Search the Community

I have been stressing over the 6 month weight loss program requirement from my insurance and found this explination on the Cigna website. It does make it a little easier to consider why they require it. :biggrin: But I still hope I have already met the requirement! Here is the reference: http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf The benefits of a preoperative weight-loss program include all of the following: • identification of those individuals who will be committed to and compliant with the short-term, long-term and lifelong medical management follow-up, behavioral changes, lifestyle changes, and diet and physical exercise regimen required to ensure the long-term success of this surgery • reduction of operative morbidity and surgical risk • improvement in surgical access with weight loss • reduction of the severity of obesity-associated risk factors, such as blood pressure, glucose intolerance, cardiorespiratory function and pulmonary function Access to a multidisciplinary team approach, involving a physician with a special interest in obesity; a dietitian or nutritionist; a psychologist, psychiatrist or licensed mental health care provider interested in behavior modification and eating disorders; and a surgeon with extensive experience in bariatric procedures, is optimal. Realistic expectations about the degree of weight loss, the compromises required by the patient and the positive effect on associated weight-related comorbidities and quality of life should be discussed and contrasted with the potential morbidity and operative mortality of bariatric surgery. With current state-of-the-art bariatric surgery procedures, patients lose an average of 50–60% of excess body weight and have a decrease in BMI of about 10kg/m2 during the first 12–24 postoperative months. Most long-term studies show a tendency for a modest weight gain (5–7 kg) after the initial postoperative years; long-term maintenance of an overall mean weight loss of about 50% of excess body weight can be expected

In my most previous posts I've been lamenting on a weight gain three years post Weight Loss Surgery(WLS). No matter what I did the extra five pounds did not want to come off. It also lead to a spike in my A1c which put me back into the Type 2 category. I'm very fortunate to have friends and family that have had WLS after I had mine. We form an informal support group by calling each other up and helping to assist in times of need. Well, it was my time of need. Two of my fellow WLS pals directed me to a You Tube channel, Dr. Becky Gillaspy. They said her videos have helped them and it might spark an idea or two for me. I looked at her videos and two in particular caught my eye. What happens when late night snacking and Intermittent Fasting. I realized that I did snack prior to going to bed. I don't snack on junk food but no matter what I snacked on prior to bed was having a negative effect on my weight. I stopped eating at 7PM and did not resume eating until 8AM which gave me an intermittent Fast of 13 hours. When I conducted my weekly weigh in yesterday I found that I was down 3.5lbs from the previous week. It is too early to claim success but it looks as if this strategy might prove to be fruitful. I'm hoping that this also helps with my A1c levels. If anyone has any information regarding the late night snacking and intermittent fasting I would appreciate you sharing it. Thank you and I hope you all are enjoying your new found health.

Hi Melissa, Reading your post, describes me to a T. I drink daily. Was bulimic before the band. Have gained 15lbs in the past 4 months. I was at my end a couple of weeks ago and was stressing about the weight gain when I found this site: somethingfishy.com. It was very helpful in making me realize that I still have an eating disorder. I sometimes wonder how many people have been banded, without realizing that it will not help their eating disorder. I still binge. Going to that site made me realize that I have been using the wrong coping methods in dealing with anxiety. I started keeping a journal and it has really helped. Anytime I want to eat because of uncomfortable feelings, I pick up my journal and put my negative feelings on paper. Then I ask myself why I am feeling this way and if I trully am hungry, or if I just want to drown the feelings out. I'm working on that now. The drinking I will tackle next. One thing at a time. Anyways, I know I'm rambling now, but I just wanted to let you know that you are not alone in this. If you haven't been to this site, check it out. I think you will find that there are many people like you and me dealing with the same issues. Take care. Jasmine

LOL I did the Lindora diet. Same as Atkins. I stopped losing and so I upped the calories in my diet and nothing. I have even begun core body training 3 weeks ago, so maybe the weight gain (2lbs) is muscle, but still discouraging. Today is first day of bootcamp. YAYYYYYYYYYYYYYYY! this should do it.

