Question:
has anyone been denied because you have lost weight in the past?

i am 40 yrs old, 5'2", 400lbs, been over a hundred lbs over weight for about 20 yrs, i have asthma, sleep apnea, degenerative joint disease, gallbladder disease, incontinance, shortness of breath, depression, etc, i was turned down because i have lost some weight on prgrms before like liquid diets, jenny craig, etc. the oldest diet probably 15 yrs ago the most recent about 31/2 yrs ago. i'm going to appeal, however, my surgeon is no longer going to be doing the surgery anymore so i get to find a new surgeon. yippee!    — tracey S. (posted on August 27, 2003)

August 27, 2003
I had several weight loss attempts - with no long term success. That's what your appeal needs to be about! I have UHC and was approved on the first try, but I also included all of the stuff I tried, how much I lost, and how much I had gained back after the 'diet' or whatever. Don't give up hope!! Best of luck! Missy
   — Missy L.

August 27, 2003
Like the previous poster said focus on the "I could not keep it off" side of the picture. My surgeon did not send in enough detail about my diet attemtps so BC/BS requested more but allowed me to provide it. I hesitated whether to include the fact that I lost 200 lbs on my own in 94/95 via 1200 well chosen calories and tons of exercise. I wasn't sure if it would work for or against me. However, I did not have a lot for diet attempts as I was not a fad diet person. I knew they were a waste of my time. I did do Redux for 7 months but only lost 36 lbs. I also tried Xenical but after 2 months just could not tolerate it. Other than that I had just about nothing - only WW from 25-30 years earlier. I finally decided to put it in because it showed how successful I was but obvisouly not able to keep it off. I do not know what they thought about the situation but I got approval 2 days later. However, I think the diagnosis of sleep apnea the day before the approval solidified my case. I was technically a slam dunk anyway as I knew it was covered and I had a 65.3 BMI and weighed 442 lbs and had some pretty good co-morbs. <p>Ask them if you lose the weight on your own will they then do the surgery to ensure you keep it off. Just being sarcastic. Definitely appeal as this is a bogus reason for denying someone. There is criteria out there that indicates that diet alone is not a proven long term solution for SMO especially. My surgeon made a reference to it in his letter to BC/BS. I will see if I can dig it up as it was a good statement.
   — zoedogcbr

August 28, 2003
My doctor wants people who had been succesful in the past because they are the ones who will be more successful with WLS. I think it will work in your favor with the insurance company Gennifer
   — Genn2973