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I totally misread this as you were denied. Oops. But for those with employer sponsored health insurance: Read the denial letter. It will give you information on why you were denied and next steps. Common reasons for denial: 1. Missing criteria 2. Not a covered service under the plan (employers can exclude bariatric coverage from their plans or it’s not offered at certain market sizes such as under 100/small group plans) 3. Alternative treatment/step therapy required such as nutritional counseling, medically supervised weight loss 4. Procedure not covered; alternative procedure covered Example: duodenal switch isn’t covered but the sleeve is 5. Age -either too young or too old All denial letters will give you next steps to take action and appeal the decision. I suggest work with your provider to file the appeal. I’ve been in health insurance for nearly a decade and i have seen these denials before.

What was the reason for the denial? The denial letter should state the reason why like missing criteria, not a covered procedure (not all plans cover bariatric surgery, especially if it’s employer sponsored coverage), alternative treatment needed for x amount of time? Cigna is a great insurer, i like them almost as much as i love BCBS/Anthem so there should be a concrete reason for the denial.

not vanilla, but the Bariatric Advantage coconut-flavored chew isn't too far off...

That isn't bad at all. I appreciate your insight. I know everyone's experience is different, but would rather see from other patients than just the coordinators at the bariatric center.

The rule of thumb for almost all bariatric patients is three meals a day with no snacking in between. This is because snacking allows you to overeat and exceed calories. We are supposed to be drinking fluids between the three meals. I have never heard of a plan that has you eat every 3 hours. Recommended serving size is 1/2 cup per meal. After six weeks, you can increase to 1 cup per meal. It should only take you 20 to 30 minutes to consume your meal. If it’s taking you an hour, then something is wrong. The food is too dense or not diluted enough or too high in fat content and causing restriction.

Everyone is different. Some people don't have any dumping ever, some are sensitive to sugar, some to fats, some both sugar and fat (boooo!) And then everyone has different tolerences as well - one person may dump on a small amount of sugar and someone else may be able to tolerate more but can't do, like, ice cream or cake levels of sugar. Your team DEFINITELY should have talked to you about dumping and the possibility of it with gastric bypass/RNY. I'd be a little leery of a bariatric staff that doesn't want to be transparent with you... I'm 3 months out and have yet to have an instance of dumping (knock on wood). I'm just starting now to incorporate some fruit - I also love cherries! I haven't tried them yet though, mostly because I'd never eat the entire bag before it goes bad haha. I've had some pretty fatty things, and I'm very glad I don't seem to be a fats dumper!

I had VSG in Tijuana, Mx. at HospitalBC with Dr. Illan, so I can only speak to my own personal experience, not Dr. Corzo. I did about 200 hours of research before my surgery and based on that research, finances, and other personal considerations, decided to go the Medical Tourism route and have been very happy with that decision. These hospitals ONLY do bariatric surgeries and are geared towards medical tourists. They run a VERY well oiled machine from intake to discharge. The process was so smooth, I was completely confident going alone. The surgeon I chose is highly accredited, has done thousands of WLS procedures, has relationships and mentorships with some of the most well known US bariatric surgeons for continuing ed, is board certified, etc. He is just as qualified, if not more so, than many of the bariatric surgeons in my area. The reality is, there are amazing surgeons in the US and just as many in Mexico and other places. Conversely, there are terrible surgeons here and everywhere else. There are pros and cons to each, and every person has different needs. Ultimately it boils down to doing your research, finding a surgeon you trust, and a program that fits your needs.

