Questions and More Questions...

You were all so great to answer me before, I am going to ask you another question.

I had my appointment with Dr. Andrei on Saturday.  He told me my insurance company wants 6 months of a medically supervised diet before they will approve my surgery.  OY VEY!!!!!!!!!  Okay, I figure I waited this long, another 6 months is nothing. 

BUT - i am really confused...I'm 5' 5" and currently weigh 252.  If I go on a six month diet and at the minimum, lose 8 pounds a month, that's 48 pounds...................I won't be eligible for the surgery if I weigh 204 pounds - - - will I???????  Or am I supposed to "pretend" to be on a diet for six months?

I am SO SO SO confused.  I'll call them later this morning, but thought I'd ask here too.

Oh, and did you all have to get an endoscopy and stress test first?
Thanks!!!
Amy

Hi Amy, I did not have to diet for 6 months, but from what I understand this is the insurances way to ensure you are able to cope and comply with the changes coming with surgery.  It isn't so much as to lose weight, it's to develop the better eating habits.  Not sure if I explained that correctly or not.  Good luck!

You know from your previous experiences with dieting that you will not lose 8 pounds a month.  You might in the beginning but your body will plateau off early.  Mostly, you need to go in and get weighed so the insurance company people can see that dieting doesn't really work for you and that you are able to comply.  However, and this might sound harsh, but if you can lose i t without surgery, by all means do it.  Not that I am saying rny isn't the best thing that has ever happened to me, but I weighed 340 pounds and before I lost on my own, 550.  So, I'm just saying, that if you go on the diet and lose down to 200 pounds, it's a win win. right? 

I think the insurance company wants to see if you can stick to the regiment of losing weight. It is such a life altering experience and life change. You have to get new habits and they want to see if you can do it. They figure that if you can't stick to it before surgery you aren't going to do after.

The insurance company isn't so concerned that you lose weight...they just want to be sure you don't gain any. If you gain then they don't feel that you are trying hard enough and won't be able to follow the rules.
They already know you have eating issues. Focus hard on just maintaining.

Hugs, connie d

Hi Amy,

I had to go into a six month program. My Primary Care Physician hoped I would lose weight during this time and not require surgery. When I looked at the book from my provider (Blue Cross) I realized that I didn't qualify since I did not have a co-morbiditis. During my 6 months I actually gained weight in order to qualify for WLS. They time went slowly but I learned a lot during this time by attending classes twice per month. I'm thankful that my insurance company required me to attend the classes because I learned a lot during this time.

All the best to you.

Kathie

Mini Hijack!

Castaic! ... I used to work for the Marine Center next to that 50's style diner on the road leading to the lake...

Memory Lane!

Thanks to all...I am seeing the "diet" doctor next week.  The nurse there told me I will get all the info I need then.
I guess I'm just anxious now that I've made the decision!

Amy

Amy,

You need to ask your insurance company what happens if you lose that much weight.  I think some insurance companies count your starting BMI.

As someone else pointed out, though, it's pretty optimistic to think you could lose 8 lbs/mo on a medically supervised diet.  If you could lose like that without WLS, wouldn't you have done so already?  When I was on a medically supervised 1200-cal/day diet (for diabetes, not pre-op for WLS), I lost a hot 1 lb a week.

Yes, I had to have an upper endoscopy and heart stress test first.  That is SOP for all my surgeon's patients regardless of age, weight, or medical history.  With the endoscopy, he wanted to have a look inside first to get the lay of the land, so to speak (and diagnosed a hiatal hernia that I already knew I had).  With the stress test, he wanted to make sure I could withstand anesthesia and surgery.

I also had to have a psych eval, blood tests, sleep study, and pulmonary study.

Jean

Great answers everyone!  I am very thankful to have found this board.  You've all been wonderful.

Dr. Andrei told me if all goes well, my surgery would be January 22nd.  That's 2 weeks before my birthday, so I am definitely excited about that! 

Just as an aside, there was a woman in the waiting room who looked great!  Very chic looking around her 40's or so.  I thought she was a post-op there for a check up or something...nope.  She was there for a lap band consult!  I'd bet a paycheck she was wearing a size 10/12, if that!  I heard the nurse tell her that she was welcome to see Dr. Andrei, but her BMI wasn't high enough to qualify.  Long story short, she waited for him but I wonder what he told her.

Oh well - thanks again!