Can anyone offer advice?

[jstenulis 0]

I am seriously considering the Lap Band for the very near future. I have only research online through friends. I was told today that the FDA lowered the requirements to enable those only needing to lose a little weight to receive this procedure.

They say you can have a BMI of 30 now. Mine is 30.7. I have 63 pounds to lose to be at ideal what range. HOWEVER, I do NOT have diabetes, sleep apnea, and only a recent problem with hypertension with my levels being too high but doctor has not considered meds for that yet. I do HOWEVER, have hypothyroidism, PCOS, insulin resistance, and high fasting sugar levels, and osteoarthritis in my knees that comes and goes. I have a very high risk of diabetes as my father and his 2 brothers and dad, and my aunt, all have diabetes. I lost my mother to breast cancer a few years ago in which I am always warned about being overweight increases breast cancer odds.

So, with all of that being said....do I have a leg to stand on for this surgery? I don't even want to attend a seminar if not.

thanks so much in advance for any help you can give me!!!!

[sandy1 1]

I am seriously considering the Lap Band for the very near future. I have only research online through friends. I was told today that the FDA lowered the requirements to enable those only needing to lose a little weight to receive this procedure.

They say you can have a BMI of 30 now. Mine is 30.7. I have 63 pounds to lose to be at ideal what range. HOWEVER, I do NOT have diabetes, sleep apnea, and only a recent problem with hypertension with my levels being too high but doctor has not considered meds for that yet. I do HOWEVER, have hypothyroidism, PCOS, insulin resistance, and high fasting sugar levels, and osteoarthritis in my knees that comes and goes. I have a very high risk of diabetes as my father and his 2 brothers and dad, and my aunt, all have diabetes. I lost my mother to breast cancer a few years ago in which I am always warned about being overweight increases breast cancer odds.

So, with all of that being said....do I have a leg to stand on for this surgery? I don't even want to attend a seminar if not.

thanks so much in advance for any help you can give me!!!!

My BMI is 32 and i am going the self pay route. I am not waiting until I have a BMI of 35-40 which is where I am heading. I have high blood pressure, take two meds for that. Extreme lower back pain and knee pain. Diabetes also runs in my family.

Good luck!

[cheryl2586 3,053]

with only 63lbs to lose it may not be covered by insurance. Just call them and ask them. Most of the time you have to have a BMI of 35-40 with two or more comorbidities for insurance to pay. Call them they will tell you

[slm2007 7]

I think if you have the co-morbities and I'm thinking things like PCOS, hypothroidism etc, might qualify. Your surgeon's office would probably know and it would benefit you to ask. I think even high blood pressure, even if not controlled with meds, might qualify you if it is documented that your PCP wants you to try to lose some weight before medicating you? Good luck

[jstenulis 0]

with only 63lbs to lose it may not be covered by insurance. Just call them and ask them. Most of the time you have to have a BMI of 35-40 with two or more comorbidities for insurance to pay. Call them they will tell you

Well, from what I've read online, the FDA has lowered the requirements for Lap Band is a BMI of 30 of higher, with at least one other weight related issue. I guess the only real way to find out is to call Cigna and ask!

[stateofzen 46]

Well, from what I've read online, the FDA has lowered the requirements for Lap Band is a BMI of 30 of higher, with at least one other weight related issue. I guess the only real way to find out is to call Cigna and ask!

Unfortunately, I doubt most insurance companies are going to follow FDA guidelines-- I believe those are more for the surgeons-- i.e., go ahead and perform this surgery if someone has a 30+ BMI. My guess is that, for the foreseeable future, we will not see insurance companies paying for lap bands under a 35 BMI. In fact, many insurance companies seem to be implementing MORE hoops to jump (like upping the supervised diet from 6 months to 12).

I hope I'm wrong, but my belief is that under 35 will still mostly have to self-pay for the surgery.