Question:
My endocrinologist put me on a diet. Says my surgeon requires I lose 10% before

surgery. If I lose 10% my BMI will only be 38. Will I still qualify??? HELP!    — Suzy Q. (posted on February 4, 2003)

February 4, 2003
Depends on what weight they send into your insurance company. It is probably the weight at the initial consult so you should be OK. <p> Personally, I have a real problem with surgeon that require pre-ops to lose "x" pounds or "y%" of their weight before surgery. They said it shows commitment. We are going to go through the rest of our lives with re-arranged insides, malabsorbing calories, vitamins and minerals, with intolerance to fats and sweets. The surgery is basically irreversable (with regards to restoring 100% efficency). This isn't commitment enough????? JR (open RNY 07/17 -142 pounds)
   — John Rushton

February 4, 2003
That whole freaking "commitment" thing just so Makes me mad, If I could have lost all that weight with out surgery why in the H*LL would I have had major surgery! and rearranged my guts all over the place. (sorry had to vent that)
   — **willow**

February 4, 2003
I agree with willow on this one! Did your surgeon say you needed to be on a diet? I would call the office and confirm that. If you haven't see the surgeon yet, wait until you have your consultation before you start any diet.
   — koogy

February 4, 2003
My surgeon also requires a 10% weight loss before surgery. The weight they send to the insurance company is the top weight before the 10% loss. Commitment is only a small part of why they require this. The main reason is that conventional medical wisdom, endorsed by the NIH, is that losing 10% of your weight, no matter what weight you are, improves your health dramatically, and lessens your risks in surgery. Those who are familiar with Weight Watchers know that they use 10% loss as a big goal, and this is why. Another reason is to start healthy eating habits which will help with post-op eating. On a personal note, I lost 30 pounds before surgery and now I'm so happy I did. It gave me a great head start on my total weight loss!
   — Michele C.

February 4, 2003
Darned good question, Suzy. My BMI was 42 when I first had my consult, and I was so pumped about getting the surgery that I lost 12 pounds between the consult and my pre-op procedures appointment. That put me at a BMI of 40 on the *nose*, which was my insurance company's minimum requirement (with no cormorbs), and my doc told me not to lose any more weight before my surgery, or I might lose insurance coverage. And that's with a doc who *didn't* require me to lose weight before surgery. Having rocketed back up to a BMI even higher than 42 on some of my previous diets, I just shook my head and quit losin' weight until surgery. I think the whole thing is nuts -- requiring pre-surgery weight loss or essentially warning against it. I'd find out FOR SURE from your doctor's office what weight they're gonna put down on the insurance paperwork, so you don't get a rude shock down the line.
   — Suzy C.

May 3, 2003
I feel like the requirement to loose weight before having surgery is not a Commitment Issue, but more like a Moral Issue. I don't like being treated like an Immoral person because of my weight. Come on, I already tried allthe diets. Janice Lundblad in Texas
   — Janice L.

May 3, 2003
Another reason that some surgeons require that loss is not because of commitment, but because it will shrink your livier. The liver is 'in the way' of getting to your stomach and small intestine, so if you can shrink it, it makes it easier and safer for your surgeon to get to the parts that need to be altered. I do agree with asking the surgeon what he/she requires and also what weight he/she will put down for insurance approval. For most of us, it's the weight they record at the initial consult.
   — garw