Introduction

Good Evenings Gents, I started looking into WLS about a month ago. I attended a seminar and submitted the initial paper work about three weeks ago. My surgeon's office contacted my insurance provider (Aetna EPO) and they have stated that they will cover my surgery 100% following a 3 month medically supervised diet. I have a bunch of co-morbidities including, high blood pressure, type 2 diabetes, high triglycerides, high cholesterol, low energy, and who knows what else. The main reason I decided to have WLS is to get control over my diabetes. I've been overweight all my life and the only time I've ever successfully lost weight is when I followed what I call the NAD diet. NAD stands for Nicotine, Alcohol, and Divorce ;) . I managed to loose nearly 100 lbs in just over a year but I had to give that diet up because it was literally killing me. Diabetes took my father when he was just 62. His father only made to 58 and frankly, I'd like to be the first man in several generations that lives to see his 70s. God willing I'll go even farther than that. I've tried everything and failed at everything I've tried so it seems that it is time to get drastic. I'm sure as I start down this path I'm going to have questions and concerns and I'm so grateful to have a place like this where I can learn, laugh, and hopefully live. My first question is about the medically supervised diet that so many insurance companies require. What is the point? Are they trying to see if you can alter your life style for even a short time before committing the $$ to surgery? If someone happens to do really well on the diet is there any chance the insurance company will tell them they don't need WLS to loose weight? Anyway, sorry for the long post. I look forward to getting to know you all. Mark

Welcome aboard Mark! Glad ya joined us. Lots of knowledgeable guys here with lots of insight and help to offer. My surgery is next Tuesday, April 15, so I can't tell ya anything yet.

It wouldn't surprise me if *some* insurance companies use the "six month medically supervised diet" requirement as a kind of hurdle to eliminate those people who aren't absolutely determined to have WLS.   One major insurer in the Boston Mass area (Tufts Health) tried to institute such a program, but the uproar among both insurees, their employers and WLS surgeons was enough to cause them to drop it.  Of course, most surgical practices encourage and/or require their patients to lose 5, 10, 20 pounds or more in the months immediately before surgery to improve people's pre-op fitness.  This makes the job easier for the surgeon and puts the patient in a better place to do well.  If someone wanted to participate in a more elaborate six month pre-op program, I doubt that a surgeon would dissuade someone from trying it.  Usually, surgeons report the patient's weight at the time of initial consult, which would probably be the time *before* starting such a weight loss regimen. /Steve

Hey Mark, Welcome to the Locker Room! As an Aetna customer, I went thru the diet too.  It goes pretty smoothly as long as you follow their requirements. The reason for the 3 or 6 month diet is to show you can stick to a regimented eating plan.   For me, it was an eye opening experience.  I only lost about 15 pounds on the diet, but it made me realize exactly how much, and how poor quality my food was.  Also, my dietician had me write down everything I ate and drank.  This made me very accountable, and got me in the habit of tracking my food and liquid intake.  It also, of course, lowered my food intake.  My dietician also got me in the habit of eating 5-6 small meals a day.. spreading my calories out.. instead of 2 or 3 big meals. After that, the transition to the bariatric plan was much easier. I resisted the idea at first too.. thought it was stupid.. LOL.. but looking back, I can see it was instrumental in getting me ready for this new lifestyle. Just go thru it, stick to it to a T.. and it will make the journey much easier. Dale

Welcome. This is a great place for info, help and ideas. I agree with what Dale said and have found, for me, just follow the Dr.'s program as there is a reason he does it that way. The supervised diet, the liquid diet (if your Dr. has one) are all there for your benefit.
I think if you choose this path, you will not be unhappy.

Best of luck,

Lou

Hi Mark, and welcome to the Mens Forum! YOUR REASONS FOR GETTING SURGERY ARE REMARKABLY THE SAME AS MINE.  ALL THE SAME CO-MORBIDITIES AND ALL.   THEY WANT YOU ON A DIET BEFORE APPROVAL TO SHOW THAT YOU ARE CAPABLE TO ALTER YOUR LIFE STYLE, AND AS A PRE-SURGERY TOOL TO MAKE IT EASIER AND SAFER TO TO HAVE SURGERY. MY EXPERIENCE WITH MY DIABETES WAS EXACTLY AS I HAD HOPED.  BEFORE SURGERY, I WAS SEVERLY DIABETIC, WITH METER READINGS UP TO 400 AFTER A MEAL.  MY 3 MONTH AVERAGE WAS 12.5.  DURING MY 1 YEAR MED SUP DIET,  (1 Year was required for me at the time through BCN.  I believe they require 6 months now)  I GOT MY 3 MONTH AVERAGE TO 8.5, AND MY POST MEAL READINGS TO 200 OR SO, AND 120-140 FASTING. NOW, 8 MONTHS POST OP, MY 3 MONTH AVERAGE IS 4.3, POST MEAL 110-120, AND 80-95 FASTING.  I AM MEDICALLY TERMED AS NON-DIABETIC, AND HAVE BEEN SINCE 3 MONTH POST OP BLOODWORK.  ALSO, I HAVE NO MORE OTHER CO- MORBIDS EITHER, AND TAKE NO MEDS OTHER THAN SUPS. I HOPE YOU EXPERIENCE THESE SAME RESULTS FROM YOUR EXPERIENCE. KEVIN

Mark, I had BCBS and went one year on the diet. It was there way to no payment !! Ibeat them . There revised down to six mo. now. You'll do fine. In the process I went from 346 to 313 with about 20 pounds in the final three wks. on the liquid diet. Good Luck and Welcome

Sounds like you'll qualify fine for surgery. I have Kaiser Insurance in southern CA. I had a 39.5 BMI and co morbid conditions. But I still had to provide proof of a 6 months medically supervised diet program.  I had participate in such a program for 8 months, and I provided a letter to my insurance company. But that only got me out of the Options program, where you drink Optifast and have nutrition classes. I stil had 3 months plus of classes, even though I'd done the weight loss routine before. The insurance company wants you to make sure you fully understand the restrictions on your dietary intake before you have surgery. In previous years, many patients got WLS without any education classes and ended up with many problem because they didn't follow protocols for water, exercise, protein ,vitamins, calcium etc. I had RNY surgery and I know that this surgery is only THE TOOL I needed for weight loss surgery. But, as the saying goes, "you have to be smarter than the tool you're working with", meaning you have to have knowledge about the tool and use your mental capabilities to use it properly.  The RNY or any other WLS will not allow you to lose the weight alone. It still takes effort on your part--for the rest of your life.

I laugh at the supervised diet.  I was required to do 6 months of "supervised diet" before my surgery.  It consisted of going to my primary doc and getting weighed once a month.  Since my doc's scale only went to 350 I couldn't be weighed there.  So they asked me to go to the weight clinic before my appts.  Well needless to say on paper it says I lost a few pounds in that six months but I believe in reality I gained 20 lbs.  LOL Not proud of it now but I treated it as a 6 month last supper! I was alittle concerned that it might have tripped up my surgery if they knew I was gaining but nobody seemed concerned so it was all good. Jim D

Mark, Welcome to the locker room.  Feel free to ask any question you want, someone will have an answer for you. All of the pre-surgery diet reasons and advice the others have stated is true.  Give the diet your best shot as every pound you can lose now is a pound you won't have to lose after surgey.