elforman

Actually, that's not true at all. It's not that insurance companies don't want to pay for procedures, it's that they don't want to waste money on unnecessary procedures or on members who will not follow up properly. With bariatric surgery, insurance companies know that paying for this surgery is less expensive than paying to treat all of the complications that will arise if obesity goes untreated, so it's really a win/win situation. The reason there are so many obstacles leading up to the surgery (particularly the pre-op diet and psychological exam) is to ensure that the person is a good candidate for the surgery and will stick to the proper regimen for weight loss then be able to lead a healthy lifestyle afterward. They do not want to pay if the person is just seeking a shortcut for weight loss and does not plan to change their lifestyle. I've been in healthcare for 32 years, 12 of them at health plans, so I'm quite familiar with their operations. At a previous job I used to help scour data for signs that members might be pre-diabetic, so that the plan could reach out to them and see if there's anything they could do to help, whether it's recommending a nutritionist, sending them videos or literature, whatever it took to get the members to improve their lifestyle before they developed full diabetes. It's certainly better for the plan's members to learn how to take care of themselves, and it's much cheaper for the health plan to not have to treat the member's diabetes. So again, a win/win.

So I'm two months into my three month pre-op diet (doing keto, no liquid diet required for me pre-op) and weighed myself on the bathroom scale this morning. It read 249.4, which means I can officially express my weight as being less than an eighth of a ton. Getting under 250 wasn't the big deal to me per se, it's that fractional comparison to put the weight in perspective that did it. That's just how my mind works, I think in numbers. Also, I know my bathroom scale is not an accurate reflection of reality. When I see the nutritionist tomorrow afternoon her scale will likely read around 254 as I'll be fully dressed and my cargo pants laden with, well, cargo, but that will still be a drop of 23 in the two months thus far. (BTW, the cargo pants are pretty much a requirement as I screwed up my back pretty good by carrying my wallet in my rear pocket for a couple of decades. Fashion and style be damned.) And speaking of pants, the better part of this morning was realizing I should finally go back into my closet and pull out some older pants that haven't fit well for a year or so. One of the things that made me finally decide to look into surgery was knowing I'd have to keep spending on ever-larger clothes. Part of my decision one day was to stop buying any new clothes at all, which unfortunately left me with just three pairs of pants that fit. It's taken a while, having to do laundry what felt like every other day, but now some of the older ones fit again. Of course, the older ones look identical to my biggest ones because I just bought the same ones online in larger sizes, so nobody is going to notice a thing. Then again, at work everyone knows I'm colorblind so I told them I usually buy multiples of everything that I know will match so I don't have to worry about picking clashing clothes each day. I think they bought that...

I have got to find a way to charge for all this great advice I'm giving...

Fortunately for me, I'm not shy about these kind of things. Only two people have responded like that to me, and each time I said something along the lines of "I'm sorry you thought I was asking for your opinion or advice. I was telling you what I have planned. If I'd wanted your input during my decision making process I'd have asked you then."

You've got to talk to your doctor. Considering carbs and sugars are directly related to diabetes and you need to maintain a certain balance, you absolutely should not try this on your own.

There is no proper rate or progress chart you should be comparing yourself to and you certainly shouldn't compare yourself to anyone else. Everybody has a different metabolism, eats differently, exercises differently and so on. Let your doctor be the one to judge if you're losing at the proper rate for you. But if you want a totally non-professional opinion, being down 75lb since surgery in early November is exceptional and I'd assume those are better results than most people will ever see.

Did the nutritionist lay out a dietary plan for you? Granted, all my nutritionist told me on the first visit was to cut out carbonated beverages and avoid carbs after breakfast. I also had to meet with a dietician at the hospital who basically said I had to meet a certain number of grams of per day pre- and post-surgery, so I took it upon myself to just go full keto. The advantages of doing keto are no calorie counting and little portion measuring, plus with all of the meat, eggs and I cheese I get, I haven't felt hungry in several weeks. So I suggest calling the nutritionist again and asking if he/she has any specific recommendations for you other than "eat less".

Absolutely nothing. That's one of the better parts about doing keto. I was given a daily number of grams of expect protein intake which I know I've exceeded more than a few times. In theory there's a ratio of calorie sources, something like 40% from protein, 50% from fat and 10% from carbs (please don't trust me, look it up), but honestly, I'm not following that. I'm just keeping carbs to a very low level and the rest pretty much takes care of itself. A few times after I felt like I ate too much, even without carbs, I just have four protein shakes the next day. Granted, just because this works for me doesn't mean it'll work for everyone, so please check in with your nutritionist. Meanwhile, congratulations and keep up the good work.

Did they still charge you full price or were you able to convince them not to as you were recovering from surgery?

