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I was denied by Aetna due to weight gain

So Im a little sad that my request was partially approved. Aetna approved the removal of the Lap Band but not the sleeve. Spoke to my doctor's office and they said they will have my doctor to a Peer-to-Peer Appeal. So I wont know until maybe Wed or Thurs what the outcome of that is. I was so excited and looking forward to it to. I didnt really understand the reason for their denial either. They said I was non-compliant with the band because of my weight gain but dont see the issues I had with it. So heres hoping for the best.

Good Topic I have no main issues yet, but I am concerned. I had WLS (Vertical Band) 20 years ago and my wife was very supporting thru all the years of being sick on and off, especially the last 5 years of severe sickness and fast weight gains. My RNY has now eliminated all my issues, and I can now eat anything I want to (But choose not to) She sees no reason for me not to eat the normal fair she eats. She is also very overweight but will not make any changes, so the "Unhealthy Crap" is always in the house, and I am finding it more difficult to resist. I do not see it as a big game changer to the point of break down, just wish we could get on the same page, for our benefit, as well as our kids and G-Kids.

Awe hunny I'm so sorry for your endometriosis struggles!! Be glad you have time on your side though and please heed my advice, when you can... start your fertility journey!!! Do not wait!!!!! It can take some intending parents 6 months to get pregnant and it can take 5 years or even more!! If you try and try and decide on adoption that can take another 1-3 years to get a baby. I sort of always assumed "they have a pill for that" type thing and here we are encroaching on the dangerous stage of 35 plus and still struggling to have a child. Not to mention the Financials. Just for perspective IVF starts at 15K in Michigan here and only goes up. It's also not a guarantee you will invest and end up with a baby! Not trying to discourage you I just wish hubby and I would have started our journey a few years prior. I wish someone would have warned me. I thought I could lose weight on my own and save money for IVF but life got in the way and we achieved neither. It will be at least another year before we can even safely do an egg retrieval due to the sleeve so I'll be 35 at the youngest having a baby which starts becoming high risk and high chance of mental defects for the baby. So please stay strong, be positive but start talking! It never hurts to get a game plan with a fertility specialist even if it's for the future! There are great options too like gestational surrogates!! It's pricey but sometimes best for women who have serious conditions such as yours! We can chat here or you can PM me if you would like to speak more fertility related. We had been trying for an altruistic gestational surrogate but due to finances and other complications we still can't swing it so all things baby are on hold while I do the sleeve and we save $$. I also need the mental break. We may decide to adopt but I was adopted so it was not what I was hoping for... Sent from my SM-N910P using the BariatricPal App Thank you! I'm 7 weeks post op so we will see what the next year brings - hopefully good things for both of us! I have put off treatment like lupron because of the devastating effects on fertility. It's me constantly wondering what the right thing to do is. Fortunately, I am young but know I have to make a serious decision by 30. I wish you all the best with your WLS and fertility - adoption may not be your first choice but you'd still be a great Mom. Congrats on being 7 weeks!!! How did everything go for you?? Also what is Lepran? I've not heard of that. It sounds like you at least know your time frame. My husband is so sweet and supportive. Says he would love to have a child or adopt or would be perfectly happy with us and our pets!! Me? Not so much... I want my baby girl!! Thank you so much for your sweetness!! I lean more towards adoption every day but I just worry so bad of them emotional turmoil for our child but at least I could empathize having been through it too. We shall see!! What state do you live in? Michigan here. Just curious Sent from my SM-N910P using the BariatricPal App Everything went the sleeve went well. 45 pounds down in 7 weeks the downside for me was the d&c surgery I had to have once my hormones went psycho. Being put under twice in one month is a huge strain on your body. I live in Lake Norman, NC and the center for endometriosis care is in Atlanta so not too far from me. Lupron is the devil - horrible side effects including infertility (1/5 becomes infertile permanently) along with weight gain and worsening depression. It's a nasty drug. If they offer it, of course do your resesrch but I recommend running the other way! 45 lbs!!!! That's awesome!!!! Get it girrrrl!!! And thanks for the advice!! I will for sure say no to that one. Is it used with the bariatrix surgery or with endo treatment? Sent from my SM-N910P using the BariatricPal App

