Tips for initial consult?

 Hi!  I went the required seminar last night and have the initial consult on Monday.  My BMI is 36 - 37 depending on which way the wind blows.  I don't have any obvious comorbidities; but I do have Barrett's Esophagus, which is a serious complication of GERD and a pre-cancerous condition requiring daily medication and I just got word from PCP that my cholesterol is elevated.  She called it "borderline" but the numbers were all higher than the normal range, so I don't know if that qualifies as "high cholesterol."  She said she wouldn't medicate for those numbers, but if I were checking off boxes of medical conditions, I could select high cholesterol.

So, last week my weight was recorded by PCP at 235.  I joined WW the next day and it was recorded at 233.   I've been doing ok on WW this week and may be down a few pounds,  but now I wonder if I should hold off until Monday to get my weight higher for that initial weigh-in.

My questions are: which weight counts?  Should I wear heavier clothing and not take off my shoes for the bariatric consult?  Anyone have experience with using the GERD as a comorbidity or having "borderline" cholesterol problem?  I have Carefirst Blue Choice HMO, covered at 100%.  

Looking forward to embarking on this journey.

 Oh, another thought.  My insurance disregards BMI if you are more than 100lbs overweight. How do they determine this since I've only ever seen weight ranges?  Mine at 5"7" is 127 - 159.  Current weight of 233.  So, yes, I could feasibly be 100lbs over, but only 70 or so from being "normal" bmi.

I was also between 37 & 38 BMI.  Although nobody ever told me to keep my weight "up", I inately knew I was a "lightweight" and made sure I kept my clothes on, AND ate lunch before my initial meeting with my bariatric surgeon. Unlucky for me, it was summertime, and a hot one too, so my clothing wasn't much help! The good news was my insurance only needed one co-mordidity, and I did have sleep apnea.
I believe thy go by the lower weight in "normal" because at my 6 month follow up (Last April) I weighed about 133# with a goal of 130# and they sang their praises that I lost 92% of my excess weight. No don't get me wrong, that is fantastic, but I wanted to hear 100% excess GONE, which I think for me was 128#. Anywho I have been as low as 122# so I got my wish in reaching that 100% (Yay, me!!!)
I wish you luck, and yes, it is wise to keep your numbers high for your initial meeting. Those are the numbers they'll submit!

I think they will take your weight at the initial appt, not PCP or weigh watchers.  Gerd is certainly a co-morbidity.  It would help to call your insurance and see exactly, if they will tell you, what you need to qualify.  Good luck. 

 The geniuses who answer the phone only read back to me what I am able to read for myself online.  GERD is never mentioned specifically.  It says this:

- BMI equal to or greater than 35, in combination with one or moreof the following co-morbid conditions:

hypertension;

a cardiopulmonary condition;

sleep apnea;

diabetes mellitus; or

any life threatening or serious medical condition that is weight induced

I think a case can be made for the Barrett's because that will ideally disappear completely.  It's definitely serious and can definitely benefit from weight loss, but whether it is "weight induced", I don't know.

With my insurance company, GERD was mot a co-morbid condition.  Your case is different though, especially if your health care providers write letter supporting that.  Have you had a sleep study?

I had researched and read the same thing. But when I seen my surgeon he said he reserves the DS surgery for patients with BMI over 50. So now what do I do? I spoke with the patient advocate, she sd to put it in writing and to be put into your file that you want the DS done or will seek out another surgeon. Well I did just that and have not heard from the surgeons office. I am almost done with my 6 months supervised pcp diet and dont want to have to wait any longer afterwards to get this started and submitted to my insurance. My BMI is 40.3 . So my question is if he still dont want to do it and says for his patients with BMI over 50 what am I suppose to do. My friend just had done with same surgeon and her BMI close to mine and he did the DS for her.

My Docs office was really good about helping me make it through the insurance maze and being able to check off their little boxes. I would bring all of these questions to your doctor appointment and they will work with you and the insurance company to see if you qualify.

I would do what you can to weigh as heavy as possible at your initial appointment.

I agree.....your surgeon's office should help you through the maze of requirements.  Mine was very "crafty" at wording things appropriately and in my favor.  I had a low BMI too (I think 38) but I had a record of a (ONE) doctor's visit where my blood pressure was up slightly (it was really just the one visit  and was never high again but we rolled with it...).   I also got my previous 5 years worth of gyno. exams which showed I had been morbidly obese for consecutive years in a row.

My surgeon also found through the upper GI pre-surgery requirement that I had a huge hiatal hernia which qualified me for the GERD co-morb. but I never took any meds. or anything.....I had occasional reflux but nothing too bad.

Stick with it!   It's totally worth all the effort!  Trust your surgeon and his/her office...they are usually experts at getting these things approved!
Best wishes!

 Should I fast for any reason prior to the appt?  I just had fasting blood work done by PCP a week ago.