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I am new to the forum and just beginning my journey towards WLS. I just found out my husband's insurance (Aetna Choice Pos II) covers the procedure and will switch to his provider at the end of the year. I have already selected my doctor and they have begun the process of meeting all the requirments for the Aetna insurance plan. Once I switch providers they will submit the paperwork for approval. I sent an email to Aetna asking them about the coverage. Below is the response from the insurance company. I have two questions if anyone is familiar and can offer answers: 1. Does this mean I will only pay a maximum of $5,750.00 before the deductable? 2. Is the maximum including doctor and hospital fees? I plan on also sending my questions to Aetna too. I've enjoyed so many of your inspiring stories and look forward to posting on my success. Thanks! This is in response to your inquiry on your coverage for weight loss surgery. Your benefits Your plan includes coverage for in-network and out-of-network services. In-network benefits apply: * Your deductible is $750.00 per calendar year. * When your deductible has been met, the plan will pay 50% of the allowed charges. * Your plan has an out-of-pocket maximum of $5,750.00 per calendar year. * Your plan will cover up to a lifetime maximum of $10,000.00 for this procedure. * Bariatric surgery is not covered if you will use an out of network provider. Your plan also covers obesity preventive counseling at 100% of the contracted rate, no deductible, and no copayment for in network providers. You are entitled to have 26 visits per 12 months, of which up to 10 visits may be used for healthy diet counseling. The information provided above is not a guarantee of coverage. Coverage is based on all the terms and conditions of your plan as well as eligibility at the time services are received.

Ladies, I've been on Bariatric Pal for quite a long time. I've certainly read thousands, if not tens of thousands, of posts. Out of all of that material, I've never read anything quite like your story. This is an amazing learning experience and one that I'm sure will be repeated by others. Well done and thank you for sharing!

Hi everyone, I was a low BMI bandster. I had good weight loss success with my band, but it has been a journey. Fills, unfills, episodes of being so tight I had to have an immediate unfill, etc. About 6 months ago I started having symptoms associated with a slip and the upper GI tests I've had done definitely show a slip. My choices are: remove lap band (which is not what I want to do), reposition lap band, or revise to a sleeve or bypass. I work for one of the largest health care providers in the St. Louis area and my insurance will cover a revision, but only with a provider in their network. Guess how many bariatric providers there are in the network? 2! One is the surgeon who did my lap band and he only does lap band. The other surgeon is currently not doing revisions and won't be for potentially another year. I could go to another surgeon and do self-pay, but that seems crazy to go through that again. I was self pay for my lap band surgery because my BMI was not high enough and I just recently paid all those bills off. I am also leery of the sleeve surgery because it is so permanent. Lap bands can always come out. I feel like the decision is being made for me. I prayed for assistance making this decision and all arrows are pointing me this way. Has anyone had success after a lap band slip, then reposition? I am worried about it happening again in another three years.

I've heard of people doing the same with beef jerky. The only problem with chewing the juice out of something and spitting out the remainder is that if done often enough, it could possibly lead to the formation of bulemic type behavior. Just be very aware of what you are doing. Are you still on liquids or can you have soft/mushy foods yet? I think the suggestion of putting the fruit in the food processor or blender is a reasonable alternative. What do your bariatric nurses/doctor say about what you are doing?

Bariatrics were excluded from my BCBS TX policy too.

My plan had no coverage for bariatrics- so not even a consult would be paid for.

I like Chewable FloraVantage Probiotic from Bariatric Advantage. Tastes like grape smarties.

I can answer the last question, the Bariatric program is usually very helpful as this is all they do! They check exactly what needs to be done and they'll tell you. It's a win win for everyone involved so they are good about checking on it.

I take a bariatric multivitamin and hair, skin & nails vitamins. O don't think it helps. I'm also losing hair rapidly. I have plenty of hair, but still worried. Im also 4.5 months out. I can feel short stubby hairs all over in my scalp coming in, so maybe that is a good sign it will be growing back soon. Good luck!

