Question:
My husband has a BMI of 35.5 w/no co/morbs except knee and back pain.

However he has a strong family history of obesity, hypertension, diabetes, and arthritis. Has anyone been approved with with these circimstances before?    — Melissa S. (posted on December 5, 2002)

December 5, 2002
My BMI is 42 and I had no Co/morbs, just back pain. And I was aproved with out any problems. I did have my back Dr. write a letter of support just incase I needed it. Best wishes..
   — Heather S.

December 5, 2002
I had a bmi of 35.5 and joint pain as a co-morbid, and was approved. My bmi is now 19, the weight is all gone. Terry Simpson in AZ did my surgery, and he was great, but many docs won't do the surgery unless you are 40.0. Just find someone who will work with you guys, they are out there. Best of luck
   — shannon W.

December 5, 2002
Your husband might want to consider lapband which can be done on lower bmi's as well as very high with much sucess.
   — Marni G.

December 6, 2002
I was a lot like your husband. My BMI is 38 --I'm still pre-op, but having surgery in January. My co-morbids are very similar to his-- i.e., high risk for hypertension and Diabetes type 2, plus back and knee problems. However, I was able to get my BMI up to 40 by dressing in layers, wearing heavy shoes, etc. (For some insurance you must be at 40 to be covered). Even if doing that doesn't get him to forty, the higher the better. Your husband should go to an orthopedist for his knees and back. I did, and was told to lose lots of weight very soon. If he gets an answer like that, ask the doctor to put it in writing-- it shows that his weight loss is medically necessary. Also, if he has a friendly internist who recognizes the risk of Diabetes and Hypertension, get him to write a note that extreme weight loss is medically necessary. Those notes will help prove these are co-morbids. Some insurance just won't consider WLS coverage for a BMI less than 40. However, Virginia and Maryland mandate coverage for over 35 if co-morbids exist. Some insurance has similar language. Find out the rules from your company. The National Institutes of Health recognizes Morbid Obesity as a disease, and includes in the definition BMI over 35 with co-morbid or BMI over 40. If your husband were rejected for coverage, he could look this up on the NIH site, and use it, plus the doctor's notes I suggested above, to appeal the denial. I hope that this helps.
   — Beth S.

December 6, 2002
One thing to consider, men usually lose faster and more. I haven't seen a lot about low BMI men, but I would be curious to see if they lose too much weight. My husband is in the same boat except he has a LOT of comorbids. He can lose weight so quickly by diet and exercise that I would be afraid for him to have the surgery. The only problem with diet/exercise is that he gains it all back just as quickly as he lost it. :(
   — ctyst

December 6, 2002
Thank you to all who have replied. The only problem with layering on the clothes is that he is in the Military and they make them weigh in thier PT clothes, which are shorts and a t-shirt. They (military Dr.'s) consider him morbidly obese because thier weight standards are much more strict. He has been on thier weight control program since april 2002 with no luck. He PT's every morning, afternoon, and night, plus does yoga on tuedays and thursdays during his lunch hour. If need be i think we are just going to have him gain about 30 lbs., which shouldnt be too hard since the holidays are right around the corner and he loves to eat. I hope that if we can get his BMI up to at least a 40 that the ins. co. (Tri-care Prime) will approve him w/no comorbids. I have had no problem with mine going through but my BMI is 42 and I have hypertension. Tri-care is great, they are pretty straight forward. BMI higher then 40 w/ or w/out comorbids and you are approved. BMI of 35-40 must have comorbids. Keep your fingers crossed for him because he really needs it not only to ward off any future health problems but also for his military (Marines) career.
   — Melissa S.