Question:
Is a BMI of 40.3 cutting it close ?

I am 5'3 and I weigh 227 lbs. I have been told by my surgeon who is doing the surgery I am a great candidate for the RNY. I have been told by other people that that my BMI of 40.3 was cutting it close? Do I need to gain more weight? HELP !!!!!!!    — Lesa S. (posted on February 15, 2003)

February 15, 2003
Hi- My BMI is 40.5 and I have a date for surgery in April. It all depends on your insurance and what they require. I would call them and ask. The National Institue for Health says BMI of 40 is Morbid Obese and that surgery is proper treatment. Why wait until it is higher? Why gain weight? Check with your insurance. Good Luck.
   — Jan S.

February 15, 2003
I am 5' and was 213, that is 41.6, I know its a little more but I got approved in 1 week and 5 months post-op I am 146, I am soooo glad I did not wait. Good luck, take care.
   — April G.

February 15, 2003
You are smart to recognize you have a weight problem - before your BMI goes any higher and you develop alot of co-morbidities to go along with it. As long as your insurance sets a BMI of 40 and your surgeon feels you're a good candidate - then you are on target. Good Luck! Sally, Harrison, MI :3/26/03
   — Sally P.

February 15, 2003
I'm 5'3" the day of my surgery my BMI was 40.7 Wt. 230 my ideal Wt. is 129. I was cutting it close too. You are morbidly obese and you do qualify. I'm 9 months post-op -90lb Wt. now 140.
   — charanewme

February 15, 2003
My BMI was 40.7...approved by insurance in less than an hour...I had co-morbids...do you have any that would help insurance make up their minds? I think you'll be fine...but if you have a co-morbid or two, you'll have a better shot. I had diabetes, sleep apnea, (get tested for that if you don't know---undiagnosed sleep apnea can be fatal during surgery), hypertension, etc!! Good Luck and Have a Sparkling Day!! ~CAE~
   — Mustang

February 15, 2003
I am 5'4", and at the time of my first consult my BMI was 40.1, tho I did have co-morbidities. My insurance approved in less than 2 weeks.
   — Carolyn I.

February 15, 2003
Start with calling your insurance and finding out what their guidelines are. That's what we did (more than once, ha,ha). My (Renee) BMI is currently 40.8 - my hubby and I are both scheduled for surgery this Thursday, 2/20/03. Document every ache and pain you have. Get letters from any doctors you see that can verify the health benefits of losing weight. Again, every insurance company is different, so pray you have one that is friendly toward WLS. We were approved in one week. I'm so glad that we decided to do this now, instead of waiting until we had more weight to lose! Best of luck.
   — jnc

February 15, 2003
I was just at 40 BMI when I had my consultation and my surgeon said that I, too, was a great candidate. The low BMI is part of what makes you a great candidate. Most insurance companies require 40 or above. Don't gain more weight! If the insurance company denies, it won't be because of your weight, it will be an exclusion or something else, but no reason to gain weight.
   — susanje

February 15, 2003
My BMI is 39 but my surgeon said I would still be a good candidate and should have no problems with the insurance company because I have co-morbidies. Hypertension being the worst.
   — D. Bell

February 15, 2003
Nah, don't gain anymore weight. Your insurance company most likely will cover you if it's in your policy. If not, good luck with self pay. BTW, who on earth told you it's cutting it close?
   — LionGirl2k

February 15, 2003
My opinion is that most surgeons would rather operate on those with a BMI just around 40 since the chance of intra-operative and post operative complications is less. Surgery is easier for them, recovery is easier for you. Honestly, at 227lbs., you will be able to move better after surgery than if you were carrying another 50 or 100lbs. This is not a slam against the members here who weigh a lot more, just my opinion. No doubt there are plenty of folks who weighed a lot more and made it their business to get going after surgery! I am just saying that you are fine! Most insurance companies use the language "equal to or greater than a BMI of 40".
   — koogy

February 16, 2003
I don't think you are cutting it too close by insurance standards. I wouldn't gain weight just to have the surgery that defeats the purpose, not to mention that it's unhealthy. I didn't gain weight to have the surgery, I already qualified, but I did put on weight before the surgery and I felt like crap.
   — Karen E.

February 16, 2003
No, as far as the surgery goes, you're just fine. However, I know my insurance requires you to prove that you have either had a BMI>40 for the last 5 years OR a BMI>35 with co-morbidities. Check with your insurance and see what their requirements are.
   — Carolyn M.

February 17, 2003
If you're nervous, just report your heighth as 1/2" shorter than you are or wear heavy clothes when you go to see your surgeon for the initial consult and weigh-in. That will pump up your BMI. (No flames please).
   — Kathy J.

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