Question:
I am Obese, BMI 30....why do I have to gain...to be a Canidate?

I wasn't sad and depressed emotionally, till I approached 3 good Bypass surgery doctors, and was flatly turned down for this operation. I am unhealthy due to this weight...I am 5'7...202 lbs. and have health troubles now due to this weight. What do I have to do to get a doctor to do this...get worse health wise, then I already am? Wanda McIntire    — Wanda M. (posted on January 10, 2004)

January 9, 2004
Wanda, I am not saying this to be mean or ugly but being 5'7 and 202, unless you have some MAJOR co-morbs, you DO NOT meet the requirments for WLS. Your BMI is 31, yes that is obese but there is a big difference between being obese and MORBIDLY obese. You need a BMI of 40 or higher unless, like I said, you have some SERIOUS medical problems caused by your weight. I was a "lightweight" when I had my surgery 5'7, 276, BMI was 43, but I had co-morbs. If 3 surgeons have already turned you down then you dont need surgery to lose. Sorry. Good luck to you no matter what path you take. ~Sidney~ Open RNY 10-23-02
   — Siddy I.

January 9, 2004
This came up at our support group meeting the other day. From Dr Philpi Schauer. Nearly 13 years ago the NIH wrote the guidelines for WLS. Atr the time surgery was a lot riskier than today, and not as well understood.Surgery helps not just those MO but thoise with serious health troubles that dontr qualify under present guidelines.<P> You might try self pay for the lap band. Hopefully the NIH will look at these issues again. Insurance wouldnt like covering BMIs of 30, my guess 60% of the population would qualify.
   — bob-haller

January 9, 2004
I agree with Siddy. Your BMI is not nearly close enough to qualify. You are so close to being being just in the overweight category. I really think you should do some more research on what WLS is and who qulaifies. Good luck to you!!!
   — [Deactivated Member]

January 9, 2004
Wanda, I understand your frustration with not being able to lose weight. Although the criteria was created by the NIH many years ago, it is still based on sound medical judgement, It is still drastic. It is not a way to lose weight quickly. It is not a cure for obesity. If your BMI is 31, and you have surgery, then someone whose BMI is even less will think surgery is appropriate for them. Eventually we would see people who have 20 lbs to lose having surgery.WLS is just not meant for that. You can go one of two ways - gain a lot of weight (which I think is foolish,since you say you already have health problems related to weight) or really start eating right and exercising (as you would have to do after surgery, anyway) and lose the weight. You might find someone to to a lap band, as the other poster said.
   — koogy

January 9, 2004
You said in your profile that you have a thyrod problem that puts on weight. Why in God's name would you want to have your body cut open, (if an open it is tough), go through healing, learning how to change your WHOLE LIFE, when PERHAPS a thyrod drug may help you (at least with a LAP BAND) to lose alot of weight???? I don't get it. If they had told me I had a thyrod problem I'd found a way to do cartwheels at 319 as I wanted ANY OUT EXCEPT WLS to lose this weight. This is an awesome serious thing to do to your body. I know you have many health problems. But do look into that tyroid problem. I would be happy for you, IF that turns out to be the real problem.... the problem to help you avoid having to have your guts altered FOREVER (or at least for this side of the Grave or the Rapture). Shoot I'm over 2.5 years post op and my BMI is ALMOST AS HIGH AS YOURS IS NOW!!! WLS is NOT a magic bullet. Please FIRST get that tyroid problem solved. Betters meds than cutting your guts and all the risks that come with it.
   — Danmark

January 9, 2004
Smart doctors. Being simply obese does not qualify you for this surgery. You must be morbidly obese which you clearly are not. See,s you are lookin for a quick fix and this aint it.
   — Delores S.

January 9, 2004
AMOS MOD HERE!<P> Now lets be nice. Not knowing her medical troubles we cant really know how important it is to get the weight off. Or how much healthier such loss could get her. Of course everyone who has gone thru surgery knows it can be dangerous and scary. But its up to the individual to know whats worth it. I hope wanda tells us a bit more about her co morbidities. I have heard the adjustable band was being looked at for lower BMIs and a self pay for that may be possible. Lets try to remember we all have the mutual enemy of Fat. Its just as hard to loose 70 p[ounds as 100. Fact is everyone who is 100 pounds overweight was at one time 70 pounds overweight.
   — bob-haller

