi is 39. 2 and I have sleep apnea, asthma, gerd, hypertension, and hypothroidism and family family of heart problems.   BC denied me based on my bmi dipping below 35 for the past 5 years.  Like many others, I lost 45 lbs about 5 years ago(It took 18 months to drop it-darn thyroid!).   Anyone had the same experience?  Any advice you can offer will be appreciated!  I will not be discouraged. thanks, Patrice