Horus

BLIS? What does that stand for? Thanks. I'd never heard of it, but it is an interesting concept. http://www.obesityhelp.com/forums/insurance/About-BLIS-and-Cash-Pay-Weight-Loss-Surgery.html

I'd never heard of this. Does it cover complications at any hospital or do you have to go to the one where you had surgery? If I got surgery it would be at a hospital 200 miles from where I live, I don't know if they'd cover me if I had to go to a local ER.

My health insurance doesn't cover bariatrics, and even if it did I was looking at plication which is a more experimental surgery and probably wouldn't be covered anyway. I think the cost of plication is about 10k, which I could pay out of pocket. My big worry is that I spoke with my insurance company and they said if I had any negative effects that insurance wouldn't cover it. So if I needed the plication removed, or if I developed gangrene, etc insurance would not cover any of it. Does anyone run into this problem, or have a way around it? Can you buy insurance to cover gastric complications? My big fear is that if I get the surgery I will be in that minority who needs another surgery down the line for complications.

I went to a seminar for lap band, the hospital employee checked my insurance and told me the insurance plan picked by my employer doesn't cover lap band. Seeing how there are only about 200,000 bariatric surgeries in the US (1/1500 of the population per year) and maybe run $15k that works out to maybe $10 per person per year to cover obesity surgeries in the US, so on paper it shouldn't be much more for insurance to cover them. Despite that, I think these surgeries are something an employer has to pick to get covered under their plan. I also live in Indiana, I thought in Indiana insurance companies had to cover the surgeries. Anyone know for sure? I may try self pay. The cheapest I've seen in the US is about $10,700 at two places, one in southern California and one in Michigan. I found this place in Colorado offering it for $8950. Not bad, considering my deductible and copay would be $3600 even if insurance covered it. http://www.lapbandrockies.com/our-fees What are my other options?

I am considering the surgery, and one thing I worry about is food getting stuck. I've heard though that certain foods can act as a lubricant to help food avoid getting stuck (BBQ sauce, mustard, etc). Does anyone have any experience with these as a way to either prevent something from getting lodged, or as a way to loosen something after it is lodged?

Something you might consider is called gastric plication. It is pretty much the same thing as a gastric sleeve but it is reversible and they do not remove part of your stomach, just sew it smaller. http://www.arabia.msn.com/lifestyle/healthandfitness/2010/december/gastricimbrications.aspx For me the biggest issue for bariatric surgery is it has to be affordable (I will probably self pay), reversible, let me continue to take my medications and Vitamin supplements and be relatively safe. Right now there are only 2 options I know of, plication and lap band. Something called an endoluminal sleeve (by endobarrier) is being used in clinical trials, it blocks off the first couple feet of your intestine with a plastic tube (that is where most calories are absorbed) and it works pretty well. So that may work too.

I thought they were fairly comparable. Lap band is supposedly 73% remission of type II diabetes. http://www.falsecreeklapband.com/about/lap-band-improves-diabetes/ Bypass is closer to 80-90% remission. Then again this study shows a bit of difference. http://www.medpagetoday.com/Endocrinology/Diabetes/24997

Right now I think it is still in clinical trials and doesn't have FDA approval. It is a sleeve made of some material (probably a kind of plastic) that a doctor puts in your small intestines and it blocks absorption of nutrients in the duodenum. http://www.gidynamic...er-overview.php http://www.ncbi.nlm....pubmed/19858703 I really hope that one works out, because that is another fairly safe tool for bariatric weight control. In a way you'd assume an endoluminal sleeve combined with a lap band would give the benefits of a roux-en-Y bypass surgery but it would be reversible and have a far lower mortality rate. I have no idea if the surgeries can be combined though, or if you'd even need to do both. The clinical study said a loss of about 19% of excess weight in the first 3 months, but I've also read a 30% drop of excess weight in 6 months, and that can be doubled with something called a flow restrictor to adjust gastric emptying into the intestines (most of the info comes from sites tied to the maker, so no idea how independent they are). http://www.yourbaria...luminal-sleeve/ http://www.wlshelp.c...ndobarrier.html But if I ever do decide to do something for my weight, I want it to be something relatively safe, reversible and affordable. The lap band seems the best idea now but an endoluminal sleeve could be a good idea too when it gets FDA approval.

I'm new to the subject, so sorry if this has been asked before. But I take a lot of supplements (probably 2 dozen pills a day) including about 8 tablets a day of fish oil, which are pretty large tablets. Can a person continue to take medications, supplements and Vitamins after being banded or is there a risk they can get lodged?

You lost 96 pounds in 6 months? Congrats, that is really good. That is about what I need to lose, close to 100 pounds. My BMI is about 41 but I am a mesomorph, so I think losing 100 pounds or so would do me a lot of good. I've read it is more waist size than BMI and bodyweight that plays a major role in your health risks. My waist is about 51", and I know from personal experience that about every 5 pounds I lose causes about an inch to shrink from my waist. And getting one's waist down to the mid/low 30s is supposedly ideal for a persons health since it is the fat in the abdomen that screws your health up. So I'd probably only need to lose 70-80 pounds to get from a 51" to a 35" or so. I'm very technical. I've heard blood sugar tends to go to normal even before you start losing weight with bariatric surgery. I don't have diabetes now but due to genetics and my body shape I am all but guaranteed to develop it someday (on my dads side of the family he has it, all his siblings and both his parents have it or had it).