UPDATE "after surgery I will get radiation my worries is gaining weight during treatment hope I'll be able to go to the gym" @@MeAndTinyTina hi there when is surgery planned? you mentioned December?? not a doc - below are just my thoughts, comments radiation is much different then chemo that i had i lost weight due to nausea, vomiting i don't "think" a side effect from radiation is weight gain!! not positive (covering my asssss if i'm wrong not sure - but i think you shouldn't be worried about weight gain "hope" I'll be able to go to the gym you said "I've been told I won't be going full blast like I usually do." if doc says its ok to go to gym, and you feel ok, great don't overdue, don't do more than your body allows' getting nervous, anxious, scared for surgery, wondering about when going to gym similar to your thoughts of having sleeve sleeve surgery (CA of course more serious) always great to receive updates thanx for taking the time to post my crystal ball shows 2016 to be a healthier, happier new year good vibes sent your way for the success of CA surgery good luck kathy hugggggs

This is my first blog on here so I'll start with an intro - I can't guarantee it will be quick but wth - it's my blog so who cares, right? I'm 30 - yep pretty young... I'm a mom of two girls who exude awesomeness and I'm married to my own prince charming (who is supportive of my weight loss efforts but is sad to see my chunkiness go) :wub: ... and I LOVE smileys LOL. I used to be "normal" weight of 125lbs at 5'1... up until I was about 23/24 and then my thyroid broke... one doctor found a nodule in it and I started having a bunch of funky symptoms (you know the usual - tired, fast weight gain, depression, cold all the time, hair falling out, etc...), well that doctor left the practice and the new doctor did blood work and told me I was fine - I just needed to eat less and walk more and after all I was "getting older" (yeah I was 24 when she said this - I still hate her )... I listened and I dieted - I did a boot camp class, Weight Watchers, and a bunch of other crap... and I just kept gaining... I kept going in and complaining and she kept saying the same thing so finally I just gave up... Fast foward to age 28 and I was somewhere over 200 lbs (I stopped getting on the scale at 200 because I couldn't handle seeing the number anymore) and I went to the doctor because I was sick... saw a new doctor at the practice because mine was on vacation and as she reviewed my chart first thing she wanted to know was why my thyroid had been untreated for the last 4+ years... apparently I was hypothyroid the whole time and I'd gained at least 80 lbs to show for it ... Long story short... It's been two years since I've been diagnosed - I've done Weight Watchers two more times, low calorie diets, the 17 day diet, simply starved myself, and Phentermine. Today I weigh 175 lbs, my thyroid is now regulated but I still can't lose weight without starving and as soon as I return to normal portions I gain the weight I lost back. Now here's where the insanity begins... I have incredible health insurance but of course bariatric surgery is one of the five exclusions on my policy - so I decided to pick up my husband's insurance as secondary coverage to get it paid for since here in the DC Metro area we're talking out of pocket costs of $50K without insurance... Well after I joined his insurance I found out that while my current BMI of 33 qualifies medically for Lap Band, the insurance will not pay for it unless my BMI is 35 which is a difference of 10 pounds! Yes, 10 d@mn pounds!!! So... since my doctor has told me to have surgery or have diabetes and I don't have $50K, I'm on what I'm calling my "fat girl swag" and trying to gain 10 pounds as fast as possible... yep its crazy but in my opinion, so is being 50 lbs overweight because your doctor screwed up for 4 years! In my weight gain journey (which is about a week old), I've quickly learned one thing... I'm not overweight because of how I eat - I'm truly overweight because of my thyroid and it sucks royally! I'm actually having to work at eating more than 2K calories a day and it's almost amusing! I'm meeting with the surgeon on Monday for my initial consult to start the process since there's about a 3-4 month process with my secondary insurance and I'm anxious to see how weigh in goes with him... I'm not sure if I'll weigh with clothes on or in a gown and what his scale will say... I know my primary care doctor's scale seems to always be about 4lbs higher than mine so if that's the case I'm really only about 6lbs away... Despite being nervous I can't weight to begin starting over and returning to who I used to be...

You are only a few days out of surgery. I was in the hospital myself for 3 days before coming home, to find out that I had gained a few pounds. From what I have read, a large majority of people were in the same boat. After surgery you were most likely being pumped full of fluids. You have just had a major surgery and your body is dealing with a lot at this point. The Fluid retention will go down soon. I saw the first weight loss about 4 days after returning home (on top of the Water weight gained).

