Question:
Insurance company 6 month doctor supervised diet--I need advise please!!
ok,,some may really think my question is completely silly, & I am prepared for whatever answers may come my way. so, I had my first nutritionist appt this week, she gave me 1500 cal diet, 3 fruits, 6 starch, 6 meat, etc per day. so here we go with my SILLY question,,do I really want to TRY as hard as I can to loose alot of weight during this 6 month diet required by the insurance company, or do I want to fail miseribly to show that I try & try & it may come off, just not stay off? & too, another thought is, if I don't try as hard as I should,,I have to answer to this nutritionist for the next 6 months EVERY month, so she, I suppose can have the authority to write in my file "not commited" or something like that.....background on me,,,I've been fat my WHOLE life, well probably starting 4 or 5 years-so I have failed miseribly at all previous diets,,,medical records, of course, only go back 7 years or so, so the nutritionist I saw & the optifast I was on both as young child or adolescent, those records are gone to prove I've been overweight forever. Please, any advise on this, will be great! I've taken weight off several times in my life & gained it all back +++++, so I feel that I need this surgery to succeed for the rest of my life & I don't want anyone to tell me that I can't have it because I worked too hard & lost alot & they say, well continue with that,,,or I didn't work hard enough & am not committed. PLEASE help!! thanks Denise — [Deactivated Member] (posted on June 27, 2007)
June 27, 2007
HI DENISE, NOT A SILLY QUESTION. MY NUTRIONIST TOLD ME NOT GAINING AND
NOT LOOSING WAS GOOD FOR ME, SO THAT IS EXACTLY WHAT I DID. I STAYED THE
SAME WEIGHT ALL THE WAY THRU THE 6 MONTH SUPERVISED DIET.
— Pam S.
June 27, 2007
Denise - I also had to go 6 months to my surgion before it was submitted to
my insurance company - but during this time period - I learned from the
Nutritionist about eating right and other helpful things! I even gained a
few pounds during the 6 months, because with all the bloodwork, the Dr
found that my thyroid wasn't working right - so, I didn't mind waiting - it
only took my insurance a coupld of hours to approve my surgery once the
Dr's office submitted it! Good luck - I am on my 7th month and have lost
102 pounds!
— PattyW57
June 27, 2007
ya know i have to laugh at what these nutrionists expect us to do....if we
could diet to begin with, we wouldn't need this fargin operation!
DUH!!!!!! i never bothered with this strict diet thing and even went on a
feeding frenzy beforehand and gained 20lbs! just maintain your weight and
you'll be fine...and just make little changes to your diet to keep the
nutrionist happy..there's another girl on here that got denied her
operation because she wasn't "fat enough" after listening to her
nutritionist and dieting....so i wouldn't worry about it....you'll be
dieting enough after your op....good luck!