January 9, 2004
Bob, lets be nice??? Who is'nt being nice? If someone is about to drive over a cliff and you tell that person, you are not being nice? Come on Bob... I respectfully disagree with you this time. This person already admitted to a thyroid problem. This tends to be one of the first things they check when you want WLS. Man I really hoped I had that problem. Imagine being able to take medicine that MIGHT have helped that and because of that to lose weight WITHOUT having to be cut open. Wow, I think alot of us probally hoped the same thing. I've read the other posts over 3 times. I could'nt detect one person not being nice. What posts did you think were mean? I can't speak for the other people, but I sure wish this lady the best and that is why I mention to try anything BUT wls! It really is a last resort. Thankfully my weight fluxs from 157-163 so I feel fortunate to have kept my weight off. However I"m still in the overweight range... almost were this lady who wants wls is now! Is it being mean to suggest so look into getting that thryoid problem fixed so she does'nt have to go through all the pain of surgery and life long changes. PLEASE, give me someone so mean in my life to help me avoid pitfalls. ;) Bob, I respect you, but I think you are way off on this one. No one who has posted yet wishes this lady anything but the best, myself included. :)
   — Danmark

January 9, 2004
Wanda, I know what you are feeling, I really feel for you. Honey, there are programs out there for you to help you loose weight. You may need to go with somthing like Weight Watchers, Jenny Craig or maybe your local hospital has a program available. Weight Watchers is a really sound program and they have free registration for the month of January and their program advocates doing it for the rest of your life. If you have a Curves by your house maybe you can join it. Or a Y or a local park district that may have a fitness center. You can do it girl, but you will just have to go down a different road than a person that has had WLS. I had WLS and am a member of Weight Watchers, I just joined so I can loose the last 30+ pounds to get to my personal goal. Good luck you can do it!
   — ChristineB

January 9, 2004
Dan previously these sort of post start like this one did and go downhill. Its just as hard to loose 70 as 100 or more. Besides my step sister has thyroid trouble, and was properly treated. Her weight continued up, and she is now MO, with health troubles:( If she gets WLS NOW it will be riskier than 3 years ago at 70 pounds over like Wanda here is. Personally I think lightweights with helth troubles should qualify for some soirt of surgery rather than making the wait till their sickier and more at roisk from surgery.
   — bob-haller

January 9, 2004
The doctors always lead me to believe that if a tyroid is treated you can always lose the weight. It's just that I have been through so many medical procedures (15 surgeries, 16th will be in two weeks) that I really wish with all my heart for no one else to have to go through any of the crap I've been through. Misry does'nt like company IMHO. ;)
   — Danmark

January 9, 2004
BTW although pre op I was scared to death of being cut open as a postie I look at my RNY as having fixed my life long problem! In NO WAY do I feel mutilated or anything like that!
   — bob-haller

January 9, 2004
I too have thyroid problems. My surgeon would not do my surgery until my levels were stable for at least 3 months. Besides, what I've read the TYPICAL weight gain from thyroid problems are less than 30 pounds. Not sure if that is true or not (read it off a website somewhere) but I havent had any problems losing weight and I still have to take meds.
   — Siddy I.

January 9, 2004
Dan I hope theres a safe effective pill for weight loss someday. Till then surgery is our best option. Its sad that some people who get their thyroid treated continue to gain weight. In my sisters case it just slowed a bit:(<P> Dan also members should know the vast majority of your surgeries were not weight related.
   — bob-haller

January 10, 2004
What are your medical conditions? My sister is 5'7 and about 180 and looks a tiny bit overweight but pretty normal. I don't mean to sound negative but I sincerely doubt this surgery is for you. You should have this surgery if being overweight is killing you. You would need to gain 50-60 lbs to qualify for this surgery and that would mean endangering yourself for a heart attack just to get the surgery. I know it's hard if you feel like you are only going up in lbs but gaining 50 just to lose 75 or 100 seems not worth it to me.
   — mrsmyranow

January 10, 2004
If you have approached three different doctors and all have told you this surgery is not for you, than I think you need to listen to what they are saying. Those doctors know your medical conditions, we don't. But I would think getting a second or even a third opinion as you have and all have told you this surgery isn't for you, than you need to look at other alternatives to lose weight. Weight loss surgery is generally the last resort of morbidly obese. You can qualify to be morbidly obese with a BMI of obese if you have co-morbid conditions that are threatening your life and your quality of life such as high-blood pressure, diabetes, sleep apnea, etc.
   — Shayna T.