@@AimsLu All I can do is share my experience with you as I am not a doctor or claim to be any kind of expert. I was diagnosed with Type II diabetes in 1999. Freaked out, was put on meds, lost weight, gained weight, different meds, lost weight, gained weight ... well you get the idea. I had a full time career, husband, 3 children, aging parents to take care of, etc. No time to take care of myself. I white knuckled my way through losing 85 lbs. in 2008 (252 lbs. down to 167 lbs.) with a restrictive low calorie diet and working out 6 days a week. Everything went into remission and I was off all my meds. It's all I did and then life threw me a few curve balls and poof my weigh began to rise again. Now it's 2013 and I'm back up to 235 lbs. Feeling embarrassed, depressed and in complete denial, I hadn't been to a doctor so needless to say I'd never gone back on my meds. November 27, 2013, the day before Thanksgiving, I woke up in the thralls of a stroke at the ripe old age of 52! When I was admitted to the ER, my A1C was 11.2 and my BP was 195/120! I was in Mayo hospital for 6 days, rehab for 10 and finally on the mend at home. Then January 3, 2014, I end up back in Mayo's ER where I was diagnosed with Thalamic Pain Syndrome. A rare, debilitating nerve condition 3-5% of the people who suffer a stroke in the Thalamus of their brain end up with. Now my whole right side is affected and while it won't kill me, I will die with it because there is no cure. The road back to having a life has been a long hard one but after going through an intense Pain Rehab Program at Mayo in the Summer of 2014, I knew I could manage this horrific pain I live in 24/7. I only give you this background because it's what uncontrolled diabetes and high blood pressure did to my life. My primary care doctor referred me to Mayo's Bariatric department in October of 2014 and I began this WLS journey. I went in wanting the sleeve and when asked why, I didn't really have an answer. I was told Mayo no longer performs the band surgery because, after much research, they've found that merely restricting food intake didn't work long term. While they still perform the sleeve, since it's only been around for about 10 years, they worry it will end up with the same results. Then they explained that RNY had been around for 50+ years and it was my best bet at sending my diabetes into remission and getting off all my meds, with the exception of my nerve meds. They also explained the yo-yo diet syndrome. You see when you restrict your calorie intake and lose weight, your body goes into it's "fight or flight mode". It constantly fights to get back to whatever your highest weight was. For me that was 285 lbs. By having WLS it resets your body. In other words, you get a "do-over"! Now once you're body finds it's comfort zone (12-24 months post-op) that's it. You need to maintain your new weight within 5 lbs, either way. If you let it get out of control again, you'll be back on that yo-yo roller coaster ride! This really excited me. To know that I could have a second chance to get this right, I was all in! Having RNY was hands down the BEST decision I've made for myself. I had surgery at 8 am on a Tuesday and by 6 pm the next day I was home. Took 2 pain pills on Thursday, one on Friday as a precaution and by Saturday I felt wonderful. I've had no complications and was med-free with the exception of my nerve meds and 1/4 of the cholesterol pill I once took (only because I'm a stroke victim) from the date of my surgery. I can't exercise like a lot of people, due to my nerve condition but I walk as much as I can. I'm 54 years young now and sure I have loose skin and a few more wrinkles (I always say "fat don't crack") but I'm healthier and happier than I've been in years. I'm only 6 months post-op so I'm still on this fabulous journey!!! I wish you the best on whatever decision you make for yourself The 1st set of pics is me at 285 lbs. & 172 lbs. and the 2nd set is me at 257 lbs. and 173 lbs.

Just thought I'd give you some of my thoughts on this. I'm someone who is covered in stretch marks. They are all over. I'm hoping that after I loose weight they might not be as noticable, I'm not really sure how they work, but I'm only 20 so I'm hoping my skin, even though its so incredibly stretched right now, will be able to tighten back up. However, a couple of my friends are having babies/already have had babies, so I've gotten to see a lot of their stretchmark experiences. My friend who had a baby this summer was tiny and had no stretchmarks at all pre-pregnancy, and after pregnancy, she has one tiny little one on her stomach that has since disappeared. So it seems that pregnancy can affect people differently than weight gain. A couple of my other friends have had no problems with stretchmarks and pregnancy, but most of them are in their early 20s, so it might have something to do with age? Anyways, I'm rambling, haha I really don't know what I'm talking about and have never been pregnant, I just thought I'd share some of my friends experiences. Good luck with everything!! Allison

