xxm4ndaaxx 2 Posted March 21, 2011 hey, im about to get my 2nd weigh in for the medically supervised diet.. i was wondering if anyone knew if there was actual requirements on this... my first weigh in i had gained 9 lbs since last appt(which was about 3 mnths before), and i have this next one at the end of this week, and im pretty sure i stayed the same, if not gained... i thought i had been doing good, but my scale isnt moving, but i guess this is why im going through this whole process....im already terrified to go to this appt because my doctor is kind of a prick, he yells at me for being fat and says hes suprised im still alive, but he agreed to do the necessary paperwork to get this going. so, im already stressed about facing him, but i wanted to make sure i wasnt going to get denied by insurance for not losing anything. my bmi is 48, no other comorbidities, and my medical records have shown that ive been overweight pretty much my whole life. anyone else have trouble with the sueprvised diet, and stil get approved? someone make me feel better Share this post Link to post Share on other sites
Rootman 1,101 Posted March 21, 2011 Boy, if ever I heard a reason to switch doctors it's this one. I'd dump him as soon as you get the surgery committed. I personally know one person that was told by his nutritionist that he had to STOP loosing weight on hid supervised diet or he would be disqualified. He was massive with a BMI of over 50 and several co-morbidities. This just goes to show that something as serious as this can still be a "game" to some and exploited by both sides. I'm certainly not telling you to gain weight but I'd be careful with your diet. Share this post Link to post Share on other sites
xxm4ndaaxx 2 Posted March 21, 2011 believe me, if i wasnt afraid of causing issues with the insurance, i would be changing doctors in a heartbeat, and i intend on it as soon as i get a surgery date haha. unfortunatly my *** chose him for me, so maybe ill wait until after surgery to deal with that so i dont piss off my insurance :-p thanks for the advice on the diet. that would really suck if i went thru all that and ended up being denied just because i lost a bit of weight on my own. lol Boy, if ever I heard a reason to switch doctors it's this one. I'd dump him as soon as you get the surgery committed. I personally know one person that was told by his nutritionist that he had to STOP loosing weight on hid supervised diet or he would be disqualified. He was massive with a BMI of over 50 and several co-morbidities. This just goes to show that something as serious as this can still be a "game" to some and exploited by both sides. I'm certainly not telling you to gain weight but I'd be careful with your diet. Share this post Link to post Share on other sites
OnTheFenceMomma 0 Posted March 21, 2011 WOW! You poor thing. You need to dump that doctor ASAP! And report him for abuse! So not cool! What kind of insurance do you have? My plan said that even if you did lose so much weight that your no longer obese, they would still do the surgery. Somehow I doubt that, though. Share this post Link to post Share on other sites
xxm4ndaaxx 2 Posted March 21, 2011 i have horizon nj health, its one of the HMOs for nj medicaid. their requirements for WLS are fuzzy, theres nothing on their site, and ive called at least 6 times to find out different things, and noone there can get their story straight. the only reason i know that they cover it, and that its a 3 month diet, is from my surgeons receptionist. she has apparently dealt with them before. haha WOW! You poor thing. You need to dump that doctor ASAP! And report him for abuse! So not cool! What kind of insurance do you have? My plan said that even if you did lose so much weight that your no longer obese, they would still do the surgery. Somehow I doubt that, though. Share this post Link to post Share on other sites
Douceur72 3 Posted March 21, 2011 Talk to the person at your surgeon's office who submits the paperwork for insurance approval, they usually know all of the inuendos. Some require a certain amount of weight loss during the pre-op period. Mine does not require loss, only a BMI of 40 (I don't have co-morbidities) and I was under the impression that I had to maintain my weight (right at BMI 40) during the 6-month 'diet' to stay eligible. I clarified with the nurse who does all of the submissions at my last visit, she assured me the weight taken at the first visit is the only one submitted. Glad I clarified because now I can start losing preemptively. And I'm with the others....dump the prick. Share this post Link to post Share on other sites
samantha209 19 Posted March 22, 2011 i am on month 6 of a supervised diet...i have actually lost about 25-30 lbs...it fluctuates...because i am actually in the nervous phase where i want to eat everything because i fear i wont be able to eat it again lol but i asked the doc and she said that the insurance company is basically looking for the commitment...they wont cancel because u lose too much or too little. Share this post Link to post Share on other sites