Pre-Op Weightloss

[KabinKitty 11]

The ball is finally rolling on getting my surgery done. Now I want to know if I lose too much weight before surgery, could BC/BS not approve me? My surgeon said no, but I want to be sure.

Does the doc have to list a current weight "at the time they submit me for approval"? I've been trying to maintain my weight so my BMI would be high enough at my initial weigh in. I've been eating more than I want and more often than I want and I hated doing that!!!!!

I want to eat healthier and lose some weight before surgery, but I just want to be assured it won't jeopardize my getting approved for the sleeve.

[Cancel 1]

I am having the same issues. I am doing Weight Watchers and hate that each week they ask me what I'm doing wrong. Not comfortable telling them I'm eating the same as always so I don't loose too much. But I really would like to lose some since it's summer. I just don't want to get below the BMI threshold for surgery approval. Very frustrating.

I'll be keeping an eye out to see what anyone else has experienced.

[KabinKitty 11]

Please, if anyone has had experience with this let us know! Also, I'm so darn tired of dragging this weight around that I get tired just walking out to Water the garden.

I'm looking for some inspiration as to how much better I'll feel when the weight starts coming off.

I do remember when I was 19 and lost 75 pounds how just going up a flight of stairs made me feel like I was almost floating!

Thanks for any input on the weight loss subject.

[vkgirl 0]

Boy, wish I had the BC/BS answer for you. At Kaiser, the doctor brought it up at the orientation and said that they only had one person where the surgeon wouldn't do the surgery, because she ended up at a BMI of 23! He said that was the only case he knew of.

[KabinKitty 11]

I'm around a 40 BMI so I doubt that I could get anywhere near that. I just would like to lose about 15-20 lbs.

[mommytoethan 1]

i have BCBS.

however, i am a band to sleeve patient. when i had the band, i had a different insurance company. they did not require me to lose any weight before approval or before surgery.

my husband switched jobs, and we now have BCBS. they didn't require anything in order for me to do the revision. my husband works for microsoft and they have EXCELLENT benefits.

each policy is different. so just because my policy didn't require any weight loss before surgery doesn't mean others are the same way.

good luck!

[KabinKitty 11]

Guess I'm not making myself clear. BC/BS is not requiring me to lose weight before surgery. My surgeon wants all his patients to make an effort to lose at least 5% of their body weight before surgery.

He says that it shows him the patient is able to limit their food intake so as to not show gain for the 3 months it takes to work through the supervised diet with the nutritionist.

I'm asking if my weight at the time the packet is sent to BC/BS has to be disclosed to BC/BS. I thought a loss might cause them to deny me.

[melinekesh 0]

Okay, My bmi was 35.7 when I weighed in. 35 bmi was the absolute minimum for the hospital to give me the surgery. I lost 13 lbs. so my bmi was 34. He told me too that it doesn't matter and he was right. I made them weigh me because I was so concerned about the anasthsia. Didn't want them giving me drugs according to my previous weigh in. No one asked any questions. I was a cash patient no insurance.

[educationrulz 18]

Jeannie,

I have UHC so my response is conditional to the fact that I have a different insurance. But, I asked this same question of my nurse case manager during my phone intake interview and she very clearly told me "YES" if I lost too much weight before surgery and my BMI went below 40 (or below 35 with comorbidities) the insurance company would deny me for the surgery. I tried to get some more specifics without totally annoying the lady and I asked something about how this related to which weight was submitted to the insurance company. We had this conversation over 6 months ago, so I'm a little fuzzy on the details, but I remember something to the effect of this applying to my weight at the time the request for surgery was submitted to insurance.

So, I took it to mean that if I was still at 40 BMI when the paperwork was submitted, but then lost weight and went under 40 BMI after I was approved it wouldn't matter. But, if I was under 40 BMI when the request went in, they would automatically deny it. Although I'm nowhere near as close to 40 as you are, that moment was when I decided that I wouldn't be working too hard to lose anything during my 6 months of MD supervised diet with my PCP. My PCP thought I was a total flake, but oh well...I got my surgery approved.

I think the trick for you is going to be the fact that your doctor requires you to lose some weight before surgery. This seems unrealistic in your case since it might hurt your chances of being approved. I think you should discuss this more specifically with your doctor so that he is clear about your conflict. It sounds like he has already told you that it won't matter, so maybe that means his office will play around with the numbers that are submitted to insurance. But that could be tricky if your PCP or weight watchers is involved in providing documentation.

The bottom line is that the insurance company is the bottom line so I think your surgeon needs to be more specific with you about why it doesn't matter and needs to explain to you exactly how they will handle it if you get below 40 BMI. I don't know if this helps you any but I hope it at least gives you some ideas about what to ask your surgeon or your BCBS case manager. Good Luck!

[KabinKitty 11]

Mary,

Thanks so much for that info. Thanks also to others who chimed in to help. Sounds like I should go easy on the weight loss. I'll get more info from the nutritionist when I go back July 6th.

Another hot summer in Ohio being morbidly obese, UCK! One bright spot is that they should submit my packet by mid August. (A 3 month diet supervised by doc's nutritionist is required.)

Doc told us at the May seminar that some people could be having surgery in 4 months. That means I could have mine in September, if we don't have to appeal it.

I'm seriously considering taking 4 weeks off work to recuperate. I drive a school bus, which is physically and emotionally stressful. Getting up at 4:45 am and not finishing till about 4:30 pm. I figure why push it, when he's already told us he will approve up to 4 weeks off.

Hope you all don't get sick of me before then!! :lol0: I feel like we're all one big family here....(((warm fuzzies))).:001_wub: