PURPOSE of physician supervised diet

My insurance only required that I had some type of medically supervised diet in the last 5 years along with my weigh-ins but my doctor insisted I do 6 mths with him first. I was actually afraid that if I lost weight then my insurance would say, well you're doing it on your own so you don't need the surgery, why you ask? Because they did it before. Well let me explain. I had BCBS of IL and was on Jenny Craig and lost 30 lbs which put me below the minimum BMI for surgery and they said exactly what I stated. This time I have BCBS of MI and my doctor didn't have me on a specific diet, he just was telling me to eat better and start walking, which doesn't make sense because if I -really- knew how to eat better, I wouldn't have been so heavy. Walking a 1/2 mile was pretty painful too. So each month I wouldn't lose weight and my walking sucked because it was painful and he would get irritated with me. He did try to send me to a nutritionist but my insurance wouldn't approve it. I have a PPO but they have no in-network NUTs. After the 6 months he referred me to the surgeon and in the last 4 mth I've lost 30 lbs (hit 30 today!) by doing weigh****chers and know I'm just counting calories and protein intake. I actually get this whole calories thing now for the first time in my life! I'm 38.  My insurance goes off of the first weigh-in with the surgeon so I should be ok to get approved. I'm now waiting to hear so I can get my surgery date. I'm wondering if you should ask your insurance the purpose of the weight loss and whether it will affect you having surgery. GOOD LUCK!

Basically it's a way for the insurance company to be sure that you're serious enough about this to change your diet and not just continue to eat the same junk that will eventually make the surgery fail. I see it as them just trying to ensure that covering the surgery for you is a wise investment:)

I'm just starting my 2nd month of my 3 month pre-op supervised diet and while I have my good days and bad days, I'm taking it pretty seriously. First off, it's giving me an opportunitiy to get used to the kinds of foods I will be eating after surgery (when I am able to eat solid food again). Secondly, I figure every pound I lose on account of this diet will make the surgery that much less risky for me. It will also shrink my liver, so I won't have to worry about the 2 weeks leading up to my surgery so much :)

As for you being too heavy or having a BMI too high, some surgeons will NOT operate on someone with too high of a BMI, but that is something you would have to ask your surgeon. And that is SOME surgeons, not ALL. More than likely if your surgeon has a max. BMI that he will operate on, he'll tell you at your appointment that you need to lose "X" amount of lbs before he'll do the surgery.

Good luck with your consult and your continuing journey! Get started on that physician supervised diet ASAP that way it's over that much sooner :)

@mrs dores.. were you given a specific diet or just told to diet?

Oh, and for me the extra time allowed me to get everything straight with the insurance. I kept them updated and sent them copies of all the labwork, test results, etc. Because of that they actually approved me in less than 24 hours after the clinic submitted the final piece of paperwork. (And the clinic insurance people helped immensely with that as well!)

Six months also gives you a lot of time to slowly ease yourself off of carbs, soda, and caffeine - because going cold turkey is not fun and the last thing you need when you are trying to deal with all the other changes is carb withdrawal and caffeine headaches!

Insurances that do not approve the surgery because you lost some weight are just plain foolish. Less than 5% of diets work. That doesn't mean less than 5% off people on a diet lose weight, it is just that it is impossible for the diet to work long term for them and that they gain the weight back. (Not that nobody gains the weight back after WLS, but the numbers and amount of weight is much, much less than traditional diets.) So yeah, you might be able to lose some weight, but your medical history should prove that you have tried repeatedly and been unable to lose and keep off weight. If it doesn't then the requirement is not unreasonable. And if you have never even tried to diet (like my husband who has literally been on only one diet in his whole life...) it does make sense to have you try to diet - they do work for some people!

Some insurances will only approve the surgery if you are above a certain BMI unless you have comorbidities (diabetes, hypertension, PCOS, sleep apnea, high cholesterol, etc.) - which means they will approve you even if you have a lower BMI. So you may need to check with them about what their requirements are.

(35 hours away from surgery...)

My insurance also requires the 6mth supervised "nutritional management". It has been great! I meet with the nurse who does my blood pressure and weigh in, then I have one on one time with the NUT. We spend about 30 minutes (or more if needed) talking about nutritional stuff - reading labels, food journaling, the difference in simple sugars / fruit sugars, "good" fat and "bad" fats, why we need protein AND carbs, etc.
She is already offering encouragement and praise for my efforts and for life post-op.

I am really glad for this time to practice eating slower, drinking sips, exercising, changing food choices, getting my vitamins in (had to add Vit C cuz it was low)... I was able to do the treatment for h.pylori now instead of finding out a couple of weeks pre-op (hopefully it worked because those meds messed me up!).