Hi Ladidi and welcome! It is not uncommon at all for 60+ folks to have bariatric surgery! I was sleeved last year at age 67. No adverse events, and I had a successful recovery. Go for it!

I'm glad I searched before posting my issues with Omar. I first spoke with him in early 2016. Found out I was pregnant again so had to postpone. He was really nice and tentative. I even joined the Facebook group they have. Fast forward. I had my baby Dec 2016 and reached out again. Omar failed to tell me that he no longer works forBaja Bariatrics. He dismissed my questions, questioned me when I told him I was considering having the single incision sleeve and kicked me out of the Facebook group. He seemed extremely shady so I contacted Baja Bariatrics directly. Henry (Omar's replacement) and Dr Illan both called me next day to explain what was going on. I'm very happy I didn't give him any money or proceed via Omar's website. He has NO affiliation with Dr Illan. Please do not give him your money.

Hello, all! I am getting ready to schedule my surgery for sometime in October. I started my "journey" (actually feels a lot like the road to Hell!) in May, 2005. It took a long time for my insurance company to finally deny me for surgery. I will be going to the Mid-West Institute of Bariatric Surgery (Lenexa, Ks.) next week to make my appt. with Dr. Jessie Lopez. Does anyone have any experience with this Doctor or his office? So far, I have had a lot of trouble getting them to return my phone calls when I was trying to make the appt. I will be paying for the surgery on my own---it seems like a LOT of money! BTW-I am 215lbs., 5'4', hoping to get to 130.

At two weeks out I was consuming less than 1000 calories per day. I know that's not precise, but my bariatric aftercare program didn't require me to count calories, fat grams, carbs, or anything other than grams of protein and ounces of water. Here was their theory: as long as you get 80+ grams of protein a day, everything else falls into place. Protein has a very high thermic effect. In other words, our bodies expend a remarkable number of calories to process and digest the protein we consume. If your protein intake is more than adequate, you'll continue to lose weight. On the other hand, you might stall and plateau long and hard if you don't eat sufficient protein. Good luck to you.

I have been trying since last June to see a surgeon for bariatric surgery. Global health has continued to deny my request to meet the surgeon and all together denied the surgery request by my Primary Care DR. My primary care doc and his nurse were very helpful to get all paperwork sent in to Global Health with the request. I also had their requirements met with another support letter from my Endocrinologist. So now I am moving forward as a self pay patient. My appeal was even denied. I am starting to believe that Global Health states that they will pay for bariatric surgery just to get new members to sign up. Has anyone else had any luck with Global Health?? I would be very interested to know. Also, should I send a letter to the Insurance Commission?

@@Inner Surfer Girl Thank you. I hadn't considered OA. I do think I need more face-to-face interactions. Next week I'm attending my first bariatric support group. Sent from my iPhone using the BariatricPal App

I do too, that's why I hang out or lurk, whatever you call it, on Bariatric Pal, a lot of times when I share advice it reaffirmed the truths in my own mind. I do know better nut I am imperfect at times. Sent from my VS880PP using BariatricPal mobile app

1. sleeved on July 3, 2012 2. Empire blue cross/shield 3. Pre-op experience: Other than some administrative frustrations (people not sure if my tests were in, and recorded, et...) I had a good experience. I was a little'pushy'....I had no intentions on waiting 6 months for surgery! 4. Post-op: great! I came through the surgery with flying colors, never filled my pain meds once home. The Bariatric Team at Mercy Hospital, was supportive both pre and post op. I am down 12 lbs so far, and trying to not to weigh myself every hour! LMAO!