I had VSG in Tijuana, Mx. I did about 200 hours of research before my surgery and based on that research, finances, and other personal considerations, decided to go the Medical Tourism route and have been very happy with that decision. I had my surgery at HospitalBC with Dr. Illan. The insurance piece was definitely a factor for me. I have consulted 3x with US surgeons in the past. And all the appointments and hoop jumping eventually caused me to lose hope and I bailed. The months and months of appointments and paperwork is exhausting and extremely frustrating! That being said, I have employer sponsored healthcare, not Tricare, so I can't speak to the experience with them, only my own. From first contact to surgery, was almost exactly 3 months. It would have been shorter, but I had some schedule considerations I had to work around. With my insurance it would have been 9+ months. These hospitals ONLY do bariatric surgeries and are geared towards medical tourists. They run a VERY well oiled machine from intake to discharge. The process was so smooth, I was completely confident going alone. The surgeon I chose is highly accredited, has done thousands of WLS procedures, has relationships and mentorships with some of the most well known US bariatric surgeons for continuing ed, is board certified, etc. He is just as qualified, if not more so, than many of the bariatric surgeons in my area. The reality is, there are amazing surgeons in the US and just as many in Mexico and other places. Conversely, there are terrible surgeons here and everywhere else. There are pros and cons to each, and every person has different needs. Ultimately it boils down to doing your research, finding a surgeon you trust, and a program that fits your needs.

Has anyone else compared VSG in the US with a long wait due to insurance (Tricare Prime) and Mexico? I am considering EOC (Elias Ortiz & Company) in Tijuana because you set the date, you go, and you simply work hard. I have watched all the videos from Sage Bariatric on YouTube (which is where I am attempting to go with insurance), but having military insurance with so many rules, I just don't know what is feasible. What have I not considered? My husband can accompany me to Tijuana so I won't be alone and he can provide support. The all around care they provide seems to be top notch. I have searched these forums and read, and read, and read some more. I thought I would seek other's advice. Thanks!

Guys I need your help ,does anybody have or know abour doctor Perez Corzo in tijuana from RENEW BARIATRIC??

I also was able to eat more than your average sleever. But also, I suspect my surgeon made my sleeve a bit bigger knowing how active I was even before surgery (it's hard to be so active when you can't eat enough!). When I was three months out I was restricting myself to 800 calories and my center's nutritionist had an absolute conniption at me. Said I was ruining the tool and if I wanted to just gain all the weight back, that was my business. I was devastated for a hot second before I absolutely lost my temper at the top of my lungs and fired her so loud they heard it in the surgeon's office across the hall. A friend of mine recommended a nutrition program she used, and I am so glad I found it. Immediately my nutrition coach (who had coached other bariatric patients before) upped my calories to about 1200, still prioritizing protein. Over the last six months she's increased it to 1600-1800, and we're just now backing off a little bit because I feel like all I do is eat. I have just a few pounds left to lose, so they will be harder to shift. I expect maintenance will be around 1600 calories depending on activity level.

Connecticut-my surgeon was Dr. Sekhar of New York Bariatric Group

first of all, that was due to malpractice. They should have taken his complaints seriously and done diagnostic work. If they had, he likely would not have died. Secondly, although bowel obstruction is more common in bariatric patients than it is in "normies", it's still very rare. And normal people can have bowel obstruction, too - my mother-in-law had it a year ago - had to go to the hospital for emergency surgery. She weighs around 110 lbs and has never had bariatric surgery. that said, I'm very sorry about what happened to your father.

Don't eat past your hunger cues. One of the things that I want to beam into everyone's head is that for a LOT of us, aftercare is pretty horrible. My surgeon's bariatric nutritionist lit into me for eating 800 calories a day 3 months out - I work outdoors and work out for an hour a day. My surgeon actually skipped two check-ins in a row after that. So I went and got a nutrition coach (whom I absolutely LOVE). I could always eat more than they said I'd be able to. But as long as I ate slowly, the restriction kicked in eventually. I lost weight hand over fist (it has since slowed down, but I'm 8 months PO and not far from goal). I wouldn't worry about it. But do watch out for stalls. They happen, they suck, and they shouldn't derail you.