I'm looking at the last week of May, though I may have to push it back a week or two. My wife is having a knee replacement done on May 4th, so I'd like to wait until she's at least semi-mobile and no longer in constant agony. Fortunately both our kids are college age and will be able to take care of us. Neither kid drives though so my daughter will take me to and from the surgery in an Uber, and if we need groceries and such while I'm recovering, we'll have them delivered.

The insurance company is only concerned with your starting BMI and your ability to stick to the pre-op diet as proof that you can stick to a difficult regimen. You'll be fine.

Hi there @erika702, I just wanted to check in with you in hopes that you stopped reading many of the replies to this post. This thread went off the rails rather quickly. The internet is a great place to go for recipes and opinions about clothes, music and other things that won't have a significant issue on your health and well-being. It is not the place to go for life-changing advice simply because those giving the advice only know their own experience and quite often they simply assume that the problems they had are the same ones you're experiencing. All they know about you is the few words you typed on a screen and nothing else. Then they assume that worked for them should work for you. Perhaps you got lucky and something someone said struck a chord with you and you found their advice enlightening, but that's rarely going to be the case. Please, just look inside yourself and for each of the fears and doubts you've had, ask yourself what the real issues behind them are. Like why didn't you stick to the pre-op diet as well as you could have? Was it because it was too difficult, you didn't like it, you found it too hard to give up the food you like, or perhaps something else completely. Then talk to your doctor and perhaps consider professional counseling. There's nothing to be ashamed of. Everyone needs help sometimes and better you should get it from someone educated and trained to help you instead of a group of complete strangers who, while trying to be helpful, may be doing more harm than good. Do all that for yourself and if it turns out that surgery isn't the right thing for you then at least you'll know why and you won't have to carry that baggage with you. Good luck however things turn out. Please feel free to PM me if you need someone to listen to you instead of telling you what you should and shouldn't do, other than my suggestion to get real help, that is... -elf

I watch baseball, play in three fantasy baseball leagues, tinker with an idea for a website I want to build related to fantasy baseball, watch too much TV based on comic books, tweet furiously and frequently at idiotic politicians, read about politics voraciously, build and fix computers, and in my spare time i write erotic fiction about blonde Asian midget transsexual amputees in their struggle to be referred to as blonde Asian little person transsexual amputees, but who still prefer the acronym BAMTA over BALPTA. Oh, and I play poker whenever I can sneak away.

Ask yourself these questions: Has anything really changed in my life since first deciding to have the surgery? Haven't I gained and lost and gained and lost many times over already? Do I really believe I can do it on my own this time when it's never worked in the past? If you can answer those honestly and still think that surgery is not the right thing to do, then talk to your doctor. Don't call and say you want to cancel, just set up an appointment because you have questions. good luck and I hope you make the right decision for yourself.

Insurance companies' protocols for treatment are considered proprietary and they will rarely, if ever, divulge them directly to a member. So it's unlikely you'll be able to get someone from the appropriate department to tell you exactly what your pre-op requirements are other than the number of months you'll need to diet. Even then, you'd only get information like that through a customer rep who is not likely to be medically trained and may not be aware of differing requirements based on comorbidities and such. You may have some luck calling the insurance company and asking for a case nurse or someone with more medical knowledge than a regular customer service representative. And if you still fail to get the information you need, call them again and tell them you wish to file a grievance due to your inability to get the proper health information you need. That will really get their attention.

You have nothing to worry about. The pre-surgical weight loss program is an insurance company requirement to make sure you will be able to stick to the post-surgical regimen. It's perfectly normal that in the period between the end of the six-month period (six for you anyway, it'll be three for me and different for others) you'll regress a bit before the surgery. The insurance company isn't going to call the doctor and hospital to tell them to stop everything because you put five pounds back on. Now if it's 15 or so in less than a month, you may need to worry a little bit, not about the surgery, but why you put all that weight back in the first place...

I'm sure there are lots of links and resources that can give you a better overview and explanation of how Keto works and I'd suggest consulting your nutritionist first, but it's not really that hard. My typical weekday is a Kirkland Protein Bar for breakfast (4g net carbs), then a hard boiled egg and piece of string cheese mid-morning. Lunch is a spinach salad with low-carb dressing (like a balsamic vinegar), some raw broccoli (also with the dressing), and a chunk of meat. Mid-afternoon is another egg and another string cheese, then dinner is like lunch but with more meat. My weekends, when I have time to cook, are eggs and bacon in the morning, and the rest of the day is similar except I have a little more variety because I need everything pre-packaged for me at work since I don't have access to a kitchen. There are great desserts such as cheesecake made with cream cheese and splenda or cool whip mixed with peanut butter then frozen. And sometimes if I want something else in place of the egg and cheese I'll have a protein shake like I mentioned in my initial reply. Plus, because the concern is only with net carbs, I found a baking mix like Bisquick called Carb Quick that's almost all fiber. It doesn't taste great in everything, but it satisfies some of the bread craving. I find I don't miss rice or potatoes all that much since I still eat enough to feel full most of the time. You need need to be careful about hidden carbs in things like pasta sauce which may have added sugars. I also found a Weight Watchers "pasta-like" substance that is almost a substitute for the real thing. I don't get obsessive with counting every last gram of carbs, I just know I'm keeping it under 20 a day at worst. One of my problems is that I've been eating so much lean meat that except for eggs and cheese, I'm not getting many calories from fat, they're almost exclusively from protein. That may not be so great either so I'm fortunate my appointment with the nutritionist is tomorrow afternoon and I'll see what she says about that.

