Sleeve criteria BMI>50

[Maldito76 0]

Hello Everyone

I am new here and this is my first post. I have only realized recently that I need major help to loose the wieght. I have been looking into bariatric surgery and have decided the sleeve is right for me for many of the same reasons many of you have.

I work for a internationaly well known "Clinic". They have their own insurance company for their employees. It is pretty good and does cover bariatric surgery as long as it is done at any of the "clinics" campuses.

However I just got off the phone with them and I was told that they have the usual criteria for open and laproscopic bypass and gastric banding (bmi >40 or >35 with comorbidities). But surgeries will only be covered on a case by case basis for duodenal switch and Gastric Sleeve with a bmi >50.

I have a bmi of 47-48. I would have to gain at least 20lbs to have a bmi>50. That doesn't make sense. I am trying to loose weight here!

I plan to go ahead and try for the sleeve and put in an appeal right off the bat. Does any one have any advice or know where i can find the research that proves the sleeve is just as effective and safer than bypass or banding?

Thanks

[Oregondaisy 2,021]

I don't know. I know several people who appealed twice and finally got tired of waiting and went to Dr. Aceves in Mexico. He's a great dr. and it's the best money I have ever spent.

[MacMadame 81]

My advice is to get as close as you can to that BMI one way or another...

Make sure your height gets measured as short as possible and your weight as high as possible. A little slouching when they measure the height and heavy clothes, drink lots of Water, eat before your appoinment, etc. and you could get up there.

The closer you are, the better off you will be, if you have to appeal.

[TennJenn 9]

Do you take NSaids? I'm pretty sure that is a contraindication to gastric bypass. There are probably some more contraindications you could cite to try to get approved for the sleeve.

Sorry I'm not of more help. Good luck!

[*susan* 1,709]

Hi Maldito, welcome to the forums! I am from Jacksonville as well, and I think I have a pretty good idea of the "clinic" you are referring to.

I found this article, which states a few reasons why the sleeve may be safer: What is the VERTICAL SLEEVE GASTRECTOMY (gastric sleeve) procedure?

[Maldito76 0]

Thanks Everyone

My advice is to get as close as you can to that BMI one way or another...

Make sure your height gets measured as short as possible and your weight as high as possible. A little slouching when they measure the height and heavy clothes, drink lots of Water, eat before your appoinment, etc. and you could get up there.

The closer you are, the better off you will be, if you have to appeal.

I was going to slouch and whear jeans but hadn't thought about the Water and eating first. thanks. I was talking to a Dr where i work and he said "well then just go out and start eating":001_rolleyes:

Tennjenn - I only take an advil occasionaly for a head ache

Susan - Thanks for the link. Yes you probably guessed right. They are very protective of their name and reputation, that is why I didn't say their name.

[Malaika 50]

I read on another site to put fishing weights or quarters in your pockets or sewn to the inside of your pants or shirt to add extra weight -- or in your shoes - generally they never ask you to remove your shoes -- silly the things one has to do to get help to have a healthier lifestyle. Good luck

And welcome to the board - happy to have you!

[cajun 46]

Best research document I have found:

1: Systematic review of sleeve gastrectomy as staging and primary bariatric procedure.

Brethauer SA, Hammel JP, Schauer PR.

Surg Obes Relat Dis. 2009 Jul-Aug;5(4):469-75. Epub 2009 Jun 9. No abstract available.

PMID: 19632646 [PubMed - in process]

This study was a systematic review of literature looking at statistics on wt loss, complication rates, postop mortality, and comorbidity improvement after the surgery. The research concludes that complication and mortality rates are acceptably low, and this surgery is effective and safe as a first stage or primary procedure.

[wayupnorth 1]

These articles are well worth reading.