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6 Month Pre-Approval Diet



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So I am brand new to this site. I went for an orientation at Einstein Medical Center a couple days ago, and already heard back from my insurance company. I need to do a 6 month physician assisted diet program and have 2 letters of recommendation before they will qualify me. BUT if I lose some weight, wont that affect my BMI and qualifying for the surgery? So bummed because this process puts me a year out for a surgery date. I feel like i could Cry. Has anyone else had to do this?

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Most all have had to do 6 months. I am on my last month now. The diet my nutritionist put me on was a 1500 calorie diet and also the exercise pysiologist put me on an exercise program to walk at least 30 minutes a day and do resistant bands 2 times a week. During those 6 months I also had to have a EKG. ,endoscopy, pulmonary function test, and blood work. Each surgeon is different in the test they need you to do

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From what I have learned from my Nutritionist is that she, when writing her recommendation letter to the insurance company, must see that I was able to eat properly. Protein, vegetables, fruits, low carbs and fat and my Water, etc. She had told me that it wasn't about losing weight and not quailifying but rather showing I can track and do as I am told for post-op. I had the same exact fear as I am right on the border line of the lowest BMI allowed. She said the doctor sends in my heaviest weight from seeing him over the time period prescribed so I would be ok. I would as the people at your surgeon's office the same questions. Hope that helps....

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Once approve you don't need to worry about losing too much. I lost 15lbs before surgery.

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Some insurance companies require you to lose a percentage during the 6 months. I also know that some have been denied by insurance and doctors because they have gained weight over the 6 month time. My doctor told me he wanted me to lose 10 pounds and that's on top of the 8 almost 9 pounds I have lost last month. I started out at 287 now at 273 he wants me at 264

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Oh so needless to say I am trying to start a liquid diet again because I have until the 16th to lose the other 9 pounds

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Oh so needless to say I am trying to start a liquid diet again because I have until the 16th to lose the other 9 pounds

I would also try doing a cleanse. We can carry 5-20 lbs of excess weight in our colon. Ridding your body of that will help!

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Cleanse as in how?

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From what I have learned from my Nutritionist is that she' date=' when writing her recommendation letter to the insurance company, must see that I was able to eat properly. Protein, vegetables, fruits, low carbs and fat and my Water, etc. She had told me that it wasn't about losing weight and not quailifying but rather showing I can track and do as I am told for post-op. I had the same exact fear as I am right on the border line of the lowest BMI allowed. She said the doctor sends in my heaviest weight from seeing him over the time period prescribed so I would be ok. I would as the people at your surgeon's office the same questions. Hope that helps....[/quote']

Fatfree, where in NC are you? I'm in Charlotte.

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Thanks everyone, but I have not had my consultation yet, so I'm not sure how this will work. I just called Einstein and gave them all of my info. I guess I should call them and ask. Hmmm.... Still kinda confused, but from what you are all saying I'm thinking I should bust my ass for the initial 6 months to show that I am serious about change! Thanks all!

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Thanks everyone' date=' but I have not had my consultation yet, so I'm not sure how this will work. I just called Einstein and gave them all of my info. I guess I should call them and ask. Hmmm.... Still kinda confused, but from what you are all saying I'm thinking I should bust my ass for the initial 6 months to show that I am serious about change! Thanks all![/quote']

I didn't have a six month process. I had a 12 week waiting time in which I had to see the nutritionist 4 times, the nurse practitioner twice, the psychologist, have a fitness eval, attend 3-2 hour life skills classes to learn what to do after surgery, get clearance from the cardiologist & pulmunologist & have an Endoscopy. My next step is to get clearance & approval from the insurance company.

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I'm in Harrisburg! Which surgeon/hospital are you going to? I'm Dr. Melkonian at Carolina Surgical and going to Presbyterian main downtown.

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