Question:
PCP THREATENS TO DISCONTINUE 6MO DIET PLAN

PCP THREATENED TO NOT CONTINUE 6 MO SUPERVISED DIET IF I DON'T LOSE ANY WEIGHT. I HAVE ONE MONTH TO GO AFTER THE UPCOMING VISIT END OF JUNE. WHAT DO I DO?? SINCE GHI REQUIRE 6MO PRIOR TO APPROVAL. I'VE COMPLETED ALL REQUIREMENTS EXCEPT THE 6 MONTH DIET PLAN. ANY SUGGESTIONS IS HIGHLY APPRECIAATED. MERIDIA WAS PRESCRIBED ,BUT I DO NOT WANT TO TAKE IT. ALSO I WAS THINKING ABOUT OPTIFAST?    — T L. (posted on June 12, 2004)

June 12, 2004
I don't mean to be harsh, but I don't see that you have much choice but to lose some weight. The insurance company requires it, and your doctor requires that you show that you're trying. If you don't want to take Merida, then lose some weight another way--try some kind of traditional diet, or Atkins or South Beach or Sugar Busters. Even if there were a way around it (and I don't see one), I don't think it's a good idea to circumvent the requirement. You will have to regulate your eating after surgery. The surgery will help you lose weight, but you will forever have to control your eating. One reason many docs and insurance companies require a weight loss plan prior to surgery is to be sure that you can do that post-op. If you cannot, then you need to consider whether surgery is really the answer for you. It would be terrible to go through the surgery and recovery only to regain all the weight because you couldn't adapt to a restricted eating program. You need to commit to that now. If you need help with a diet, or decide not to use Meridia, then talk with your doctor about that. Perhaps s/he could refer you to a good dietitian who could design an eating plan you can live with for six months. Best wishes.
   — Vespa R.

June 12, 2004
Some surgeons require 20 -30 lbs. This may be good practice for you.
   — Robert L.

June 12, 2004
Try Atkins for a week or 2 until you see your Dr.. It is pretty easy to follow, and you should lose 5 to 10 pounds in the 2 weeks til your appointment. Even if you show a small loss, your Dr. should continue your diet monitoring. As the others have said, you will have to do some diet monitoring as a post -op, so trying any routine diet plan is good practice. Good luck!!
   — Fixnmyself

June 12, 2004
Well, many of us have done Optifast with great short term results. I did it 12 years ago and lost 60 lbs. I gained those 60 plus another 70. I would recommend trying other things to meet your physicians requirements and qualifying for the surgery. Good Luck!
   — brinkman_d

June 12, 2004
First of all I do not believe in weight loss surgeons who insist that you lost X amount of weight before they will operate on you, other than for health reasons to make surgery safer. That said, if your insurance requires a 6 month supervised diet to get approval then I feel you have to try and comply and give it an honest attempt. Losing some weight isn't going to prevent you from getting approval, unless you are on the bubble to begin with, but it is going to show a committment to a new life style. The docs and insurances know that the long term issue is keeping any lost weight off, not necessarily losing it in the first place. You are going to have to make a lifetime committment to new healthy lifestyles and choices, so why not start now and prove to yourself that you can do it. <p>My surgeon did not require any weight loss, and I was a SMO at 442 lbs, but he did require a protein and veggie diet only for the two weeks before surgery to shrink our livers. So I ate as much protein as I could shovel in and with veggies and deviated very little from that request and ended up losing 21 lbs before surgery. That was 21 less I had to lose after. It made me just that much healthier going into surgery. If this is something you really want then you need to make up your mind that you will do whatever it takes to get approval and on with your new life. I'm sure they are not trying to say that if you lose some weight you don't need the surgery they just want to make sure you will do what it takes. This is a very risky surgery, no matter how healthy you are. They are permanently rerouting your intestines and doing permanent changes to your stomach. It is not something to be taken lightly. <p>Track your foods on Fitday.com and write down your exercise. Show your PCP that you are serious and I'm sure he will continue to work with you. I'm not trying to be judgemental here, just trying to push some reality at you. Good Luck! I know you can do it!!
   — zoedogcbr

June 14, 2004
If you are not compliant with a doctor supervised diet pre op are you going to be compliant post op? As far as Chris D's comment on weight loss surgeons requiring you to loose weight pre op, Chris D it is not the surgeon that is requiring her to loose weight, it is the PCP. Why don't you want to take the Meridia? If that you help you curb your appetite I would go with it and who knows may be you will loose a little weight in the process?
   — ChristineB

June 15, 2004
So, just lose two or three pounds. I did and was still approved. You can read more about it in my profile if you like. K
   — Kimberly S.

June 15, 2004
If you do not want to take Meridia, so be it, but find a diet you can live with if you want the help from your PCP to get your 6 mos. supervised diet documented. I do not agree with WLS surgeons insisting upon it, but some believe that it's an indication of your willingness to follow the rules post-op. Not meaning to be harsh, but if you've done this for 5 mos. and not lost any weight, can you really follow instructions post-op? and believe me, following instructions post-op is crucial to your success--because you're going to have to do that for the rest of your life.
   — Cathy S.

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