Hi: I'm jealous of how good you are feeling . I had band #2 put in on 7/20 after my stubborn slip wouldn't fix itself after 3 months and some weight gain. I'm still very lethargic and am still having alot of shoulder pain, but this is probably because I got a head cold two days post op and I went back to work on day 6 (new job - had to). I remember having alot more energy the first time around, but I also had been on a liquid diet for ten days pre-op and weighed 287 pounds. This time I thought it would be alot easier because I weighed 208 and didn't have a pre-op liquid diet and the port was fine and left alone. So, maybe it's the all liquids post op that's doing this. Or, it could be that I'm just pushing myself too hard and first time I had two full weeks off. Anyway, best wishes to you. Hopefully you'll reach restriction soon and be on your way down on the scale. You're really not expected to lose much weight until you reach restriction and then you'll find you have to remind yourself to eat. Believe it, it's true.:thumbup: Take care. Sue

I don't know what else to do, my weight keeps going up regardless of working out daily and counting calories. My insurance doesn't cover WLS so we're thinking going to Mexico. Has anyone with pcos and constant weight gains has success with the sleeve? Sent from my iPhone using the BariatricPal App

I’ve had a curious day. I forgot to weigh in first thing this morning. So I weighed just a few mins ago. It says I weigh 327. That is after my shake and coffee. I know, logically, that this doesn’t mean I’ve necessarily gained weight but it’s messing with my head. Also, my blood sugars are not so good today but I cut down on my long acting insulin to see if it’d help with the lows. LOL. It did! Not to worried about that right now. Nerves are coming into play. It’s not a freak out nerves but I am having a bout of the doubts. I know I’m going to do this but some things are worrying me. My mom is sick and she’s my support system. I’ll likely be alone more than not in the hospital. I have pretty severe social and general anxiety. So that’s a big worry. No matter what I’ll be alone overnight due to our critters needing one of us home. I’m writing this down to let it go. I’ll do wonderfully!

Has anyone gained weight or stayed the same weight during the 6 mo pre op diet? If so, were you still approved?

I had gastric bypass surgery 5 years ago. I was incredibly determined and managed to lose 180 lbs. in a year's time. I'm 5' 9.5" and I went from a size 28 to a size 10. Now, I've regained a lot of weight and I'm starting over. I thought it might be helpful to list the steps that caused my weight gain. My goal is to tackle these 6 and starting moving in the right direction. Does anyone else have additional things that contributed to regaining weight? Stop weighing yourself Stop tracking your food intake Stop exercising Drink liquids with meals and ignore the 15 minutes before/30 minutes after rule Start eating your old favorite foods Stop visiting Bariatric Pal forums

I was denied for a net weight gain, But in my defense my 37 yr old husband has a heart attack and also needed a triple bypass. It was so hard on me and while he was in the hospital it was too hard to breathe let alone eat. Which I didn't. I'm asking them for an exception, I'm trying to get healthy with my husband and I can't keep up with him now...which is a great thing for him. I know what I did wrong, and I'm hoping they see that I've had a very difficult time the past 6 months. If not-I can do 3 more months of NUT visits. And I intend to continue. If the senator can't help- than so be it. But I at least put in the effort to continue to fight!!

I love your statement "To accept that I am worth this." I am brand new lapband. My surgery is February 11th. I've read a couple of your blogs. Please keep going. I'm so concerned about the menu part and feeding my family at the same time as I restrict what I eat. When members like you post their menus, it gives me ideas. I can't really give advice on the 2 pound weight gain, but congratulations on the overall 30 pound loss! Cindy

Hey Jessica. We were banded the same day! I have lost 16 pounds pre-op and as of today...3 since surgery. I was also told that weight gain/loss is not important right now. Healing and getting our protein and water in are!! I wish you all the best!