January 10, 2004
It is hard being over weight, you will try for anything to get it off. That is why people make money selling 'magic' pills to the masses. But Wanda, your BMI is what some WLS patients end up at, not start at. I am not meaning to be cruel here, but this surgery is intended for those that are far far larger than yourself. I had surgery with a BMI of 43, and I have told many people that if I was the all approving WLS god, I never even would have approved ME to have this surgery.
   — RebeccaP

January 10, 2004
I'm 5'7" and was 355 (bmi 55) when I was approved for surgery. You are not even 100 pounds overweight. My goal is to be about 200 and 5'7", so REALLY, you're not doing that badly. Your at the stage where diet and exercise will help. Gastric bypass surgery is for the morbidly obese, not the overweight. I wish you luck and pray you will never NEED gastric bypass surgery. You're lucky.
   — terriny

January 10, 2004
Please forgive me for posting one more time. Bob is right in that MOST of my medical problems were not related to wls. But SINCE WLS I have many MORE problems added to the other ones. My gout still remains. But thanks to WD-40 I can treat it effectivly. But my arthritus has speed fast and is still spreading. It was ONLY in my knees and neck PRE OP. Now also in my shoulders and worse in my hands. I had no idea how painful it could be. I believe the arthritus in my hands is due to wls. I can't stand ANY pressure on my stomach or I'm in alot of pain. Probally have an ulcer. The pain is worse since my gallbladder was removed. I HAVE NO ENERGY. Feel like crap. I had more energy and was in less pain BEFORE WLS. So, yes while I did have problems, I have a he## of alot more of them now. So I hate the thought of someone who has been turned down by three doctors (believe me, if they thought they could get money by doing surgery on her they would! I know doctors) who has a thyroid problem that perhaps has'nt been at least "tried to be treated" going through all the long ordeal and pain of surgery. It's funny that only one person posting here has a different view. <wink>. Wanda, I know how frustrating weight is, but please TRY to treat the thyroid. If it works great. If not, you should be in alot better postion to get a lawyer and fight for wls. At least you are lucky in that you are tall. You should be 5'3 and weight 319. I'd give anything to be your height. Don't give up, but don't close the door ether by refusing to try treating the thyroid. You may be fortunate enough that it will work for you.
   — Danmark

January 10, 2004
I am 5'8" and weigh 205 with a BMI of 31.2. I have problems with severe pain in my hips, knees, shoulders and back. In other words, I am pretty much like you. The difference lies in that I had open RNY 2/02 when I weighed 325 and I am so grateful to weigh 205 and to be able to move and do things I could not do before. I take pain medications along with my vitamins and watch my diet carefully. I cannot exercise because of Chronic Fatigue Syndrome/Fibromyalgia. I'm just writing to say we are standing in the same spot, one with a cup half full and one with a cup half empty. Perhaps some therapy would help. Seeing a rheumie for those knees and getting meds and maybe cortisone shots might help. Consider an exercise program. Have you tried the South Beach Diet? I've heard good things about it. Also, keep track of what you are eating on Fitday and see where you can alter or cut back. Good luck. Nina in Maine
   — [Deactivated Member]

January 10, 2004
No insurance company will cover it. And I don't believe you will find a surgeon who will perform the procedure for you. The general rule seems to be BMI of 40 or greater, or BMI of 35 with serious co-morbids. And those of us who have lower BMI's still have trouble getting insurance to pay. This procedure is not done for cosmetic reasons.
   — Kara J.

January 10, 2004
All I can say is keep trying! the day I went in for surgery my BMI was 33.3, and I was not required to loose weight for the surgery. My surgeon saw it as a way to prevent me from getting bigger. What is your weight history. Mine has slowly been creeping up over the years. Don't let what people say get to you. You will find out as I did, that those that we don't really fit into the skinny crowd, yet even though we are over weight with problems a lot of people on this site will not accept you as part of the group either. Don't ever give up! This surgery was the best thing I have ever done in my life! If you want to talk more email me. Bridget Mini Gastric Bypass 11/18/03, 234 lbs, now 196 lbs.
   — Mini Gadget

January 10, 2004
You'd have to be at least 225lbs and have co-morbids (diabetes, high blood pressure, high cholesterol, sleep apnea, arthritis, infertility, stress incontinence, family hx of the above or cervical cancer, previous weight loss attempt documentation (weight watchers, Rx Phentermine, etc..,)pictures & a letter of necessity from your family physician. Good luck with everything.
   — jengrz