— lizzie42
June 27, 2007
HELLO DENISE, I HAD TO SEE A NUTRITIONIST AS PART OF THE PRE SURGERY
BARIATRIC WORKUP MY BARIATRIC SURGEONS STAFF PUT ME THROUGH, AND THE
NUTRITIONIST JUST GAVE ME HER LITLE SPEECH AND SIGNED OFF ON ME. HOWEVER,
WHEN I SIGNED UP WITH MY SURGEON DR. PAUL ENOCHS BARIATRIC PROGRAM I
WEIGHED 466LBS AND HE CURRENTLY ONLY PERFORMS WLS
IN ONE HOSPITAL IN LOUISBURG, NC; AND THAT HOSPITAL HAS A POLICY THAT A
PATIENT MUST BE 400 LBS OR LESS TO HAVE A WLS IN THEIR HOSPITAL. SINCE I
WAS POSITIVE THAT I WANTED THIS SURGEON TO PERFORM MY SURGERY, I WAS FORCED
TO COMPLY WITH LOSING 66LBS PRE SURGERY. (NOT AN EASY TASK FOR MOST OF US
WHO LOVE TO EAT). MAYBE EVEN HARDER WHEN YOUR SPOUSE WORKS AT A NATIONAL
BUFFET CHAIN AND CAN GET YOU A DISCOUNT. ANYWAY, I BEGAN CUTTING BACK AND
DIETING ON APRIL 02, 2007, AND I HAVE LOST 58LBS DOWN TO 408LBS AS OF
MONDAY 06/25/2007. I HAVE 8LBS TO GO AND ANOTHER PROBLEM FOR ME WAS I
NEEDED PROOF OF MY WEIGHT FOR A 5 YEAR HISTORY AND REALLY DID NOT HAVE THE
RECORDS OR DOCTORS VISITS TO BACK ME UP. I PUT TOGETHER A VERY
COMPREHENSIVE 5 YEAR PICTURED WEIGHT HISTORY WHERE THE PICTURES HAD DATES
ON THEM AND I TOLD INSURANCE AUTHORITIES HOW MUCH I WEIGHED IN EACH
PICTURE, PLUS I WENT TO PREACH IN CAMEROON AFRICA SO I HAD PICTURES FROM
THAT AND I ALSO INCLUDED MY PASSPORT AND ENTRY AND EXIT VISAS WHICH
SUPPORTED THE DATELINE OF MY PICTURES AND THEN I PREPARED A NOTARIZED
STATEMENT AFFIRMING MY
FIVE YEAR WEIGHT HISTORY, AND PUT IT ALL TOGETHER IN A 48 PAGE PRESENTATION
FOLDER / BINDER AND WHEN I TURNED IT IN I WAS CONFIDENT IT WOULD BE
APPROVED PRETTY QUICKLY AND IT WAS APPROVED IMMEDIATELY ONCE THE INSURANCE
COMPANY GOT IT IN THEIR OFFICE AND REVIEWED THE CONTENTS. I TOLD YOU ALL
THIS BECAUSE, I HAVE COME TO UNDERSTAND THAT THERE ARE A LOT OF HOOPS WE
NEED TO JUMP THROUGH TO GET INSURANCE APPROVAL AND YOU MAY NEED TO DO
SOMETHING LIKE THIS NEXT AS WELL. I WOULD MAKE AN HONEST EFFORT ON THE
DIET, BUT REALLY YOU NEED TO FOLLOW YOUR HEART. I WISH YOU EVRY SUCCESS FOR
YOUR WLS EFFORTS AND IMPROVED HEALTH TOO, TOGETHER WITH A VERY HAPPY FUTURE
FOR YOU AND YOUR SON. I HOPE THIS HELPS YOU. HAVE A BLESSED DAY!!!
REV. LEVI
— [Deactivated Member]
June 27, 2007
For you to be successful with the surgery you have to learn how to eat,
that is what this 6 month diet history is about not so much a big weight
loss but to help you be successful in the long run. If you have weight loss
surgery and then eats chips and dips and pops and junk you will gain it
back eventually. This 6 month diet history is to maybe help you lose 10 20
pds it does show committment also just that amount even if you are 400
pounds helps get the liver smaller and make the surgery safer for you.
Don't mess it up on purpose, use it as a tool just like you use the surgery
as a tool. Learning how to eat is just as important as the small stomach
you are putting it in. God bless you on your journey, take whatever help is
offered to you.
— DonnaB.