I have no clue why this popped up on my phone this morning but as I read first post then second a few more then I stopped reading. I forgot I had the app honestly because I stopped being on here. I had just decided to do the surgery a few months ago, went to the seminar, my first appt was done and I was still up on the air about it. As I started to go through the process, all of the testing read more and I joined this forum to get other people's experiences, see how you all are doing, looked at some on youtube videos I guess to see if I really wanted to do it this time. I started the process three years ago and stopped halfway said I didn't need it because I eat healthy salads, veggies not alot of food, bake not fry and I excercise but here I am three years later. Still weigh the same as when I started, I'll lose it and gain it right back but never go over what I've been. It wasn't my time back then and one thing that I read that I absolutely agree with is that you truly have to mentally prepare yourself for this. I've made my decision based on the fact that I want to be healthier without all the meds I take daily. I can and will honestly say I don't have a problem with food because I barely eat. Which is also a problem lack of eating which I've been working on. I have health issues high blood pressure, asthma, pseudotumorcerebri, and REM apnea as to why I qualify for the surgery because your BMI has to be 40 or above mine is and was 38 my first dr visit. My weight gain came from me taking the birth control shot years ago and I have never been able to go back to under 200 lbs and currently 248 I'm 5' 7". I'm scheduled for surgery Dec 6th and I have my last pre op test today. No backing out this time. I am stocked and ready to start my liquid diet in 2 weeks. Wish you all the best of luck on your journeys ????

Awe hunny I'm so sorry for your endometriosis struggles!! Be glad you have time on your side though and please heed my advice, when you can... start your fertility journey!!! Do not wait!!!!! It can take some intending parents 6 months to get pregnant and it can take 5 years or even more!! If you try and try and decide on adoption that can take another 1-3 years to get a baby. I sort of always assumed "they have a pill for that" type thing and here we are encroaching on the dangerous stage of 35 plus and still struggling to have a child. Not to mention the Financials. Just for perspective IVF starts at 15K in Michigan here and only goes up. It's also not a guarantee you will invest and end up with a baby! Not trying to discourage you I just wish hubby and I would have started our journey a few years prior. I wish someone would have warned me. I thought I could lose weight on my own and save money for IVF but life got in the way and we achieved neither. It will be at least another year before we can even safely do an egg retrieval due to the sleeve so I'll be 35 at the youngest having a baby which starts becoming high risk and high chance of mental defects for the baby. So please stay strong, be positive but start talking! It never hurts to get a game plan with a fertility specialist even if it's for the future! There are great options too like gestational surrogates!! It's pricey but sometimes best for women who have serious conditions such as yours! We can chat here or you can PM me if you would like to speak more fertility related. We had been trying for an altruistic gestational surrogate but due to finances and other complications we still can't swing it so all things baby are on hold while I do the sleeve and we save $$. I also need the mental break. We may decide to adopt but I was adopted so it was not what I was hoping for... Sent from my SM-N910P using the BariatricPal App Thank you! I'm 7 weeks post op so we will see what the next year brings - hopefully good things for both of us! I have put off treatment like lupron because of the devastating effects on fertility. It's me constantly wondering what the right thing to do is. Fortunately, I am young but know I have to make a serious decision by 30. I wish you all the best with your WLS and fertility - adoption may not be your first choice but you'd still be a great Mom. Congrats on being 7 weeks!!! How did everything go for you?? Also what is Lepran? I've not heard of that. It sounds like you at least know your time frame. My husband is so sweet and supportive. Says he would love to have a child or adopt or would be perfectly happy with us and our pets!! Me? Not so much... I want my baby girl!! Thank you so much for your sweetness!! I lean more towards adoption every day but I just worry so bad of them emotional turmoil for our child but at least I could empathize having been through it too. We shall see!! What state do you live in? Michigan here. Just curious Sent from my SM-N910P using the BariatricPal App Everything went the sleeve went well. 45 pounds down in 7 weeks the downside for me was the d&c surgery I had to have once my hormones went psycho. Being put under twice in one month is a huge strain on your body. I live in Lake Norman, NC and the center for endometriosis care is in Atlanta so not too far from me. Lupron is the devil - horrible side effects including infertility (1/5 becomes infertile permanently) along with weight gain and worsening depression. It's a nasty drug. If they offer it, of course do your resesrch but I recommend running the other way!