Has anyone here had a gastric sleeve and also has Mast Cell Activation Syndrome (MCAS)? I just need to know that someone else safely had it done and didn't have a major multi-systemic reaction to the surgery or in post-op. I'm prone to anaphylaxis but I've had other surgeries (knees and shoulder) since diagnosis and with my surgical team being cautious I made it through surgery without having a major reaction. I previously had a consult with a bariatric surgeon and she said she wouldn't touch me; that it was too risky. But that was maybe three years ago and I'm definitely more stable now than I was then. My pain doctor wants me to get a second opinion so I'm going to meeting with a bariatric surgeon in a few weeks and also meeting with my mast cell doctor. I was just hoping that someone who it has experience with it could reassure me that it can be done safely. Concerns I have: - my diet already has to be restrictive because of the MCAS. I worry about getting enough protein in when I have to avoid tree nuts and all meat products. I can have milk (lactose free) and eggs. - I read that my meds have to be crushed or split post-surgery. Is that for forever? I have some capsules that I take that can't be crushed or broken. I also have liquid medication I take that gets diluted I'm about a cup of water. I use that water to take all of my pills, and there's a fair amount of pills. - exercise is an issue for me. I've anaphylaxed during an easy yoga class before. I've built up to be able to do seven to ten minutes on a seated elliptical or seated stepper. But I'm not going to be running any 5ks anytime soon. Is it still an effective surgery if my workout options afterwards are extremely limited because of my MCAS? - if I'm on meds that have caused weight gain for me, is it possible to still lose weight while being on the med? I can't safely go off of the meds unfortunately. I think I'm just scared to get my hopes up that this surgery could be a safe and effective tool to help me lose weight. I'm 5'4 and 400 lbs. I need help. The likelihood that my surgeon will be familiar with or educated in mast cell diseases is really low and I know that I'll have to do a lot of advocating for myself. If you've made it this far thank you for listening. Any advice would be greatly appreciated.

*trigger warning if you are scared about gastric bypass this is not a good post to read also it is a long * (admin if I shouldn't have posted this please delete) I debated long and hard about whether or not to talk about my dad and how he died. I never want to scare anyone and tbh his death wasn't so much because of the gastric bypass he had but rather the prejudice and malpractice of his primary care Dr and the hospital he went to for emergency care. My dad came into my life when I was 28yrs old. I didn't know I needed a dad honestly. He started dating my mom and considered me part of the package. He protected her, he protected me...no strings attached totally unconditional regardless if I wanted him to or not he was going to be there for me. Turns out even at 28 I needed a dad. He was 6ft 5", almost 500lbs, tattoos, beard, and a biker. Dad never talked a lot, he preferred actions. If he agreed with something he'd say "No doubt". If he didn't well he'd just shake his head and turn away. He had had 4 heart attacks by the time he had his gastric bypass surgery in 2009, He went down to 190ish lbs. Everything was great. He did everything he was supposed to do. Crushed his meds, no alcohol, watched his food ..he followed all the rules. Fast forward to July 2021. Dad and mom had split a few years back but he was still my dad. Around July 30th, he started having abdominal pain and couldn't go to the bathroom. He did something he hated to do.. he went to the Dr. The Dr filling in for his Dr took one look him..biker with tattoos wearing a leather jacket and on Medicare and immediately ignored him. He told dad if it was so bad go to the emergency room. So dad did. Hospital er looked at dad...biker with tattoos, wearing a leather jacket and on Medicare and assumed..drug seeker! Told him there was nothing wrong with him. They did no test and sent him home. About 2am on July 31, Dad was in horrible pain and call EMS, they weren't part of the hospital he had gone to earlier, in the ambulance they did an ultrasound on the way to their hospital. One of the paramedics picked up his cell phone and called the first number on it...my mom. They told her to meet them at the hospital, it was bad real bad. She and his biological daughter got to the hospital about the same time. Dr told them there was 3 options...1 take him into surgery immediately ..he would most likely died on the operating table 2. try to get him strong enough to have surgery he would most likely never wake up or 3 give him morphine and let him die. They chose option 3 and less than 30mins later he was gone. So what did a simple ultrasound find? Dad's large intestine had twisted so badly that while he ate, food couldn't get past the twist. Imagine making a balloon animal and twisting the balloon then keep blowing up one side.. the inevitable happened. The food side popped filling his body cavity with food and stomach acid. He didn't have to die. Had the Dr listened, they could have found it and done surgery to fix it. The hospital and the Dr, naturally, claimed no responsibility it was obviously the 12yr old gastric bypass that killed him. I wish I could say they were sued til they cried but dad's biological daughter refused. Me, I wanted their heads on a silver platter but I don't look good behind iron bars. My mom isn't very happy that I am having bariatric surgery less than a year after my dad died. She is trying to be supportive but she is scared. I often wonder what advise would he have given me. I got my insurance approval letter in the mail today and said to myself "so this is really going to happen". I swear I heard "No doubt" Sorry this was so long.