I joined this forum in 2012, but wasn't really active. One friend who I connected with on here and she vanished, so I just never really came back. I just had a revision from sleeve that was done Nov. 2012, to bypass on Tuesday. I had some GERD, but not severe, but full weight gain. I also was 30 pounds from goal weight at my lowest. I knew the sleeve wouldn't work for me, because it's not about how much I eat, but what I eat when I feel like eating. You guys, this is HARD. Before sleeve, I didn't eat much, even less after. Now, I'm freaking dying to eat. Really, I just want coffee with my creamer and I'll be good. I've always said, I could drink coffee all day and be fine. I can't get comfortable. I handle surgery really well, like shopping the day after hysterectomy, appendectomy, etc, but this?! I'm still on pain meds & anti nausea. I could really use some encouragement, cuz I'm miserable. I need to know there's light even in a week. I'm really struggling. For those who have done this, any words of encouragement?

I'm a little discouraged. I'm currently 14 days post op. I have had no issues and other than fatigue, I feel great. The weight has been falling off every day and all of the sudden on day 10 it just stops. I'm thinking ok no problem it's just a stall. It'll be over before I know it. Two days later I step on the scales and was shocked to see that it had suddenly went up 2.5lbs!! Obviously I'm still on liquids, calorie intake 400-500, since surgery I've lost 11lbs. & I was a lower bmi patient. Still how is this even possible?!

You can totally eat too much eventually! DougNichols posted about running into a 4-yr sleever who was still overweight and just ate around her sleeve. I'm on vacation now and have been consuming a ton of calories, too! You can't down an entire cheeseburger or a burrito or something, but if you eat frequently, eat high-calorie items, and drink sugary drinks and are sedentary, you could easily gain weight. I probably had like 3000 calories yesterday....I'm not stressing because I also walked 10 miles and was active otherwise (swimming, etc), but if I was sedentary, this would definitely translate into weight gain.

To a certain extent, if you will have loose skin, you will have loose skin. It will firm up some, but if your skin was damaged from your weight gain, it can't heal itself. It can shrink up some, but won't gain elasticity if it was lost. Light weight training can help, I've heard, so can keeping your skin moisturized, to help the collagen and elastin. The places where you have stretch marks- those are marks of the elasticity of your skin being damaged. I know I'll always have loose skin in those areas, unless I have cosmetic surgery. My calves will be fine, but my upper arms, thighs, belly and breasts will be loose and saggy.

Carol, Carbs started to creep back in to my eating, and I'm learning quickly that if I don't stop it, it quickly leads to weight gain, not just a stall. The further out I am from surgery, the easier such things to down - my smaller stomach does not help me here. Fortunately, I learned during the pre-op diet that getting the carb count VERY low for a few days completely kicks the cravings and makes it much easier for me to stay on track. So, when I get into trouble, I have to white-knuckle it through about three days, and then it tends to be smooth sailing. I'm afraid I'm coming to the conclusion there are some foods I just have to say goodbye to if I want to keep my weight off. I'm not an "everything in moderation" kind of girl. Happily, I'm learning to find substitutes I enjoy, and am discovering a world of low-carb, sugar free baking options for those times I just have to have a treat. See if you can go "cold turkey" for about 3 days, it might be all you need to get back on track.

Anyone take nardil after being sleeved? Nardil is an maoi that is known to cause weight gain. Wondering if the craving for carbs would be tamed with the sleeve?

My lifelong weight problems were due to several factors such as heredity, bad lifestyle choices, and an introduction to crappy processed food very early in life. From the time I was a toddler I ate canned Franco American macaroni & cheese, hot dogs, Rice-a-Roni, ramen noodles, and other cheap processed "foodlike" substances. Unfortunately, most of these foods are starchy and promote weight gain. My grandmother weighed more than 400 pounds when she died. She was obese many decades before the obesity epidemic took off. My mother was also morbidly obese at the time of her death. Although I think there's some genetics involved in my tendency toward fatness, some of my poor lifestyle choices were to blame. I am also hypothyroid and insulin-resistant. These two conditions are not good for weight control.

I turn to food for comfort. Any major negative or stressful life event that's beyond my control causes me to binge "comfort foods". Over the past 9 years I've slowly gained 120 pounds, lost 75, and gained back 50. I can seriously narrow down the weight gain to 4 events. Of course now the damage is done, and hindsight is 20-20. I'm hoping with better coping mechanisms and self awareness I won't fall back into old habits.