I absolutely love my "Bariatric Advantage Advanced Multi EA". Tastes like a candy bracelet. And I love my Calcium Citrate Chewables, they taste like tootie rolls. I had my VSG on Feb 1st and don't want to swallow huge pills if I can help it. I have enough other things to swallow, like the probiotic. I mix in my liquid Trace Minerals with a large bottle of Water and can not taste it . =D I'll exhaust you talking about vitamins! lol (I still need to learn to make my posts succinct. >.>)

Like I said earlier in this thread, I still do 2 or 3 protein shakes a day, 2 of them are 4 oz and one is 16 oz. There are some great flavors out there, and if you get a little creative they are even better. My favorite at this time is Summer Melon mixed with Sugar Free Watermelon/Kiwi Koolaid. I purchase the Summer Melon at Bariatric Eating. That is my afternoon drink, it is a mixture of flavors of Watermelon, HoneyDew and Cantalope. I also have 2 mocha latte's a day just a simple scoop of vanilla powder, or sometimes chocolate, a mazel coffee packet and 4 oz water, sometimes I will add a shot of sugar free caramel syrup. I have an Atkins shake when I wake up in the morning, and then the others are if I get to want a snack during the day, I bypass the snacks and grab the protein, sometimes I will grab a cheese stick, or a babybell round but normally a drink.

I pray the bariatric clinic contact you soon!

I agree, I hope the bariatric clinic contacts you soon as well. So, the constipation... (here comes my barrage of questions... not necessarily to answer, but to think about and consider) How long has it been since you had a bowel movement? They didn't find impaction? The enema was ineffective, did you hold it long enough? So, there is a bariatric clinic near you and you're waiting for a call. I would call and pester them. If you have to suck it up and pay out of pocket for an appointment, it will likely be worth it at this point. This is not something that you can just ignore, all potential serious problems aside, there is no reason you should have to sit around in pain just because you haven't been able to figure it out. If there is any confidence that it truly is constipation and the enema didn't work, you could possibly try a colonic (I make no claim to the safety or medical appropriateness of doing a colonic while you are constipated, definitely run it by your doc if you think about doing it) (I've done a couple. They're weird and somewhat unpleasant, but once you get over the mental squeamishness, they're not a big deal). If all your testing is clear, I think constipation seems like the most likely culprit. The tylenol 3 is only keeping your peristalsis slowed down, so it helps the discomfort, but also could be exacerbating the problem. During all this, are you continuing with a stool softener? (docusate sodium or Miralax, or whatever?) I really don't know... I think I'm tapped out of advice. When I was constipated, I hit it with everything I had. I started on the softener, used a stimulant laxative, followed up with a suppository, and then followed that up with an enema. Even that only got me about 1/2 way to where I needed to be, but continuing to thoughtfully hit it with additional treatments and sticking with daily Miralax eventually got me back on a reasonable schedule. Good luck! Pester that bariatric clinic. They aren't going to feel any pressure to quickly contact you, you are the one suffering. I really hope that you get it figured out and start feeling better soon!

Thank you! Are the bariatric advantage chews chewy or crunchy? My Nutritionist said only take crunchy vitamins. How are your calcium levels now?

Nothing but compassion for people that have weight issues. I have walk in the shoes of an obese person. I never want to lose that perspective in life. It would turn me away from WLS if someone came up to me preaching how I need to do this. Most people don't want weight loss advice.....Especially from a bariatric patient.

I was sleeved January 25th, 2016. I am down 35 pounds since my journey started last November (24.3 pounds down since surgery). For the last week or so I have had pain in my right hip... I can't tell if the pain is really up in the joint or if it is more to the front of my thigh/in my pubic area... all I know is it HURTS... it hurts if I sit my "normal way" on a hard surface (I often tuck my right leg up and under my left leg when I sit) and it hurts when I walk (though if I walk a lot it sort of calms down some and isn't so bad for awhile). I have arthritis in other joints, and I am wondering if (as the fat goes away) I am losing the "cushioning" that held all my parts together; and that is revealing pain from damage done to my body while I was overweight. I probably need to see my doctor, but my next post-surgical appointment is on the 14th and they simply can;t see me until then. I may need to go to an orthopedist, but in the meantime - has anyone else experienced this or something similar? I don't think bariatric patients are supposed to take Ibuprofen - which has ALWAYS been my go-to for ANY kind of pain - is it not allowed? Should I try Tylenol? Is that even likely to help me with this kind of pain as well as Ibuprofen would?