Hi JUNE friends! I get notifications when there are posts and how emotional I was to see all the NEW 2022 Junies posting! Made me reflect on everything that has happened to me in the last year. Recorded my highest weight in NOV 2019 at 305 at 5ft1in at the doctor's office. Cried and talked with her about surgery. She was all for it. Let that sit and fester for another year, what was the rush? I have only been thinking about this for the last TEN years. Finally, Nov 2020, my levels were prediabetic. I was on two high BP meds. I knew I needed to stop this. My insurance sucked and conventional route was not going to happen. MANY MANY insurance companies DO NOT cover bariatric surgeries any more. WHICH is ridiculous since it is the only elective surgery that reverses or ends so many mortal diseases. Why wouldn't they pay? Between HBP and soon to be diabetes, probably need knee replacements, and on and on!! I had to find self pay. I was too nervous to look at Mexico, and found Blossom Bariatrics in Vegas. I started my Pre-Op diet May 25th, 2021. Surgery was June 15th, 2021. Best DECISION I EVER MADE! We have all been there. Should have done it sooner, hmmm-ed and hawed for months and months once my doctor and I talked about it. Then there was covid. The delays never ended. But to all the new people.....TRUST THE PROCESS, LISTEN to your body. It will know what to do. If you do the work, it will follow. I consider myself a SLOW loser. I was not, will not, and won't ever be an exercise lover. I couldn't fathom doing any exercise when I was 305lbs. It was a terrible cycle. I can't walk and move my body because my knees hurt, my back hurt. I didn't walk much when I started this journey but then, after the tiredness subsides, you think wow, my knees don't hurt. I can go for a walk with the dog. Then, I WANT to walk the dog. For me, everything was baby steps. BUT, suddenly the pants are looser. You start to see your face change. Then, those close to you start to notice. Slowly, but SURELY, it comes off. The ONLY WAY to lose this weight is by calorie deficit. It is the ONLY WAY we can all do this. It is NOT EASY. Having surgery is NOT easy. We still have to change the way we eat. We are still have to fight those old habits and desires. I read everything I could, joined this group, and a couple on FB. I read all the advice. I am here to tell you a few of mine. I HATED pictures of any kind. I didn't take many before or after surgery. DO TAKE PICTURES!!! I love seeing people's before and afters and transformations and I just can't go back. and POOP. No one talks about the POOP or lack of it. It was my biggest side effect and still an issue. HAIR LOSS, it happens, just start those biotin pills NOW! SO, sorry for this long post, it was kind of emotional and I needed to just write it all out. You took the first steps. You got this! I still feel like I just did and am in the stages you are. But, as I close in on my first anniversary, I am overwhelmed. I hit the 100 pound lost mark. Then, this week, I hit ONEDERLAND. Lots of milestones all at once. I am anxious to see what my pounds lost will be on June 15th! Trust yourself and the process. There are NO steadfast rules. I hate when I see posts and people are so adamant and actually rude about stuff. In the end, you make the rules. I'm an open book and will answer any questions. You can message me or post. Literally remind yourself, it's ONE day at a time. Best wishes Junies!!