I'm two years out, no issues before or after with food, Gerd, vomiting..etc. I had high blood pressure and sleep apnea before & those issues have resolved themselves. Struggling with weight gain but this too shall pass Sent from my SM-G900T using the BariatricPal App

I have Aetna and was never told it would be an issue if there was weight gain during pre-op. Sent from my iPhone using the BariatricPal App

I am aware that calories do cause weight gain. Sent from my iPhone using the BariatricPal App

A hernia doesn't cause weight gain. Calories do.

I had a hiatal hernia repaired with my surgery. Don't think it is a cause for weight gain. If anything, it interfered with me being able to eat or drink. At times, I had to drink a warm liquid in order to be able to eat. I lived with it for several years.

Wanted to ask you all if having a hiatal hernia is a cause or can it cause weight gain? I got sleeved in May 2015 and a few weeks ago my surgeon did an EGD and he found that i have a hiatal hernia which i think is way to early since i am only 1 year post-op and also mild dilation. My weight has been fluctuating alot recently and now i am seeing numbers that i had not seen in a long time. I'm a 6"1 male and i was always at the 180-182 mark but now my weight is hovering at the 188-190 mark.. my diet and routine has been consistent which also makes me feel somewhat frustrated with this weight gain. if anyone has any information please share. I am going back to see the surgeon in 2 weeks to discuss the results and see what is the next course of action. Thank you Sent from my iPhone using the BariatricPal App

Stress can be tough! Mom died in 2002, 20 pounds. My son was born in 2009 and he had multiple problems, my wife was diagnosed with cervical cancer a month after, 30 pounds. My wife had a brain tumor this year, no weight gain but suddenly I had a blood pressure problem. When she was in the hospital I went to my doctor because I was feeling bad he prescribed a blood pressure med and made me promise to take it before leaving the pharmacy and call him in the morning to make sure that I was alive. My blood pressure was 222/111.

I am on a Diet to drop my extra pounds I put on but did you still get approved even with weight gain? Sent from my SM-G920R4 using the BariatricPal App

Excellent!!! What do you contribute your success to? I read many posts from people struggling with weight gain and not feeling the restriction after some time. I am four months out and worried about putting the weight back on. Any advice for long term success?

Your body hoards liquids after trauma. The swelling protects you. But it can lead to temporary weight gain. Sent from my iPhone using the BariatricPal App

@@Julie norton I get that none of us are exempt from weight gain. I've just made nutrition and working out my lifestyle. I still weigh myself in the morning. I just don't think about my surgery anymore.(the thrill of watching my weight go down is gone) I'm getting my motivation from living at the gym, I like being a bad ass at my age. lol Its become my addiction. I don't think of myself as a surgery patient anymore. I plan to participate here when I can. I just don't feel like part of the group some days...Life has just moved on.

There are a few reasons you are feeling tired without any reason. One of them is anemia, which is a lack of red blood cells and conversely, oxygen from the lungs is not properly brought to the tissues and cells. Anemia may be caused by deficiency of vitamins or minerals, internal bleeding or chronic diseases. Women who are at “that time” of the month are susceptible to anemia as blood is lost during menstruation. Still, iron deficiency due to menstruation is less than in pregnant women or lactating mothers, as their body needs extra iron to maintain healthy blood levels. Things may also go wrong when your thyroid glands refuse to cooperate with you. Thyroid hormones, thyroxine (T4) and triiodothyronine (T3) are responsible for metabolic processes in the body. Too much thyroid hormone causes hyperthyroidism which speeds up metabolism while too little thyroid hormone slows down metabolism. Hyperthyroidism causes fatigue and muscle weakness and starts in the thighs. Doing energy demanding activities become difficult and other symptoms include weight loss, feeling warm, shorter menstruations, increased heart rate and thirst. Hypothyroidism also causes fatigue and muscle weakness. The symptoms are reversed to hyperthyroidism such as weight gain, feeling cold and longer menstruations. Diabetes, notorious for causing a range of problems in the body, is also related to fatigue. As glucose is the staple fuel of the body, it is not utilized properly in patients with type 2 diabetes as the absence of insulin causes the glucose to build up in the body. Without its staple fuel, the tissues of the body are not nourished properly and causes fatigue. Sadly, being sad can also be the reason you feel tired. Depression induces negative feelings and also has negative effects on the body as it causes a reduction in energy levels, changes in sleep and eating patterns, decreased concentration and overall laziness and worthlessness which keeps you in bed all day. Reference: http://bit.ly/2f9bC1e