June 27, 2007
Hi Denise. My surgeon requires the BMI be 60 or below and mine was 63 when
I started the process. Also, my insurance co (BCBS of MN) usually has a 6
mo to 1 year requirement of medically supervised dieting. Nola at the
surgeon's office told me she could usually slide it through with 3 months
and since I had to lose 30 lbs anyway, it was killing 2 birds with one
stone. Also, she did tell me that no insurance company would take you
actually LOSING weight while on your dieting program as a reason to deny
the surgery. Also, the lower your weight, the less risky the surgery. I
basically stayed on the high protein, low carb and sugar. No sodas, I drink
only crystal light or flavored waters (although I stopped the flavored
water becuase was told after surgery I couldn't drink the carbonated ones
and I don't like the non-carbonated ones). I eat 3 eggs with turkey
lunchmeat and one turkey smoked sausage cut up and mixed with it each
morning and really keeps me from getting hungry longer than when I just had
toast and and egg or two. For my sweet fix, I eat one of the Hostess 100
calorie snack packs (3 little cupcakes at 100 calories). I eat a frozen
meal for lunch every day (Lean Cuisine, Southbeach Diet or the green one
that I can't remember the name of). I do eat the larger ones, the
"dinner" size for lean Cuisine and also bring a salad with low
fat dressing. It fills me up. I have another snack in the afternoon,
usually almonds or cashews (which REALLY DO help with hunger and are high
in protein). I was amazed at how the protien made a big difference in my
hunger. I will eat a dinner of chicken of some kind or salmon or something
lean with a lot of protein, veggies like broccoli or cauliflower (not much
of a veggie person) and a small potato or some O'Dells frozen hash browns
(0 fat, 0 cal). Basically, I kept my caloric intake between 1500 and 2000,
but didn't watch that too much. I lost 13 lbs the first month, 8 lbs the
2nd month and 5 lbs the 3rd month and since have lost another 2 so I did
lose what i needed to and will continue eating this way up to surgery,
hopefully I will continue to lose some more as it does make me less of a
risk factor the lower my weight goes. Good luck, and don't worry about
losing or not losing. But if you can do it, it is better for you to lose
what you can just for the risk factor.
— itzmetami
June 27, 2007
I went to an oriontation last night with a Bariatric surgeon. He said the
main reason you have to work on losing weight before you have the operation
was because..........It helps them and you durring the surgery. The
reason,.The heavier you are the bigger and fattier your liver becomes. They
have to lift the liver with a devise in order to perform the surgery. It
also becomes slippery and so the amaller the liver the less complications,
the quicker the surgery and the better off you weill be health wise, He
requires his patients to lose a minimum of 10% of their EXCESS body weight
before he will do it. So, if you are 100 pounds over, just 10 pounds ect.
It is all relative to your excess body weight. I don't know about you, but
I want NO complications during my surgery so I will give it my best to do
what they expect. think about it??? From the surgeon and insurance
companies point of view. If it were easy everyone would do it..
— bderuiter
June 27, 2007
— crystalsno
June 27, 2007
Denise,
I have been writing a food log since January and sending it to my insurance
company each week. It is one of their requirements before surgery and I
also had to lose a certain amount of weight befroe they would approve
surgery, I did all they required and got approval. It is a pain in the
..... To write down all i eat but, I do it, so I can show them I can
succeed and lose the weight. I would be afraid not to what the want cause
then I would not be able to have the surgery that I so need. Think positive
and you will succeed in this new adventure of your life.
— Evelyn J.
June 27, 2007
As another so righteously put it if we could diet we would not need
bariatric WLS! At the same time I agree with the person who said we need to
lose weight because of our fatty livers that can get in the way, and cause
complications! How much do you think you can safely lose without them
refusing your request for WLS? I would say a safe weight loss would be
around 20 lbs or slightly more. I would not go crazy with it. I know how
your feeling many of us are and have been in your boat. Don't give in or up
so quickly! Wishing you all best with your sucess in the future. Tell them
if you weren't committed you would not be considering such a serious
surgery to save your health!!! Good Luck.. Sincerely, Judy R
— ozlady1000
June 27, 2007
Original poster here.................I want to THANK EVERYONE so much for
your responses,,,Please don't misunderstand, I DO want to do well & I
AM commited to this decision that I am making--getting to the appointments
IS hard for me, I am single mother, full time job, & I really don't get
much help from people to watch my son--so I have to juggle between making
sure I can pick him up from daycare on time & also making sure my job
doesn't FIRE my a&% for leaving early all of the time for the next 6
months!!!! But, so far work has been pretty supportive, I just hope as the
months go on, they remain that way. I KNOW how to eat healthy, I was a
vegetarian for 9 years & eat whole grain foods & lots of fruits
& veges--since I've had my son, I have added meat back into my diet,
but we eat more fish & chicken (YES, my 3 year old son LOVES fish) So,
this NUT should be fine, I just don't want her to be able to say I'm not
committed enough--or at the other end of spectrum that I've lost so much
& now CAN't have surgery--I've been up & down with weight for as
long as I remember my life & this "tool" is what I need to be
SURE that I can't let this happen to myself again!!!! Thank you all for
being so supportive & FULL of such valuable information!!!