Eh, I take these things in stride and don't get overly emotional. I think at best I had a bemused smirk on my face for a few moments. I think I'll be happier when some of my t-shirts featuring carnivorous bunnies will fit me once again. https://shirt.woot.com/offers/its-okay-its-organic?ref=cnt_ctlg_dgn_30 https://shirt.woot.com/offers/meatatarian?ref=cnt_ctlg_dgn_9 https://shirt.woot.com/offers/you-have-to-try-this-guys?ref=cnt_ctlg_dgn_30

You don't seem to need any advice, you've got this. I'll admit I got lucky in that my nutritionist told me at my first consult for the first month (of three) to just avoid carbs after breakfast, and that was it. I kind of took it upon myself to go full keto, keeping myself under 15g of carbs a day and it's working great, down 23 in two months. Due to what amounts to head-to-toe injuries exercise is not an option for me right now, so I can literally say I'm doing all this without breaking a sweat. I haven't felt hungry a single minute since I started and I'm chomping on a hard boiled egg right now. Like you I have no pre-op liquid diet requirement, so that certainly makes life easier. As for protein shakes, I found a giant barrel of cookies and cream flavored something or other at Costco that I mix with unsweetened almond mile. Search the boards and you'll find lots of recommendations for both powdered and pre-mixed shakes. Good luck with everything.

I think one of the misconceptions going on here is that you won't be able to enjoy the same foods after the surgery as you could before. That's just not true. What is true is that for a significant time after the surgery you will be severely restricted, otherwise you won't lose weight and therefore, what's the point? Once you reach your goal you can have all the same foods you enjoyed before, just in smaller, healthier portions. Yes, you can eat pizza again someday, but instead of ordering a large from Dominos, eating half for dinner and the rest for lunch the next day, or worse, all of it for dinner, you can get a very good, small pizza from a real Italian place in your neighborhood, and enjoy a quarter of that because 1) you'll eat so much slower, 2) you'll take smaller bites and 3) it'll taste a lot better than any sauce-covered cardboard disk you get from a mass-produced pizza chain. Plus you'll get four meals out of it instead of two. Bottom line is post-surgery you have to learn to appreciate quality over quantity. Just because something tastes good or makes you feel good eating it does not mean you have to eat as much of it as you can. That will come with practice and patience, and probably some trial and error as well.

How high is your deductible is you're afraid you won't meet it before the surgery?

Asking for advice on the internet is like someone in an improv troupe asking an audience member for a suggestion to kick off a bit. When presented a with multiple options they're going to get many of the same things called out each time (Starbucks! Donald Trump! Your mother!) and they'll pick the one that's the most unique and stands out. The problem with looking for consensus advice on the internet is that it's not a valid sample and everyone replying only has experience with a sample size of one, hardly valid from a scientific or mathematical standpoint. Complicating things is that all of us have different bodies and physiologies, so even though we may display the same symptoms, the root cause could be completely different and require a different approach.

If you're that concerned, wear some small ankle weights or carry a few rolls of quarters in your pockets to the initial consult. That's a lot safer than eating a couple of large pizzas the night before.

Hi all, For those doing liquid diets or adding protein shakes to their regimen, I found what looks like a great deal. It's three bags of 2.2lb each of protein drink mix, or 120 total servings. It's 19g of protein, less than other powdered mixes, but only 2g of carbs. But the best part is that it's $30 total with free shipping and it comes in 24 different flavors, so you can get three different tastes. https://slickdeals.net/f/11370755-6-6lb-impact-whey-protein-30-free-shipping I searched the MyProtein brand here and there are lots of good things written about them. Edited to add: I just ordered the salted caramel, brownie batter and Boston cream pie.

You might want to talk to the hospital first. Also, bear in the mind that your insurance company pays bills in the order received, and you are going to get bills from the surgeon, the anesthesiologist, the hospital and possibly other associated bills from the day of the surgery. If you have a $1000 deductible, and the anesthesiologist's bill is submitted first, you're probably going to owe that in full as it will be less than $1000. If you've already met your deductible then you'll only owe your 20%.