First I must state I know this is life long, and have no issue with resolve of watching every morsel I consume, I wear a fitness watch and do well with tracking everything. My honest real issue came when I started working 110+ hours a week and not doing what I used to do everyday ie (walk 4 miles and bike 11 miles) yes I did that every single morning without fail and I know full heart; I didn't loose weight as fast as others, as I was building muscle in place of the flab. (currently i do not exercise at all!! My body joint hurt because of the even small weight gain my body is revolting literally~ I am ready to do ALL that I must! I am looking if someone has gone through this for guidance and the best fight is fought informed! SO I seek knowledge of where to start besides the fundamental basics, as I am sure I can not be alone in this!

I have 10 days till my last Nut appointment I have to loose some weight because I am over the weight I was when I first started my doctor told me in fine I will still get approved but I'm stressing because I think I may get denied I have aetna please help what can I do this last 10days Sent from my SM-G920R4 using the BariatricPal App

I'll bite and say that after I found out my Mom had terminal cancer, I went into a tail spin of depression and anxiety. Yes, depression meds can cause weight gain - but 5 pounds of weight gain. My depression/anxiety (which I'm still medi cated and in therapy for) may have helped my weight gain but 95% of it was me eating cheap convenient meals. It wasn't so much fast food as frozen carb loaded dinners and pizza/chinese delivery. I will probably have to take meds my whole life. And maybe they'll cause me to have a lower metabolism. But that just means I have to work harder and eat smarter. We made excuses to the point of morbid obesity. So, I'm done with excuses - even if there is a slight (note slight) bit of reality to antidepressants causing weight gain.

@@Barepigies3 I had the kind of depression that required 8 months of therapy and Paxil to correct a chemical imbalance. The therapy gave me the tools I needed to manage it and the Paxil helped reset my brain chemistry. I still have to be aware of my emotions, to this day. But for years, it was untreated and it contributed to my weight gain. But it was because I had come to use food as a coping mechanism that I gained weight, and I could have opted to make exercise my outlet instead. I just didn't. The fact of the matter is, it won't do any of us any good whatsoever to sit around absolving ourselves of responsibility and saying, "No it's my genetics, it's my depression, it's because I didn't get enough hugs as a child..." No...it's because we ate too much and moved too little, and we developed unhealthy relationships with food. That's it. I wasn't trying to attack you, I'm just pointing out the fallacy in your thinking. Nobody is helped by passing responsibility off onto someone or something else, we have to OWN this in order to fix it. I don't need anyone to feel sorry for me for where I got to and I don't feel sorry for myself. In fact I feel like I've finally taken control of the situation, and that's empowering.

I was sleeved on 10/6. And last week when I weighed myself I was 212... then my period started on this past Monday 10/31. And I weighed myself today and I'm 215. Is this normal? Or have a screwed up somewhere?

The genetic theory does not apply to me. I was Slim all my life till 2014. You can check my photos in my Gallery. I also suffer from depression on and off, and never gained weight because of it. My Graves Disease (autoimmune thyroid disorder) did 180 degree turn 2 years ago, I piled on weight 2014-early 2016, yet my Endo says that Graves contributed about 25% to my weight-gain, rest was my unhealthy eating during those 2 years. I gained 90Ib in 2 years due to eating loads of chocolate and fatty foods, and stopped even going for walks, let alone exercise. I have lost 70Ib so far, and nearing goal weight, albeit slower 8 months post op. If genetics were true, and even Graves Disease where you have high metabolism and can eat almost anything without putting on weight, I would have never gained this 90Ib! I wish ......