I just had my sleeve done today by Dr. Sekhar with New York Bariatric Group. I cannot say enough wonderful things about him, his staff, and the practice. He made me feel at ease right away and having a personal concierge to guide me through the requirements and track all of the documents for me made the process a lot easier. The concierge also handled all referrals for me and found providers in my area. I’m in Connecticut so i recommend the Farmington, CT location if you’re in mid state or around the Hartford area. Wonderful practice, wonderful doctor and overall a really smooth experience.

This thread was a wild ride. I also don't believe OP was trolling, but I think there are more issues going on here than just dealing with the weight loss stuff. If you're still reading this OP, I sincerely recommend you try to speak with a therapist about the issues you've been discussing. If you can find a bariatric therapist, great. Otherwise, any certified therapist should be able to help provide you with a caring ear. You seem to be carrying a lot more weight than just the physical pounds, if you get what I'm saying, and speaking to someone can help lighten the load. Regarding the specific things you've been discussing, a few thoughts. First, as others have mentioned, the procedure you chose is a tool like the other procedures, but it's a tool that statistically results in the least weight lost of the rest. That doesn't mean you can't be extremely successful, just that it might be tougher. You say you don't want to be one of those people weighing every gram of your food on a postage scale. Well, I'm one of those people and I've been lucky enough to have a lot of success so far. That said, I don't necessarily watch every gram, if I'm a little over it's not the end of the world. But most people have absolutely no idea what a portion of food actually weights until they actually weigh it. When I started out I was shocked on how small my 4 oz potions of food were, if I had been eyeballing them I would have had twice as much as I should have. So I would get a cheap scale (you can get them for $10 or less) and start weighing EVERYTHING. You say you don't have time, but it takes practically no time at all. Weighing all my ingredients takes at MOST 3-4 minutes per DAY. You just put stuff on your plate like normal, but first put the plate on the scale. I had some cantaloupe for a snack earlier, and I just put the bowl on the scale and watched the numbers as I filled it and stopped when I hit my limit. It took pretty much the same amount of time that it would have taken to put the cantaloupe in the bowl without using the scale anyway. You also mentioned you weren't interested in a sleeve because you believe the recovery time would be a month. I can only speak for myself but four days after my sleeve I drove 30 miles to visit with family, and I was fine. I took about a week or so off of work and went back with no problems. Everyone is different but from what I've seen posted by others, that's generally the experience most folks have. I'm not saying you need a revision, but don't let the potential recovery time deter you from a procedure if you and your doctor feel it would be appropriate. Best of luck.

I thought about ketamine for depression. Was it working for you? What is the issue with using it after bariatric surgery?

I experienced this as well. Instead of trying to force it, eat the few bites you can, wait 20-30 minutes and start drinking tiny sips of protein to help push it down a little. Eventually you will be able to handle more. I am now 32 days post op and in the 3-4 days I've noticed a better capacity to tolerate foods and am now eating minestrone soup, 3 oz at a time, 2-3 times a day between my water and 2 protein shakes. When I emailed the bariatric team, they told me it may have been due to swelling on the inside the finally went down and that many patients by a month out can handle 4oz (and some 4-6oz) at a time, but everyone is different and has different tolerances.

