GP refuses to submit referral

Hello ,

I am from Mississauga, Ontario and seriously considering getting gastric sleeve done. My BMI is 39 and while I don't have issues like cardiac problems or blood pressure, I do have aches and pain in my knees(I am only 40!) .

My doctor submitted a referral for a medical program instead of the surgery referral and refuses to fix it citing reasons that you don't qualify as your BMI is not over 40 and you ain't got any co-morbidities.

I called Humber and they say they can change the referral from medical to surgery if the doctor calls them and makes that recommendation. The issue is my GP refuses to do that and is encouraging me to lose weight through exercise and diet . I have done that multiple times and just gained all the weight back.

Can you please advise how do I get this fixed. Any advice is appreciated. Thank you.

Sorry that you are going through this.

I would get a referral to a Wharton Clinic. http://whartonmedicalclinic.com/clinic-locations-toronto.htm l Once at the Wharton clinic, then the doctors there can refer you to the surgical program.

I think that your doctor has no idea of what you are going through...maybe find a new doctor...

All the best,

Barb

Unfortunately, your doctor is correct if you don't have any comorbidities your BMI must be over 40 to be eligible for the surgical program. Or over 35 with a comorbidity.

I wish you luck with your journey ahead.

Eligibility:

• 18 years of age and older
• BMI greater than or equal to 40
• BMI greater than or equal to 35 but less than 40. With at least one of the following comorbidities (as determined by your physician):
  • Coronary heart disease
  • Type II Diabetes mellitus
  • Hypertension
  • Diagnosed sleep apnea
  • Gastroesophageal Reflux Disease (GERD)

I may be wrong, but I feel the list of co-morbidities is broader than this? I have PCOS, osteoarthritis and fatty liver and my doc considered that when referring me to the surgery program. My BMI is over 40 at this time, but I have been working on losing weight while on the waitlist...I expect that with the long long wait, I'll be closer to 35 once its surgery time. Everyone I have interacted with in the program has told me that if my BMI does drop, this will not disqualify me because of my co-morbidities.

Has anyone heard differently?

It's quite possible that more are included, what I cited was directly cut and pasted from the OBN website.

And so many of us have sleep apnea without knowing it/ being diagnosed. I know that was my case. But my BMI was 44 so I qualified on that alone. I have heard of people beginning the medical program only for the hospital to refer them to the surgery program. Of course you also need a history of weight loss attempts that can be documented. At least TWH required this.

Unfortunately your doctor is correct and you don't qualify, based on the criteria, whether you have a sleeve or RNY isn't really your choice as the clinic surgeons decide for you, it's major surgery which can have lots of complications. Am I happy I did it, yes, do I wish I could have changed things without going this route, yes too, but being overweight wasn't why I went through this major surgery, I did it to gain control over my Diabetes/Hypertension/High Cholesterol/Sleep Apnea/Gerd/Cardiac Issues. I'm definitely getting healthier but its still a daily struggle.

If I might chime in here for a second. I agree with the others, If you can get your doctor to get you into the Wharton program then it would be up to those doctors to refer you. Once in there they have dieticians, doctors etc that can help you make the necessary changes for a healthier lifestyle. They would also ask you to do a full blood panel. You never mentioned if you have any co- morbidities such as sleep apnea, Gerd or so on. If you have any of these issues you would be a candidate.

If the above avenue fails, there is always the Mexico route (out of pocket mind you)

Good luck on your journey!

I agree also. I was declined by the program the year before ( I gained weight - not on purpose the following year). I have PCOS and a history of heart problems in my family which my family doctor tried to use since I was only a point below the qualifying BMI but I was turned down. They offered me the non surgical program instead. So they are particular about what co morbilities qualify. I wish I had better news:( good luck