Discouraged... :(

[JSahi 6]

I am almost done with my 6 month supervision diet. I'm on my 5th month. March is my last. It's going by quickly. My bmi is 55/56, I have yet to lose a pound. Well, I lost 3 pounds in 2 months but gained that back plus an additional 6 pounds. Yup, 9 pounds. I've been eating and exercising the same as my pcp told me too. I guess I am just worried I wouldn't be able to get the surgery because of my weight gain after doing all of this. hopefully I have lost weight when I do my next 2 weigh ins.

Has anybody gained weight during the 6 months diet and was approved? Tell me your experiences.

Thanks.

PS,

I have bcbsil H.M.O & my surgeon will be Vafa Shayani. They want you to lose 10% of your starting weight. Not sure if it's required but they said it helps the liver for day of surgery? (if this info helps any)

[B-52 7,113]

My 6 month diet started out good, as with any other of the many diets I have been on....then it went all downhill, also like any other diet I have been on......

If I could diet, I would not have needed the WLS and I would not be on this forum right now.....

When I was considering this surgery, I was told my insurance wanted me to complete this, and have it signed off by a Dr., complete with progress notes, charts, etc....when I asked why, I was told it had to be documented that I did indeed try, and FAIL, at other traditional weight loss programs.....even though that was true, they still wanted something "Official" in my chart.....

That dos not mean you should not try and do your best....you should do your best and have it on record how good you are at traditional diets....

This diet IS NOT to be be confused with the pre-op diet for liver shrinkage....the 6 month diet. with my insurance, had to be done anytime within 2 years prior to my surgery date....

Once I was approved, and a surgery date set, I then planned for the pre-op diet which took me 2 weeks of nothing but shakes....

[2muchfun 8,927]

I have BCBS and didn't lose any weight during the 6 month nutrition phase. Didn't matter. I doubt they would deny you.

[Kime-lou 648]

I think this is just to attempt and show the insurance you are serious about this. My BCBS didn't make me do the 6 month diet, I just had to show that I had a BMI of over 40 at at least 2 years, which wasn't difficult to do.

[Sojourner 2,446]

Though I did not gain weight during my required 6 month medically supervised diet, I did not lose much either.

You did not mention any co-morbidities that you might have. My BMI was not 40 when I was approved for my surgery, however I had 3 serious weight related co-morbidities documented for several years. I was approved for my surgery with my PCP's first letter of medical necessity.

Best wishes for your success...it is a long process to get started, but so worth the effort!

[kazjim98 618]

I went up and down a few pounds during my 6 months...in the end my weight stayed the same. I really think you will be just fine..Best Wishes!

[JSahi 6]

Thanks everyone. I dont have any additional problems like sleeping/breathing problems or high blood pressure (even though I'm on the border of having it my doc says) or anything else. Just been overweight most of my life.

[CBM7766 9]

All insurance companies are different but the vast majority have a policy in place for reviewing Bariatric Surgery. Some say 5%, some say 10% and some say just don't gain during your preop time. If your insurance company's policy (and I am sure your surgeon has prerequisites as well) says 10% then you may have a hard time getting approved with no loss. You can call customer service and ask them exactly what the policy says.

[dazzlingone 58]

I have BCBSIL also, but I switched to PPO last year I instead of the ***. I was told it would be easier to qualify with less hurdles. However I agree you should probably call customer service, they can tell you about the medical policies that govern these things. I did not have to do the 6 month observation diet.

[dazzlingone 58]

That was supposed to read instead of the ***

[JSahi 6]

I did call them and they told me that they are not responsible of whether I get the surgery or not, they just pay for it if my PCP approves of me getting it.

H.M.O requirements run a bit different than PPO. That's why I wanted to find out if someone had similar problems as me. I will try calling the Bariatric Center where I attend and try getting some info from them in the morning.

[Lela Clark 41]

When I was doing my 6 month diet plan my dr office told me not to lose any weight. I would go up and down about 2 lbs each month. If we could lose weight we wouldn't need the Lapband. I have tried everything and the most I ever lost was about 15 lbs until now. Good luck with you insurance.

[bethcav 68]

I have bcbs required six month diet and wanted me to lose 10% of body weight. Seen nut once a month. I learned better food choices, portion sizing, etc. I lost thirty pounds. I was afraid to get weighed the last month because I was afraid my bmi wld be less than 35 so what I did was wear 2.5 weights on each ankle and dressed in the heaviest clothing I had and the scale didn't budge from last weigh in. Im not proud of what I did but I wasn't going to be denied after six months. I know the six month diet helped me post op and to this day. Having said all that I cldnt of lost and keep the weight off without my band. So even if your not losing carry what you learned foward and best wishes.

[B-52 7,113]

When I was doing my 6 month diet plan my dr office told me not to lose any weight. I would go up and down about 2 lbs each month. If we could lose weight we wouldn't need the Lapband. I have tried everything and the most I ever lost was about 15 lbs until now. Good luck with you insurance.

AMEN!......why have WLS when you can diet???? WLS is NOT a diet...it is life altering....

[CBM7766 9]

The insurance company will not say no if your BMI falls below their number (usually 35 or 40) after your weight loss period. They go by the BMI recorded on your first visit with the Bariatric Center. But you have to meet all the other criteria too. Seeing the dietician, pcp approval letter, psych visit etc.