Can you lose to much weight and be denied prior to surgery?

Morning all , I'm in early days of this life changing process,  my MO/GP finally approved my referral(She warns me it might take up a month to be actually submitted(Military likes to drag things out and requires rubber stamp from Ottawa) So I'm expecting anywhere from 1-2 years from this point to surgery.

My question is what if I loose a significant amount of weight before going under the knife? I'm a life long yo yo weight loss then gain victim, I'm currently hovering at 255-260 lbs and a bmi of 39.5-40 , I do have sleep Apnea, GERD and borderline HBP and a staggering amount of Diabetes, Heart Disease and HBP in my family on both sides.

I'm reading stories of people losing up to 30 pounds on Optifast, that would drop me below 35 BMI? Anyone been denied this late into the process? I'm concerned because my weight does tend to fluctuate .

Anyone else concerned about being denied so late into the process?

I know the military has it own rules and regs so they may be different.  But for us, our approval was based on the initial weight.  Some insurance requires a 6 month diet monitoring but most folks didn't lose much during that.  It was basically a weigh in and class.  After we were approved, we started a 4 week optifast liquid diet, 5 shakes, 1 small food meal a day.  We were to lose 8% of our excess weight before surgery.  Everyone did but approvals were already done then.  Normally, 35BMI and co-morbidities will get you approved. 

1-2 yrs seems like forever.  I know my 5 months seemed like forever.  Once you make up your mind, you are ready to get on with it.  Hang in there.  Life is wonderful on the other side. 

I was denied very late into the process because I lost too much weight pre-op.  I had the same co-morbidities as you, and was required to do a 3 month diet. One week towards the end of the 3 month diet - the doc's scale weighed 4 lbs less than mine, and  I dropped below the magic BMI and became self-pay.

But being self-pay was not a bad thing.  It was the best money I ever spent in my life, and my surgeon had good rates for self-pay patients.  I'm glad I was able to have affordable surgery, and continue my association with such a great doc.

It depends very much on your insurance. Most go by initial weight but a few will deny you if you drop below a BMI of 35 so you have to check what your insurance says.

Sleep apnea should let you drop below a BMI of 40 unless your insurance requires two co-morbidities. The GERD isn't counted as a co-morbidity by some insurances but is for others and for the HBP, most want it to be not well controlled with medicine. So it's not enough just to have it but you also have it be bad and uncontrolable. Which sucks.

IOW, it really just depends on your particular insurance policy.

I was worried about the same thing but my Dr. said not to worry about that. I did optifast. I lost 20lbs on Optifast but it didn't stop my surgery.  I had some complications after surgery but even with all that considered it was definately worth it all. Good luck!!

When I called to schedule my initial consult my BMI was right at 35- they told me not to lose any weight before coming in for my official weigh-in or I would be denied by insurance.  They recorded my official BMI as 36 (I put on 2 pounds and wore my heaviest clothes/boots to the consult).  Once that was submitted to my insurance, it didn't matter if I lost weight. Good luck.

My surgeon is really good, he looks at where you were at in your heaviest stage. He said that everyone has their weights "set point" and your body often wants to go back to its heaviest weight.

I lost a large amount of my weight and now have a BMI of 32 but he is still going to do the surgery because at my heaviest I had a BMI of 40 and he is still keen to do the surgery.

Without the surgery he has found It is quite rare for people to be able to sustain permanent weight loss.

I totally understand your concern though, but I think it's important to get healthy and you should start now - even losing 10% of your body fat can have huge health benefits

I hope your Surgeon is as understanding and realistic as mine.

Good luck!

I am almost in the identical situation as you are. Seeing as how thi is over 2 years old I hope that you had a succesful surgery by now. I'm booked for surgery in early Feb. 2015 pending the clinics receipt of my payment code. I'm right at the 39-40 line and worried that if I lose too much before Feb that I'll be declined. How did it go for you in the end?