January 10, 2004
Gain weight to have the surgery? Wow, how sad that people think this surgery is so magical that they will intentionally gain weight to have it. Those of us who have had it, and have *chosen* to take it all the way to thin, know that it ain't no walk in the park. Most of the folks that I personally know that had the surgery around the same time I did (two years ago) have settled for chubby and are thrilled to just be able to get up out of a chair themselves and wipe their own behinds. Now, I, on the other hand, am insanely obesessed with dieting, exercising, diet pills, weight lost shrinks....the whole nine yards....so guess what, to get thin with surgery you still have to bust your @ss to do it, at least for the vast majority of us. ...so skip all the hassle of gaining weight, fighting insurance, getting your innards rerouted, only to have to diet and exercise anyway...and just diet and exercise. Kim open RNY 7/17/01
   — KimBo36

January 10, 2004
This is just my opinion but if I were in your shoes I would keep trying other options, I know that it doesn't always work and I am living proof of that but I am thinking that there must be alot of reasons that 3 drs turned you down. I wish you all the luck in the world, but don't gain any weight just to get this surgery.
   — Saxbyd

January 10, 2004
My heart goes out to Wanda. I understand completely how it feels to have some magic number thrown out at you (40 bmi) with no consideration of who you are as an individual. I'm 5'2" and weigh in around 210 (bmi 39). I have hypertension, fibromyalgia, and cerebral palsy with a lot of joint pain. I had two Dr.s (PCP and Gyn) write letters recommending wls for me. And yet my insurance has denied me because of lack of medical necessity (all appeals have been exhausted). I'd be willing to bet that if the medical reviewer spent 1/2 day with me I'd be approved in a New York second. And the way my policy reads, gaining 15 pounds may not be the magic bullet, as they stated in the denials that I didn't have any "uncontrolled" co-morbidities...never mind that the meds that keep me in "control" also make me sick every day. Fortunately, I have a caring surgeon, and the means to self-pay and I'll be having wls on Feb. 4. When I got my first denial, I had not considered self-pay, and I thought that was it...game over. So I do understand how it feels to be denied, and feeling as though you're going to be the last overweight person in America because you can't lose the weight conventionally, and you've been denied the surgery. And I know how it feels getting up every morning in incredible pain, and thinking it's going to be that way for the rest of your life. Wanda, please know I'm keeping you in my thoughts and hoping you'll find the strength to keep on searching...because trust me, the right solution (or opportunity) will come to you, sometimes it just take time.
   — Le P.

January 10, 2004
The only thing is, Wanda, that some insurances require you to have a BMI over 40 for at least 5 years. I guess you COULD gain to be a candidate, but I don't know if you want to be morbidly obese for 5 years and still take the chance of being denied. I wish you the best. Terri
   — tinky471

January 10, 2004
Wanda, Did you realize that with only a 12 pound weight loss you would be out of the obese category. I never would have had this surgery if I weighed what you do now. I'm about the same place you are now...5'6" and between 195-200 and am still obese after losing 180 pounds. I also have hypothroid, aching knees and back(from carrying 350+ pounds for over 10 years)and I still take medication for high blood pressure. Since my WLS I have also developed iron deficient anemia for which I am receiving DAILY iron infusions and low levels of B12 for which I take weekly shots. With my highest BMI being over 60 my weight was killing me. These things are a small price to pay to be just "obese" and there are other risks invloved in surgery. You are still at a point where you can take control of your weight. I would have given anything to be able to start where you are now and not to have had to take the drastic step of WLS.
   — Pamela B.

January 10, 2004
Wanda, I know how hard it is to have your heart set on having surgery that will potentially save your life and have someone tell you know. I am 5'6" and 287lbs. I have diabetes and my kidneys are not very strong. My insurance company denied me surgery because of an exclusion. But wanda, there is light at the end of the tunnel. I have been on Atkins for 2 weeks and have lost 19lbs. I know it is a lot slower loss than if I were to have surgery, but it is a loss and if you do it and stick to it you could loose just as much weight as you would had you had the surgery. Keep trying :)
   — harleigh2002

January 11, 2004
My mother always said, "If you hear it in stereo, you might want to listen". I think your surgeons are trying to tell you something and you need to really think about it. God obviously has another plan for you. Surgery is NOT the easy way to lose weight - it SHOULD be saved for those who are morbidly obese and are at the end point. My dear, you are NOT dying of obesity - you are barely obese! For the sake of keeping insurance coverage for those who are morbidly and super morbidly obese, I am glad your surgeons turned you down. It is better for other's in the long run. I wish you the best of luck in the future. Perhaps you should give Weight Watchers a try. You could lose 20-30 pounds pretty quickly by following thier guidelines - which would probably make a major difference in your joints!
   — MissKimberly

