Need some support and reassurance!

[TrophyWife 11]

So I will give you a brief history of my situation and hope someone can offer any advice and support.

So about 5 years ago I decided I wanted to consider surgery, but it seem rather drastic considering that I had never "really" tried to lose weight. So I made a deal with myself that I would join WW and do my very best to lose weight than if that was not successful would consider surgery. Well long story short I weighed in at my first meeting @ 314 lbs. OMG! and started the program. Over the next 18 months through much sweat and tears lost 107 lbs. I hit a plateau and was very frustrated after about 6 months of not getting any support through my group so decided to do what I had wanted to do for a long time and joined a running team and over the next year did 2 full marathons and 3 halves and really didn't think about a plateau even though I never lost anymore weight. Well I ended up injuring my foot, due to the fact that I was doing marathons and still over 200 lbs.

Well I took some time off to heal and gained back a little then a little more and then became depressed about weight and gained a few more. Then had several family tragedies and gained a few more.

Okay back story told here is my frustrated. I decided back before Christmas that it was time to have surgery and take my life back before I weighed 300lbs again. On my first appt. I weighed in at 279lbs and a 46 BMI. Well I am prediabetic, still suffering from foot and knee pain, but other than that no real health issues...yet. So I have completed all tests, physc. evaluation and am 1 month into my 3 month supervised diet required by insurance.

So my case worker calls today and apparently the insurance company wants 2 years of medical records showing a BMI of 35 with medical conditions, or higher without and apparently my previous weight for that one year is low and might cause them to deny my surgery in April. Really? I've been heavy for 25 years and due to the fact that I had 3 years where I killed myself every day to stay not as fat it will keep me from being able to take my life back because Im not sick enough. So sad today and just feeling defeated.

If anyone has been through this would appreciate feed back and sorry if this is badly written. Just got home from work and needed to unload so that I can sleep tonight.

If you've been through this or anything similar please share and if Aetna was involved even better. I would just appreciate hearing that I should get a grip and everything will be fine.

[mark! 449]

My BMI was never under the requirement for surgery, but it was REALLY close one year. I sent in my weight records for 5 years instead of 2, at least that what the sheet I sent to my surgeons office had on it, showing I was well over the BMI for the other 4 years, the 1st being the one that was close. Aetna was really quick about approving my surgery, I really hope they look at everything for you and give you the nod of approval. If not, you can always file again and see if that helps. Good luck.

[TrophyWife 11]

Thanks for your info. I don't want to whine. It's just that everything has been going so smoothly. My husband and I are both having the surgery and I just don't want anything to keep that from happening.

[my3sons 51]

I think the idea of sending them more info- as in our BMI/weight for a couple of years before WW is a good idea- I also wonder if it would help to send a narrative about your struggle and re-gain...check with your insurance person at the dr office on what helps push things through- good luck, try not to get discouraged...things tend to happen precisely when they are meant to....

[JerseyGirl68 1,172]

I totally agree, sending them more than 3 years of weight history should help. My coordinator explained to me that they really want to see a history of weight issues, going back at least 3 years, more can only help your cause. Good luck