First Consultation

November 23, 2005

I am getting the ball rolling. Had my first consult today and was amazed to find out that I was NOT morbidly obese........I am SUPER obese , which it seems is beyond .That was great to hear .My ins., Anthem, has a BMI range

that you have to fit into for them to cover the band. So before I can get surgery to lose weight.........I have to lose weight.The more things change the more they stay the same.

Jeff

dimples · November 23, 2005

Hi I am not sure if I understand you when you say You have to lose weight first. Isn't that the purpose of the band, because you can't lose the weight on your own. How much weight do you have to lose in order to get insurance to pay?

tomorrowsdream · November 23, 2005

I've heard of people over 400 lbs. getting the band. They come in different sizes. Actually "super obese" sounds better than "morbidly obese" which always makes you fell like you are at death's door for some reason

I think someone informed you wrong....do some more checking. I've never heard of anything like this before. If you could lose weight on your own, you would have done it. We all would have, and then no one would need the band. Doesn't make any sense.

paula · November 24, 2005

was amazed to find out that I was NOT morbidly obese........I am SUPER obese

I had to chuckle when I read this. Its probably the only time in your life that you will ever be "happy" with being labled as "Super Obese".

Jeff, you are right. Alot of times doctors have their patients go on a pre-surgery diet - I think its required if you are over 250 pounds. Their reason is because the diet reduces the size of the liver - making it easier for the surgeon to move around in our belly. Many of our LBT members have had to do this. If you need any food suggestions for this phase... just ask!

Good luck and God Bless!

November 24, 2005

I'll try to answer all at the same time.

The SUPER obese label applies to a BMI over 50.

My ins. Anthem BCBS will cover the band if My BMI is between I think 35 and 50

Either way I have to get my BMI below 50 and coverage is there. Soooo I now have to lose 48 lbs to get a device installed to lose weight!

I am going for it. The interesting part is that WHEN I lose the 48 will I still be that hot on having surgery????

Jeff

NJChick · November 25, 2005

Jeff, Renebean is going thru the same thing as you, her insurance company won't pay unless her bmi is lowered. She posted on the insurance thread about it.

Before I had the surgery I thought to myself....gee I can lose weight and once I start do I really want surgery. Well I answered myself right then and there. Yes !!! I know I can lose weight, I've done it a gazillion times, I've even lost and kept off for 10 years 150 lbs..... but thats the key, keeping it off. Can I keep it off.... NO! I can't thats for sure, my closet tells a story with all the sizes in it. So my decision was to have the surgery b/c I couldn't keep the weight off.

I love my band, I'm going thru life tasting it instead of inhaling it now its an awesome feeling.

Good luck with your decision.

Bruce Peter · November 25, 2005

Does anyone here know the formula used to dertermine BMI?

November 25, 2005

http://www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm

This is a link to an online BMI calculator. There are many others. I think the Inamed site has one too.

Jeff

PS

For you non math challenged "do it yourself" types......

http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-adult-formula.htm

Bruce Peter · November 25, 2005

Thanks Jeff

paula · November 25, 2005

Sorry Jeff - I misunderstood your original post.

You are right, losing weight to fit into the "right range" for your insurance to cover a weight loss procedure - IS crazy!

But heck, if they are gonna pay for this - Id do just about anything! ...well, almost anything.

sunshinenh · November 27, 2005

Hi Jeff - I am in the same boat. Have Anthem too. They really do not cover Lap-Band for BMI over 50. They only consider By-Pass if you are over their range. I know I can lose weight with the best of them. As for keeping it off, I have a terrible 43 year record of keeping it off. This is a terrible hoop Anthem has created. I really feel for you. It is beyond frustrating. I have finally met their weight requirement and they did approve. Keep fighting - I think it will be worth it.