— [Deactivated Member]
June 27, 2007
Hi Denise. I think we all struggle with those questions. But here is the
thing about your situation. Your integrity is more important than surgery.
I say do your best. You are a 47 BMI, and I personally think that even if
you try your best that you won't go below a 40 BMI in 6 months. Diet,
exercise and be honest. The truth of the matter is that if you could
conquer weight loss without surgery, why would you have surgery? You have
tried all your life, and you know yourself. This gives you the final
opportunity to prove that, so prove it. Then you have a clear conscience
and your personal integrity is in tact. Take care, Patricia P.
— Patricia P
June 28, 2007
Hi Denise, I asked my Nutritionist the same question at my first
appointment. She said the one thing she wishes she could get her patients
to understand, is that the insurance company will not reject you as long as
you are still within the required BMI to have the surgery. She told me
that, being that my BMI is 49, there is not a danger of me losing to much
weight, because when the year is up, I will still be within the guidelines
they require to have the surgery. I am working very hard at losing as much
weight as I can, and have lost 9lbs in 2 weeks, with the help of ALLI. My
thought is, the worst case scenario, is that, I, by some miracle, take off
100lbs or more in a year, and I won't even need the surgery, and, if I
don't lose enough, then at least I'm off to a good start before the surgery
Either way, it's a win/win situation! Do your best to get healthy during
this time. You'll be glad you did!
Blessings,
Vicki
— Jrsmomi
June 28, 2007
Hi, I was on the 6 mo. diet. I weighed 349 lbs. I put myself on a 900 cal.
a day diet. I did this to prove to ME that I can cut back, learn a new way
of eating, and I didn't want to die from my weight problems. I didn't do it
for the doc. or the insurance protocol. I changed EVERYTHING about the way
I ate, and exercised. My insurance pushed me through quickly. I lost 67 lbs
on my own during the 6 months wait. By no means did this hold me back in
the ins. eyes. It proved I was damn serious that I needed, not wanted this
surgery. It gave me a great start, training, what ever you want to call it,
what I would need to do after surgery to succeed. This has been my greatest
tool in staying with the program that is needed after surgery. Jean
— wonderfull5357
June 28, 2007
Im so glad to see that others besides me had the same question. I have
medicare and am required to do the medically supervised 6 month diet. My
BMI is like 57...and I am so ready to get the process started. I just hope
I can pass the psych exam. Thanks to those who answered.
— sdw1963
June 28, 2007
i am currently going through the supervised diet too. next month is my last
visit. the main changes i have made is to eliminate sugar and soda and cut
back on fats and carbs, i have made these changes based on what i need to
do after gastric bypass. i have lost 11 lbs and that is not much but good
enough to prove i have been trying and every little bit will make the
surgery easier on the surgeon. good luck the six months seems like a long
time but it will fly by. holly
— RNlvnCARSON
June 29, 2007
Wow, I too am on the 6mo. journey to cut back and learn how to eat right
and get fitter for the surgery. It is good to know there are others like me
out there who panic and wonder can I do it. So cutting back on sugars and
sodas is my milestone now and exercising. If I put my mind to it and stick
with it Im sure I can do it to the best of my ability.. Good luck to all
those on this journey as well..Oh and I think its wonderful to have such
great feedback from people that already been thru this and succeeded..gives
you more support and understanding. God Bless All
— phatazznettie
Click Here to Return