Strange Scenario .. anyone else in the same boat?

[krafticus 0]

Hello all,

I have been reading the board and other information and know that I am ready, willing, and able to have the the band .. but there is a small issue.

Currently, I qualify under my insurance with the exeception of the 6 month supervised diet. I met with the dietician last night and it seems I am VERY borderline for my BMI (I have 3-4 co-morbidities). We weighed in last night with shoes on, keys, wallet, phone in my pocket to get a few extra lb, and I come in at 37.1 (without this, I am 35.9).

It seems unethical, but the dietician is making me maintain my weight for the next 6 months instead of losing anything. If my weight drops down to under 224 during this time, I lose out.

Now, this is hard for me to grip, as I don't want to stay this way a day longer; however, I know the band could essentially save my life.

Has anyone else been in this same boat, and if so, how did you proceed?

Thanks

Mark

[Bella Luna 1]

I am in a similar scenario. However, my insurance doesn't require the 6 months waiting period. But I am just 5 pounds below having a 40 BMI. So I'm not trying to loose right now, not until I have the final go ahead with the insurance and have a surgery date set. It feels weird. I keep wanting to go exercise and start this diet going, but know that I have to wait. (I plan on just adding some ankle weights when I go in for the actual weigh-in). It is hard, but I know that if I again try to diet again without the band I'll fail again, and my only hope is getting the band, thus I need to just be patient until I have the tools necessary to succeed this time (the band). Good Luck and just think of the ultimate benefit for waiting.

[Kristy29 0]

My sister had gastric bypass, and she actively gained weight in order to qualify. Sometimes you have to do what you have to do.

Interesting thing though, when I went for my seminar the nurse actually talked about this. She said that if you are borderline, and then go on the pre-op diet, it won't matter because the insurance takes your weight from that day.

Maybe call your insurance and tell them that you weighed this much at your appointment, and you want to lose a few lbs during the pre-op phase because you know it will make surgery easier on your body.

My doc requires a 5% weight loss or he will not perform the surgery, so not losing is not an option.

[tinksmom 0]

My doctor's practice routinely submits the beginning weight before the 3 or 6 month dieting. They assured me that it was always done this way and the insurance companies had no problem with it. But the doctor also had no problem when during the pre-op period I concentrated on changes in diet not weight loss.

[dreamingofbeingskinny 1]

I did not have this scenerio but another friend did, and like the first poster, she actually wore leg weights when weighing in. I know it sounds ridiculous and unethical, but I do believe in doing what u need to do in order to get this done. Insurance companies can be very tricky and they will not think twice about denying you. Talk to your doctor and see what else u can do to qualify, dig deep, family history etc. Trust me when I say your doctor wants u to have surgery as much as you do...Remember this is their business. Most docs have pretty savy offices and can help you stay approved. Best of luck and keep us posted!

[BetsyB 9]

I'd have the dietician double-check with your surgeon's insurance specialist.

Lots of times, they go with BEGINNING weight---loss during the supervision time, even to a BMI lower than the one they require--is okay in those circumstances.

[abracadabra 0]

Please check to see if your insurance takes only your starting weight as most do!

I have BCBS of MA and they use the starting weight from day #1 consult. My surgeon encouraged and expected (but not required) me to lose weight during the preop process and I was very borderline when I saw him- BMI 41 w no comorbidities.

More than likely, you shouldn't face any issues if you lose weight. In fact, it makes you a better surgical candidate because it makes for an easier surgical case and you have shown that you are comitted to the lifestyle changes for post op.

Good luck!

[zeniada 9]

i too am told i need to go on a 6mo supervised diet and if and only if i fail will my doc even consider doing surgery and it's not even the lap band it's the bypass! i dont want that so I'm gonna go to mexico and get it done on my own i have a BMI of 50.1 i need help!!!

[spoiltmom 44]

I'm so glad you posted this b/c I'm in the exact same boat! My BMI is 37 with comorbidities. My insurance requires a 6 month diet first but I'm scared to lose any weight now.

[oldoneyoungagain 200]

I'm so glad you posted this b/c I'm in the exact same boat! My BMI is 37 with comorbidities. My insurance requires a 6 month diet first but I'm scared to lose any weight now.

I too had to go on a supervised 6 month diet per BC/BS but didn't lose any weight and I got approved. I did have the comorbidities with a BMI of 40, plus I was over 65 years of age, which I had to find a surgeon who would do the surgery. This all took place starting last Sept. with the surgery on 3/17/10. I think with some insurance companies the operative word is "supervised diet" and since we associate "diet" with weight loss we think we have to lose weight. They also required my primary doctor supervise the diet, which he did, but he was wanting me to get this surgery because of the comorbidities so he just noted my medical file that he seen me for weight loss and discussed diet. Did he actually care if I lost weight during this period, no. All this information was turned over to the insurance company and got the approval within three weeks. Just an FYI for you.

[khunt719 2]

I too had to do my 6 months with a dietician. I gained 30 lbs in the 6 months in order to qualify and it took awhile but I did. After my final weigh in with her, I went on a diet and lost the 30 lbs due to eating like a bird and exercising like crazy. But now I have the band and wouldn't have done it any other way. I would have done anything the dietician asked just for me to be approved.