January 11, 2004
I do not mean to minimize your problems, but many people have this surgery in hopes of getting to the weight or BMI where you are now. This surgery is for people who are MORBIDLY OBESE, not those individuals who are just considered obese. It is a drastic solution for those who are at least 100 pounds overweight or those individuals with a BMI of 35 with comorbidities. Should you gain weight to qualify for this surgery? Not if you are 12 pounds from having a normal BMI! If a surgeon did operate on someone in your situation I would have to question his/her ethics and wonder if he/she should have a medical license.
   — Kristen S.

January 11, 2004
I don't know anyone who's lost 10 lbs. a week for very long after WLS. If you're losing at this rate, you go, girl! DOn't worry about surgery . . . my doc looks for a 10 lb/month avg. A previous poster said . . . <p> "I have been on Atkins for 2 weeks and have lost 19lbs. I know it is a lot slower loss than if I were to have surgery, but it is a loss and if you do it and stick to it you could loose just as much weight as you would had you had the surgery. Keep trying :) - jeannie charlson <p> And for the original poster . . . <p> Try Atkins, etc. This surgery *is not* easy. There's pain, adjusting to re-reouted plumbing, which involves more pain, changing our whole relationship with food, taking mass quantities of protein supplements and vitamins. Dealing with gas, diarrhea, "stuck" food (which involves a lot of pain), the possiblities of complications . . . <p> I did it, I'd do it again tomorrow, and I've had a fairly easy ride. But it's *not* a magic fix, and I'm only a few pounds less than you, after having lost 125 lbs in 10 months. <p> I'd bet your insurance will pay for counseling, which I'd suggest is a great tool, even if you do have surgery. Maybe you can explore *why* you think that gaining 50, 75, or 100 lbs is easier and better than losing 20-25? <p> Do you really think that giving up *eating* is a fun or easy thing? Imagine not being able to eat more than 1/2 cup or so of food for the rest of your life? *shakes head* <p> Good luck with your journey . . . I really hope it is a short, pain-free one for you.
   — RWH G.

January 11, 2004
I notice that in your profile, you say you need to lose 70 pounds (down to 132). However, a loss of about 40 pounds puts you in the "normal" BMI range. I'm only 5'4" and my surgeons goal for me is 131. This is major surgery and is not intended for those with 40 pounds to lose. As for your co-morbids...the thyroid problem with never go away. I have been hypothyroid for 12 years - it's lifelong. The incontinence may or may not be taken care of by weightloss but it's not considered a co-morbidity since it's not a potentially life threatening condition and, depending on the cause of your aching joints, weightloss may or may not take care of that. If I were in your shoes, I'd ask my PCP to refer me to a dietician and work closely with him/her to find a eating program that you can work with. Also, some forms of exercise can help with the painful joints, shortness of breath, etc. Ask your PCP what you can do to help yourself. Don't consider these responses a slam. Most of us have gained and lost 40-50 pounds (or more) many times over during our battles with morbid obesity. I was considered a lightweight (238 surgery weight, 248 all time high) and even I have lost 40 pounds on a multitude of diets. Be grateful that you need to lose so little to be BMI "normal". If you don't feel that you can lose this weight with dietician/PCP, you'll have to self-pay because I can't imagine insurance paying for it and I'd definitely consider a band, not RNY. However, I would definitely question the ethics and motives of any surgeon willing to do this on somebody with your BMI and lack of SEVERE co-morbidities. Good Luck.
   — Carolyn M.

January 12, 2004
Wanda: I wish there were "something" in the surgery line that would fit your case. I feel for you, because it's so difficult to lose weight, no matter how much we have to take off. As for your amount to lose, 70 seems like a lot at your height. I'm also 5'7", currently weighing 195, and if I make it to 170 or 165, I'll be very happy with that, and would be considered successful, having started at 270 (my highest pre-op weight). My frame is large, though, so I feel I would be fine at the high end of my "normal" weight range. My own most successful attempts at losing prior to WLS were Weight Watchers (I lost 25 the last time I went), and Atkins (lost about 20 on that). I still can't explain to you why I didn't "stick with" either plan - they are both good and if you stay with it, you will lose. Of course, if we knew the answer to that part of the problem, none of us would have to have WLS! I hope that you will find the answers you are seeking. Best wishes.
   — Carlita

Click Here to Return