BARIATRIC REALITIES: Causes of Obesity – What Factors can YOU Influence? (Part One of Three) I’m guessing most of us understand that the disease of obesity is a complicated one. There are a number of factors that contribute to obesity. Some of these factors you may be very aware of; others you may be surprised about. Some of the causes of obesity are things you cannot do anything about; other causes of obesity are things you can influence. It’s important to recognize the difference. Why? For starters, you can stop beating yourself up over the things you can’t do anything about. It’s also important that you focus on putting forth effort where it will get you the best results! It’s essential for both doctors and those suffering from obesity to have a mutual understanding of these causes of obesity and which people can influence, so that: 1) Doctors can develop or increase empathy for the struggles of those suffering with obesity. When doctors better understand that many people with obesity have struggles that go beyond fighting their biology which negatively impact their weight, the doctors can more compassionately and appropriately address these issues and refer patients to see other professionals, if need be. 2) People struggling with their weight can evaluate the numerous factors impacting obesity and work toward accepting those things they cannot influence. In addition, they can take responsibility for putting forth effort into those aspects of their struggles with weight that they can positively impact. All righty, then! Let’s look at three of the main contributing factors of obesity and then talk about each one, emphasizing what, if anything, each person can do to have a positive impact on their weight. Genetics Culture and Environment Metabolism Genetics Obesity definitely has some genetic determinants, as researchers have clearly discovered. If there are a lot of obese people in your extended family, you have a better chance of being obese than someone from a family without a history of weight problems. Although there are many more obese people in the current population than in previous generations, this cannot all be linked to genetics. The genetic composition of the population does not change rapidly. Therefore, the large increase in obesity reflects major changes in non-genetic factors. Listen to this… According to the Centers for Disease Control and Prevention (2002): “Since 1960, adult Americans have increased in height an average of 1 inch but have increased in weight by 25 pounds.” So in 50 years, the human species has grown taller by only an inch but heavier by 25 pounds. That tells us there is more than genetics influencing weight gain in this country. PATIENTS: Even if you have a genetic predisposition for obesity, there are other factors involved, including the food choices you make and whether or not you exercise on a regular basis. Some of these behavioral factors are habits learned in your family, so what appears to be a genetic predisposition may be a familial pattern of unhealthy habits that can be broken. DOCTORS: Remind yourself that patients cannot “eat less/move more” and have any effect on their current genetic makeup. Acknowledge to patients their genetic predisposition for obesity in a compassionate manner. Help to gently educate them about the factors affecting their weight that they can influence. Do so in a “firm and fair” way, providing encouragement rather than admonishment. Culture And Environment In addition to one’s genes, a person’s culture and environment play a large role in causing people to be overweight and obese. The environment and culture in which you were raised impacts how and what you eat. Some people were taught to eat everything on their plate and couldn’t get up from the table until they did so. Others never sat at a table for a meal but watched television while they ate. Some kids are fed well-balanced meals while others exist on fast food or microwaved mac and cheese with hot dogs. In some cultures, simple carbs make up a substantial part of every meal. In other cultures, fruits and vegetables are consumed regularly. When you are a child, you’re not in charge of buying the groceries or providing the meals. You did learn, however, about what and how to eat from those with whom you lived. And guess what that means? How you feed your children is what they will think of as “normal” and will most likely be how they eat as adults. (I’m always concerned when weight loss surgery patients tell me their kids are “just fine” even though they eat the same unhealthy foods as the obese parent. It’s only a matter of time before the kids start to gain weight and have health problems as a result of their unhealthy diet and learned eating behaviors.) PATIENTS: Although your genetic composition cannot be changed, the eating behaviors you learned in your family, from your culture, or developed on your own can be changed. You alone now determine what kind, and how much exercise you do and what and when you eat. Your behavior is completely within