Greetings @Im4miracles - Michelle, I got my sleeve surgery in 2016. I lost around 130 lbs During the time from 2020, I had gained some of the weight back. I also had severe GERD (where the GERD was so severe that I was vomiting my food almost everyday). I went back to my Bariatric surgeon in February, 2020 to revise my sleeve surgery to a Gastric Bypass with hernia surgery I have to admit that I had similar concerns about the Gastric Bypass that you do. I was concerned about the dumping syndrome and wondering if I could keep the weight off with revision to the bypass surgery. I got my Gastric Bypass surgery with hernia surgery in March 2020. It was the best decision I ever made for myself because in hindsight I don’t have this severe GERD anymore. Once I was released from the hospital, I didn’t have much pain and didn’t have to take my narcotic pain killer. At my 6 month post op appointment, my bariatric surgeon was extremely pleased with my weight loss progress because I had lost 124% of my original body weight. My current body weight is in the mid 130’s. I was really scared that I would experience dumping syndrome after my bypass surgery - which I did not. In my experience, I haven’t had malabsorption of my daily nutrition in my body. My bariatric vitamins don’t taste horrible (I take my bariatric vitamins daily). Fortunately, my tastebuds haven’t changed because of the bypass surgery. I can eat all foods that I had eaten before I got my bypass surgery. I no longer have to take the Protonix 40 mg because the bypass surgery cured the GERD for me. Lastly, the weight that I had lost from my bypass surgery hasn’t returned because I use my Lose It application (food journal) to budget my calories, I walk everyday for 30 minutes at a minimum, and I use the nutritional plate method (that my medical nutritionist told me about). The plate method is where you divide your plate in to three sections: first section is 50% of the plate is made out of fruits and vegetables (I typically have 25% of fruits and 25% of vegetables in this section), second section is 25% of protein food, and the third section is 25% of carbohydrates foods. Using the nutritional plate method I make sure I’m getting the proper nutrition. Michelle, I hope that what I’ve written has given you food for thought. I have successfully gone from a sleeve surgery to a bypass surgery without any complications and i am extremely happy about my weight loss journey, thus far

Hello! Just a short story of how I got here! 8/2012, I underwent the Gastric Sleeve. I went from 230 lbs to 140 lbs. I had a hiatal hernia repair during this surgery in 2012 and again in 2021. Every since I had the sleeve in 2012, I have had reflux. Within the last few years, it has increased, severely. It did a little better when I had the hernia repair in 2021. However the hernia has returned and the GERD is even worse. I wake up quite often gagging on stomach acid. Sometimes waiting to go to bed three hours after my last meal/snack, will help SOMETIMES. A lot of times, I have to sleep sitting up. I am taking Protonix 40 MG twice a day for many many years. If I skip a dose, I regret it! I, unfortunately, have gained quite a bit of my weight back. Once I started gaining, the front desk clerk at my Bariatric doc's office told me I didn't need to come back. I kind of felt like I got kicked out of the program!! So it just got worse after that. Because of the severe GERD I am having, I bit the bullet and went back to see my bariatric doctor. I was ashamed because I lost 90 pounds after my surgery but have gained 60 of it back. He didn't seem to say much about that. However, he suggested that the best way to get the GERD under control was to revise my surgery from the Sleeve to the Bypass. I have concerns! I am worried about the diet and will I screw up again? I am worried about mal absorption, dumping syndrome and all the other complications that can come from the Gastric Bypass. I worry about how the vitamins will taste (silly I know, but if things taste nasty, I have a hard time eating/drinking). What if I can't stick with it like I did the Sleeve? This is a permanent surgery! I am scared but I feel like it is necessary to relieve me of this terrible GERD. I could end up with Barrett's Esophagus and worse, cancer of the esophagus. Would really appreciate outlooks and suggestions! Thanks in Advance, Michelle

Well, I unfortunately tested positive for Covid on May 8, so my initial appointments got pushed back. I now see the bariatric nutrionist for the first time on May 29, and the surgeon in June 2. I’m eager for the appointments but know I need to get through this rough patch first!

Well, I unfortunately tested positive for Covid on May 8, so my initial appointments got pushed back. I now see the bariatric nutrionist for the first time on May 29, and the surgeon in June 2. I’m eager for the appointments but know I need to get through this rough patch first!