Cardiovascular disease and type II diabetes run strong in my family, and I'm considering lap band surgery as a way to reduce my risk of these illnesses. I've read many people no longer need meds for hypertension or diabetes, and that many people's cholesterol and triglycerides improve. I already have metabolic syndrome and take several medications which are only somewhat effective to protect my cardiovascular system. Has anyone experienced improvements to their cardiovascular system or blood sugar? I don't have type II diabetes (yet, but I'm pretty likely to develop it down the road), but I've read 80-90% of people get their blood sugar under control with this medical tool. I also read 80% of people can quit their hypertension meds. Any arguments against this (people who still had diabetes, high cholesterol, high triglycerides, hypertension, etc) even after the surgery?

Thanks for the replies. I will go to a seminar and see what they say. As for being more muscled, I think it helps me with mobility, energy and protecting my joints (so the muscles can absorb some of the shock when I walk, so it doesn't go to the bones). But overall being 315 pounds is not healthy. I appreciate the book recommendation. There is no way I could lose 75-100 pounds w/o obesity surgery and keep it off. What I meant was that I can focus on ways to control my risk factors for CVD, diabetes and osteoarthritis that are independent of weight loss. I can take Vitamin D, magnesium, eat more fiber, keep exercising, etc. (I already do all that stuff) and all those things will improve my health even if I still remain morbidly obese. So losing weight isn't the only way to preserve my health. But it is a major way. I'm perfectly willing to diet and exercise and do my part to lose weight. So thats not a problem. I love that the band is reversible though, because if something less invasive comes along down the road I can switch to that method.

Hello. I am totally new and right now am just looking for ideas. I am 29 years old, 6' and weigh 315 pounds. I have hypertension, cholesterol and triglyceride problems. Also type II diabetes runs in my dad's side of the family (I don't know about my mom's), however right now I do not have it (but due to my morbid obesity and genetic heritage I think I will suffer from it within 15 years or so). My dad, all 4 of his siblings and both his parents have it (type II diabetes) or have had it (his parents are dead now, but they lived to their 80s). I also am having leg, foot, knee and some back pain. I am still reasonably physically active. I can hike, bike and walk for an hour or more without problem. I am built more like an offensive lineman in football, so I think the extra leg muscle is helping to keep me active and protecting my joints. But I seriously worry that I am going to start having more serious health problems as I age, and most are due to my obesity. I feel like if I address my obesity I can address my joint problems, my cardiovascular problems, my risks for type II diabetes and improve my sleep. My dad is 58 years old and really can't do much of anything anymore. He has severe diabetes and cardiovascular problems. All he does is work and sleep. I realize obesity is just one of many areas of my health I need to address, but I also realize it is one of the biggest ones I have to worry about as most of my serious health concerns revolve around it. Anyway, I want to do something about my obesity, but part of me feels medicine is advancing so fast maybe I should wait 5-10 years for a better surgery to come along, and then get that. There is a company in MA that is working on a sleeve that is implanted via the mouth that covers the first foot or two of your small intestines. It is less invasive and also assists with obesity. Part of me feels I should focus on ways to address my health risks (take more Vitamins, eat more Fiber, exercise, etc) and just wait to address the obesity side of it down the road. My point is that, I'm really just at a crossroads. I worry about what damage my health is undergoing or will undergo due to being so obese, but I also feel like if I hold out then better, cheaper and safer medical technologies will come along. I also realize that even though my health is at risk, it could be 15+ years before I start to see serious effects from it. So I don't know if I should do it now or if I need to wait a few years. On another note, because of my size I require alot of calories every day. My normal caloric intake is 4000-5000 a day. If I eat 3000-3500 a day I lose about 2 pounds a week (can't keep it off, but I can lose weight on that kind of caloric intake). If I eat less then 2500 a day I get light headed and tired. I see alot of people talk about only eating 800 or so calories a day after bieng banded. I don't want to lose weight too rapidly (it can damage health and help cause loose skin), so for me to lose weight comfortably I think I'd need about 2800 or so calories a day. Is that possible after being banded? Can you puree Protein shakes and drink them to get the calories you need? I want to lose weight, but if I am feeling lethargic and tired all the time (because I am eating far too little) then its not going to be worth it. Can they put the band lower in the stomach to make the stomach pouch bigger? This is probably rambling, but I'm trying to say alot at once. Basically I am wondering if I should get banded now or if I should wait 10 years or so and hope the technology for obesity is better and get banded then, and hope I can do things other than lose weight to address the health problems I feel I am going to start running into as I reach middle age. I like the lap band because it is reversible, and the complication rate is fairly low.