Question:
I'm trying to write an extensive diet history...

...but haven't been involved in formal dieting programs like Weight Watchers, Jenny Craig, etc. nor have most of my weight loss attempts been physician monitored (although I've heard "you need to lose weight" millions of times-I could self pay if I had a nickel for everytime...). Most of my dieting has been "self prescribed" following fads (low fat, low carb, Dexatrim, Slim Fast). I was considering requesting my middle school, high school, and college "physical" records as well as more recent doctor visit weight doctumentation and then describing the diet and weight lost/gain that accompanies the documents. Do you think that will be neccessary? I don't even know if the schools keep "school physical" records that long. Also will this diet history satisfy the "documented failure X5 years of reasonable medical management and Enrollee compliance" stated in the preauthorization guideline from my doctors office? I also am unclear about challenging the stipulation that "Enrollee must be incapacitated in terms of employability and/or normal activities of daily living." I'm employed and my PCP physical and blood work came back normal. I am not "incapacitiated, but daily living is difficult carrying the extra weight (BMI 53). Any advice/suggestions appreciated!    — Shawn B. (posted on November 27, 2000)

November 27, 2000
Wow, those are some strict guidelines. Almost ridiculous. Do they want you to wait until you are INCAPACITATED? Can you get another Doctor? One that is a bit more WLS sympathetic? Usually surgeons who perform this proceedure can get you a list of them. But if you're stuck with the Doctor you have: I sympathize with you. Here is my suggestion, have your family and/or long term friends write letters of what they have observed of your struggle withyour weight while you were growing up. This would include your dieting attempts, your general morale and maybe your lack of mobility.... i.e. "Karen always wanted to park closest to the store, so she wouldn't have to walk, it was so painful to her" ... Observations such as these may convince the Doctor that 1.you've tried and 2. You didn't suceed. Letters from many close friends and family (have them write how long they have know you etc.) can't be all suspect. Your Doctor will have to take them into account and it may just do the trick. They also could write those guidleines to sway some people from trying to pursue it. Just go for it, fight for it, do everything within your power to achieve it if that is what you want (with in the law, please!). The Doctor cannot stop you, there are ways around them. Good Luck!
   — Karen R.

November 27, 2000
Thanks Karen for your motivating words. The guidelines I described above are actually from the insurance company. I got them from my PCP's office who has already said to me the surgery is medically necessary. I just need all the amunition I can get before going up against my insurer because as you can see they are making me jump through hoops! I won't give up....thanks again
   — Shawn B.

November 27, 2000
I copied the front cover of every diet/exerise book I had... over 50!!! (does anyone want to buy some used diet books... LOL) I also copied the cover of all the exerise video tapes... and also the manual cover to all my exerise equipment. I think that's a great source of proof...
   — Michele Z.

November 27, 2000
My dieting history was very general and did not include real specifics of how much weight was lost or gained because I just couldn't provide that type of info. I never did the Jenny Craig's, etc because I never believed in their "success". But like you, I made my own general attepmts here and there. I just documented those the best I could, and there was no problem with my insurance (Kaiser). As far as being "incapacitated", later I'll send you Kaiser's list of co-morbidities. If your BMI is 53, more than likely you have some comorbidities. As obese people, we learn to live with our ever increasing disabilities, because if we didn't, we would never get up out of bed. We also have a tendency to shy away from doctors and not get the medical help we need because we know every doctor is going to say "lose weight". Did your blood work include tests for diabetes? Do you have symptoms of sleep apnea? If so, have you ever had a sleep study? Do you have regular joint pain? If you truly have no comorbidities, how about your close family members? Often this is a sign of what's to come, so document this as well. Good luck!
   — Paula G.

November 28, 2000
Ok..I have a confession to make and I apologize from the bottom of my heart if any of my doctors see this...I lied about some of my dieting attempts...I listed Jenny Craig and some different ones that I didn't go to because I so desperately wanted this surgery....not only because I wanted the surgery but because I felt that I didn't want to go through alot of years of miserable failure...it amazes me what these people expect you to go through before you can get help with your weight......I almost got called on it because the insurance company then came back and wanted documentation from these places and I thought oh boy I'm in trouble...what I did was to have my family doctor, whom I have been going to since I was a child, write a letter to the insurance company and tell them about my weight as a child and as an adult...I also wrote a letter and had the doctors office fax it to the insurance company, explaining how my life is affected everyday by my weight.....I emphasized the skin rashes and boils I would get so often...I told them about my humiliation at amusement parks...I told them about my family history of heart problems and how at 27 I feared for my life and wished to live it rather than let it pass me by.....you have to remember that the person deciding your fate is a human being to who can feel for another, maybe not totally understand but you have to put it in a way that will appeal to there more humane side.......I am not telling you to lie, I'm just telling you what worked for me....in the end I gave no other documentation to the insurance company about my dieting....I did find out that I had sleep apnea and that seemed to push the approval, so I would suggest trying to find out anything that is wrong with you and put it in writing so they know...Irritable bowel is another symptom that can be considered a co-morbidity..good luck!
   — christine L.

November 28, 2000
Michele- you are a genius! WTG Shawn- You're very welcome!
   — Karen R.

November 29, 2000
Shawn.. I got a copy of my medical records dating back to my birth. this way, I had a record of my weight through the years. You can see what I put together for my <a href="http://www.mywls.com/Diet_History/diet_history.html">Diet History</a> at my website. Good Luck to you!!
   — [Deactivated Member]