your control. Work toward accepting the fact that you are in charge of, and responsible for, your behavior and every food choice you make. For every choice, there is a consequence, positive or negative. And NO EXCUSES! It doesn’t matter how busy you are, whether you get a lunch break at the office or whether you have to cook for a family. Even if you have five kids in different activities and spend your life taxi-ing them from one place to another, you are the adult and you are responsible for how you eat and how you feed your children. It takes a very responsible person to acknowledge, “Although I have a genetic predisposition for obesity, I am responsible for making healthy choices about my eating and exercise. For me and for my children.” Focusing on what you do have control over rather than that over which you are powerless, leads to believing in your capabilities. So take charge and make positive changes happen! DOCTORS: Engage your patient in a discussion about the cultural and environmental factors that helped shape their current food choices and exercise behaviors. Empathize with them, noting they are going to have to put forth consistent effort to change years of bad habit formation. Encourage them to get support, whether it is from friends with a healthy lifestyle, a health coach, a personal trainer, or the use of free online exercise videos. Help them set a short-term, reasonable goal and set an appointment with you to follow up. Remember, docs: That which is reinforced is repeated. Reinforce even small steps forward you see in your patients. This can go a long way in encouraging them to continue making healthier choices. A step forward is a step forward. Notice and praise every single step forward your patient makes! Resting Metabolic Rate Resting Metabolic Rate (or RMR) is simply the energy needed to keep the body functioning when it’s at rest. In other words, RMR describes how many calories it takes to live if you’re just relaxing. Resting Metabolic Rate can vary quite a bit from one person to another, which may help explain why some people gain weight more quickly than others. And why some people seem to find it more difficult to lose weight than others. There are some factors related to metabolism that you can’t change, but there are actually some that you can influence and change. Things you cannot change about metabolic rate: Metabolic rate decreases with each passing decade, which means the older you are, the slower your metabolism gets, making weight loss more difficult. Sorry ladies - Men generally have a higher metabolism, meaning they burn calories more quickly than women. You can inherit your metabolic rate from previous generations - which can be a benefit… or not. An underactive or overactive thyroid gland can slow down or speed up metabolism. Some things you can do to influence your metabolism and burn more calories include: Eat small, frequent meals. Drink ice water. You can boost metabolism temporarily with aerobic exercise. You can boost metabolism in the long run with weight training. PATIENTS: I’ll bet you didn’t there was much of anything you could do that would increase your metabolism. I’m hoping you choose to implement the ways you can help your body burn more calories. And what do you know? They are completely consistent with healthy post-op behaviors that you’re supposed to do anyway: 1) Eat small, frequent meals. CHECK. 2) Drink water (so add ice and boost that RMR). CHECK. 3) Engage in exercise, both aerobic and weight bearing. CHECK. There’s no reason NOT to anymore! (That’s a slogan from a really old commercial…) The point is, your specific RMR is both something that is unique to you, and that will slow down with age, is gender-influenced, and can be affected by thyroid issues. Accept the things you cannot change and DO the things you can to get the most out of your own, unique RMR. You DO have choices! Opt not to make excuses and JUST DO THE THINGS YOU CAN! DOCTORS: I’m pretty sure that educating patients is in your job description. Even though you have an allotted set of minutes during which to accomplish all your goals with a patient, point out the ways they can boost their metabolism while you’re looking into their ears, or hitting them on the knee with that little hammer. Present it as a, “Hey! Guess what I was reminded of today?” sort of thing. It’ll probably be absorbed better than a mini-lecture. Leave yourself a sticky note in the patient’s folder to bring it up in your next session… and then a new educational point for the next meeting, along with the small goal you set with them so you can be sure to praise them for their efforts! Patients and Doctors and all Allied Health Professionals: We need to work together to do the following: 1) End Fat Shaming 2) End Blaming 3) End Lecturing 4) Encourage reciprocal AWARENESS and ACCOUNTABILTIY 5) Encourage reciprocal EDUCATION and DISCUSSION 6) Encourage reciprocal GOAL-SETTING and FOLLOW-UP Stay tuned for Part Two of BARIATRIC REALITIES: Causes of Obesity – What Factors can YOU Influence?