Can't prove 5 years of obesity

If you go back five years from 2005 that, of course, takes you to 2000. I was on the Atkins diet then and had lost forty pounds. Naturally, after six months of it or so I gained back fifty. So I go back further into my medical records looking for a weight listed. I find one dated 1996 with a weight of 226 pounds, my height is listed as being 5'4". That would put my BMI then at 39. Now I weigh between 240 and 245. I saw my surgeon for the first time last week and his office measured me at 5'3". Which puts my BMI at 43. So what I'm wondering about is that 1996 weight recorded. If I were 5'3" back then, my BMI would have been 40. Do you think my insurance will go off of the height listed in 1996? Or the height listed recently by my surgeon's office. It makes a big difference in whether or not I can prove five years of morbid obesity. *Sigh* I can just see myself getting denied over something stupid like this. I've worked two years to get to this point too. Lynda

Hi Lynda- I know exactly how you feel about possibly getting denied over something stupid. My insurance isn't going to be in UHC's system for another 2-3 weeks. Although I am medically covered, I don't want to risk the Doctor's office sending in the letter too soon and UHC losing it or denying it because of a stupid card I don't yet have. I am 4'11 and weigh 250 lbs! My BMI is 50. I weighed a high 215 when I got married 3 years ago. I guess you can tell by the weight gain that marriage makes me happy. I know I have been so guilty of the negative thoughts that I am just going to bring it upon myself. I am now challenging myself to start thinking positive and I vision myself this time next year wondering why I fussed so much. (I bet you will be too) It has been a rough journey for me, and I only see the rainbow and the end of this long road. I know you and I will be just fine. Take care, it will work out...

Lynda, Do they want 5yrs. proof of morbid obesity? Or just obesity? If it is obesity then you are probably ok. Do you have any comorbidities? That would help too. I am fighting a total exclusion with my policy...I feel your frustration. Brandi

Lynda, I started reading your post and almost fell off my chair! I have the EXACT same issue! I was incorrectly measured at some point by a former PCP as 5'4 and at the time when I questioned this they told me I must've grown..yeah right. No huge deal until now when I am trying to get approved for bariatric surgery! When I got copies of their records I am charted as being anywhere from 5'2- 5'3.75 !!! Now, if that isn't confusing??!! Plus, it drastically changes my BMI. I solved this issue by getting an "official" weight by my PCP and bariatric surgeon. I also added a comment on my personal letter to the insurance company explaining the height "issues". I was told by the surgeon's office it is expected to have fluccuations in weight on your medical record. I too had lost a great deal of wt and regained several times...several times dropping my BMI below the 40 mark. This was sufficient explanation to them for proof of morbid obesity for the past 5 years. Now my biggest hurdle is getting them to accept the medical records for the physician supervised weight loss attempts for 6 months w/3 months consecutive. I have this but, don't have them supervised by a nutritionist/dietician. This is a requirement by Aetna...but, of course unless any of us knew in advance we were planning WLS we would'nt have been involved w/a dietician for past weight loss attempts! Just a way the insurance company can delay approval and see how committed we are to the surgery. As if any of us would casually seek our intestines being re-routed and stomach resected..just makes me sick knowing I have NO control over this. Good luck w/your approval. Please feel free to email me. Lisa Distefano

I just had the same problem. Because I was not obese 5 years in a row (but I was 5 out of 7 years) they don't want to cover it. I am appealing but I don't hold out much hope. We shall see. Good luck to you.

I'm really nervous also. In 2000 I was prego with my first child and 2001 prego with my second. I have to prove five years. What do you think they will say???