Question:
what if my BMI is only 33 can I just bring it up to 35 to qualify?
My research shows surgeons in Mexico will do the surgery with a BMI of 33- however I choose to do it in US-I have medicare and they will not do it unless I am 35-I have several factors that accompany the weight-osteoporosis,sleep issues reflux.etc.I feel like my only recourse is to stuff myself to get to the 35- isn't this counterproductive- any comments suggestions? PLEASE HELP!!!!!!!!! — irish248 (posted on November 28, 2005)
November 28, 2005
Hi, you are between a rock and a hard place. Have you had an evaluation by
a surgeon yet? If you have enough co-morbities, they may consider you. It
is really up to your surgeon. Start with a good evaulation and see how it
goes from there.
— shoutjoy
November 28, 2005
Hi - I was in your same situation. I brought up my BMI for nothing,,, be
cautious, some insurances require you be over a 35 BMI for a specified
amount of time. Mine was 5 years so I put on the extra weight for nothing.
I ended up going to Mexico for surgery...
— kimmy
November 28, 2005
You are really taking a gamble with that kind of thinking. The bmi
threshold is set to balance out the risk of surgery versus the risk of
obesity. So if you have a bmi of 33 your co-morbid risk is a lot lower than
the risk of death or complications surgery.
Also, if you don't have documented, medically treated co-morbidities
(generally speaking, High blood pressure, diabetes to name a few) a bmi of
35 won't be enough to get you approved.
I don't want to sound insensative, I know how hard it is to be obese in
this society and I know how it can hinder your life. But this surgery and
the life you have to live after it is not easy either.
Please consider your options before you decide to gain weight.
Take care!
— Rachelq
November 28, 2005
The Medicare guideline is as follows:
100.1 - Gastric Bypass Surgery for Obesity
(Rev. 1, 10-03-03)
CIM 35-40
Gastric bypass surgery which is a variation of the gastrojejunostomy, is
performed for patients with extreme obesity. Gastric bypass surgery for
extreme obesity is covered under the program if (1) it is medically
appropriate for the individual to have such surgery; and (2) the surgery is
to correct an illness which caused the obesity or was aggravated by the
obesity.
Make sure your Surgeon has documented the illness(es) you have which are
caused by or aggrivated by obesity.
Please remember, the lower your pre-op BMI, the less weight you will lose.
The decision to make the cut-off 40 and 35 is based on outcome studies and
not arbitrary.
Yes, you are close, but intentionally adding weight is irresponsible. Seek
treatment for your conditions and maybe you can continue to bring your
weight down. You were 34.2 and are now 33 - keep up the good work.
— nursenut
November 28, 2005
I invite you to come to the DS forum and review micheal ordeal about
surgery, hes on his fourth sugery in 4weeks, and we are praying that he
lives, this is not to be taken litely, been on bipap for ten years, easily
managed, had it before obesity, ostoporosis, from atheletics, reflux, again
befor obesity,also caused the apnea, I will have wls to cure my diabetes
type 2 , more then for obesity, I am a 37-40, if i was a 33, and did not
have a diabetes 2, i would not consider wls at all, definitely would not
consider the rny under any circumstance. that way of life is very hard, you
need a reality check, I have been persueing a ds (cannot have a rny,not
compatible, for 10 months). come to the ds forum. read mikes story, think ,
of the risk, and diet.
— walter A.
November 28, 2005
in Mexico, some also sell their sisters. too.
— walter A.
November 28, 2005
Janet, I REALLY don't want to come off insensitive here, so I will do my
best. WLS is a HUGE life altering surgery, it is not easy, it is not fun,
and it is a last course of action. This surgery is for people who's health
risks from being morbidly obese outweight the risk of death or
complications from a major surgery. My BMI was 43 at the time of my
surgery and I was considered a lightweight....your BMI is where some of us
end up AFTER surgery. When I see someone (on here or people I know)
comment on how they want to gain weight to be approved, I'm a bit offended.
Now, that aside, co-morbs for approval on a low BMI need to be more than
reflux and sleep issues. You need serious, medically documented diseases
with a BMI under 40. Also, osteoporosis isn't a co-morb and very well
could exclude you from this surgery all together. (Depending on the type
you choose) Like I said before, I'm not trying to offend, but I feel you
deserve an honest answer. Good luck in your endeavors.
— RebeccaP
November 28, 2005
Ahh I know several persons who were technically undeweight and went on to
do very well. Family histories of co morbids, drove them to it.
— bob-haller
November 28, 2005
Why would you want to gain even more weight? Please, consider yourself
lucky that you aren't where a lot of us where. If you BMI is 33 you CAN DO
IT!! We'll be here for you. Surgery is just a tool not a end all. You
still have to exercise, watch what you eat and how much you eat. (Diet if
you will) I don't mean to be harsh, but the are a lot of disadvantages
too.
— WilsonCrimson
November 29, 2005
Can you HONESTLY say that you have FAITHFULLY followed a good diet and
exercise plan? I think that most overweight people make excuses for their
excess weight and see WLS as the "MAGIC Bullitt". There are many
risks associated with WLS and I'd advise anyone (BMI >35 or not) to
really consider the LIFELONG consequences of this decision. Keep a food
journal, documenting everything you stick in your mouth. You'd be
surprised at how much you really eat without thinking about it. get out
and move, walk your dog, go to the gym, hire a personal trainer to keep you
on track. Remember, once you have the surgery it's for life. If I had it
to do over again, I'd have worked harder when my BMI was 33 to lose the
weight on my own instead of waiting until I was 370 lbs where I had no
choice. I don't regret my decision to have WLS but I'm not quick to
recommend it to anyone especially those that are just borderline.
Also, you need to get a good psychiatrist and take a look at why you are
overeating. Get an anti-depressant if you need too. I take Effexor and it
really helps with the issues that caused me to turn to food as my
comfortor. Let's face it, we're all overweight because we OVEREAT. The
'it's my genetic makeup' excuse is Bullshit. It takes 3500 calories to
gain a pound regardless of your genes. Cut out the fast food, the
Starbucks, the snacks/candy/chips etc. You'll find that this helps.
I don't want to sound negative, but I really feel that you'd be better off
by losing weight without resorting to gaining just to get WLS. Good luck!
— jean.campbell
November 29, 2005
My BMI was 32 and I had co-morbidities of High BP and pre-diabetes. My
insurance paid IN FULL and a surgeon in the US of A did the procedure with
flying colors. Please don't consider eating yourself to death in order to
get this procedure done, it's not worth it. You run the risk of not even
qualifying once you have gained the weight and risk other weight related
health risks Ie,,, diabetes, high bp, heart attack or even
worse.......Also, this surgery is pretty life threatening (might want to
think about that before you consider having the surgery in Mexico)
— [Deactivated Member]
December 15, 2005
Janet!!! Stop thinking like that this instant......it will not profit you
to do such things....you will be fine if you seek the right types of
attention for your self. You are in a bind, yes...but you must reconsider
this option...Gaining weight to have surgery is an outragious way of
thinking. You are already in a mess due to your obesity, adding weight will
make you more miserable and not having an absolute answer for this will
cause you much more adversity in the long run. When i started this process
my BMI was 59.2....I have severe arthritis which left me in a wheel
chair...I had surgery to make myself healthy. Do the same for your self
now...You can do it...Start now, take good care of yourself, diet and
exercise get proper medical attention...seek support, support support and
support, by the way have I mentioned support? You may have issues now but
adding weight will only make your life worse....God Bless you on your
journey...feel free to email me any time you would like to help you deal
with this....Rae
— Rae Ann P.
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