xX_iSLAY_All_Day_Xx 21 Posted November 7, 2012 My major concern lately has been about not losing appropiate weight during my 6 month diet period before consultation. My BMI is borderline (41.9)... Sooooooooo, I e-mailed my patient coordinator yesterday telling her "hey, I don't wanna be doing all this for nothing..!" Ive read over and over again that some insurance providers/medicare/medicaid want you to do the diet to get in the habit of making great choices.... Uh, I asked if that was the case for me, she says, "if your BMI isn't below 40 by consultation you should be fine. Um, okay. I don't have much of a weight loss window! o_O I'm confused..doesn't the insurance company want to see that you are getting something from the dietary intervention? If I lose as much as 15 pds. I will not be qualified for the surgery.... I guess I'm supposed to just stay where I am then. smh Anyone else borderline and baffled like me? Share this post Link to post Share on other sites
TinyMamiOf3kids 1,280 Posted November 8, 2012 I lost 15lbs in 30 day diet and I was still approve. Share this post Link to post Share on other sites
Shonabear 107 Posted November 8, 2012 I didn't lose any weight during my 3 month consultation. I actually gained and they blamed it on the quitting smoking thing. Sent from my SGH-T989 using RNYTalk Share this post Link to post Share on other sites
xX_iSLAY_All_Day_Xx 21 Posted November 8, 2012 I weigh 232 now.. if I drop down to 226 at my height I will be 39.9... I'm just gonna stay active and eat right.. and hopefully maintain to keep above 40. They wont be using my highest weight at the start of the diet, they will be using the weight I am at the time I show up to consultation.. I'm sure it will work itself out. Nerve wrecking. Share this post Link to post Share on other sites
flip-flop-gurl 6 Posted November 8, 2012 I had to maintain my same weight for 6 mos. If I had reduced my BMI at all, from what I understand, I would not have qualified based on my insurance. 1 xX_iSLAY_All_Day_Xx reacted to this Share this post Link to post Share on other sites
Stephanie 49 Posted November 8, 2012 My insurance told be that as long as my bmi is above 40 at the time my first weigh in was and that I have documented history that it was over the last two years that was good. I asked about when I started my 6 month diet and if it went below 40. They said that was okay because they want you to try to continue to lose weight and if you didn't lose weight or gained it mainly that there could be a problem and you may not be as committed to this. They want to see you lose weight and succeeded. Because you will have to do this after the surgery. 1 Shonabear reacted to this Share this post Link to post Share on other sites
ladyspl 161 Posted November 8, 2012 My surgeon told me not to loose any weight on my 6m diet. Not to gain, but not to loose. So I maintained. Got my approval monday, surgery date is November 15th 1 xX_iSLAY_All_Day_Xx reacted to this Share this post Link to post Share on other sites
Shonabear 107 Posted November 8, 2012 My insurance told be that as long as my bmi is above 40 at the time my first weigh in was and that I have documented history that it was over the last two years that was good. I asked about when I started my 6 month diet and if it went below 40. They said that was okay because they want you to try to continue to lose weight and if you didn't lose weight or gained it mainly that there could be a problem and you may not be as committed to this. They want to see you lose weight and succeeded. Because you will have to do this after the surgery. Stephanie that was exactly what my requirements were. They wanted me to lose to show I was dedicated. They did take into consideration that I quit smoking asst the same time I was pursuing this. Sent from my SGH-T989 using RNYTalk Share this post Link to post Share on other sites
xX_iSLAY_All_Day_Xx 21 Posted November 8, 2012 Good to know that I'm not the only one who has to do this "maintain" thing.. I thought it was kinda weird. I guess it doesn't matter if in the end you get what you are shooting for. I wont question my blessings. Share this post Link to post Share on other sites
xX_iSLAY_All_Day_Xx 21 Posted November 8, 2012 BTW, my surgeon requires you to take an exam on post operative diet and potential complications.. if you miss more then two he will postpone your surgery...! WTH?!? So needless to say I have to study my own studies and how to eat after surgery.. FML! lol Share this post Link to post Share on other sites
Shonabear 107 Posted November 8, 2012 BTW' date=' my surgeon requires you to take an exam on post operative diet and potential complications.. if you miss more then two he will postpone your surgery...! WTH?!? So needless to say I have to study my own studies and how to eat after surgery.. FML! lol[/quote'] The test is not hard. Sent from my SGH-T989 using RNYTalk Share this post Link to post Share on other sites
cookier224 238 Posted November 8, 2012 My major concern lately has been about not losing appropiate weight during my 6 month diet period before consultation. My BMI is borderline (41.9)... Sooooooooo' date=' I e-mailed my patient coordinator yesterday telling her "hey, I don't wanna be doing all this for nothing..!" Ive read over and over again that some insurance providers/medicare/medicaid want you to do the diet to get in the habit of making great choices.... Uh, I asked if that was the case for me, she says, "if your BMI isn't below 40 by consultation you should be fine. Um, okay. I don't have much of a weight loss window! o_O I'm confused..doesn't the insurance company want to see that you are getting something from the dietary intervention? If I lose as much as 15 pds. I will not be qualified for the surgery.... I guess I'm supposed to just stay where I am then. smh Anyone else borderline and baffled like me?[/quote'] I had to do a 3 month diet (supervised) i only lost 3 lbs and was approved. I was warned not to lose too much due to my bmi. So i just cut out sweets. 1 xX_iSLAY_All_Day_Xx reacted to this Share this post Link to post Share on other sites
xX_iSLAY_All_Day_Xx 21 Posted November 8, 2012 I went to see my PCP today and he told me if I lose 5 pounds I'm under... so I said screw it. I'm just gonna give it an honest attempt to lose weight because I just can't sit here and make NO kind of attempt to lose weight at all. Seems weird for me because I'm constantly trying to find a formula or plan that works.. so far I've had short lived success in the majority of them. My BMI makes it all stressful so I mind as well just try..either it will work this time around or it wont. By April I will be absolutely completely without a doubt sure that my plans of action are ineffective. lol I'm tired of battling weight!!! Share this post Link to post Share on other sites