Proof of attempted (Failed) weight loss

[HalloweenBaby24 447]

I've been looking into getting Lap Band surgery and am sitting in on a seminar for it this up coming week (Beginner).

I meet certain criteria for the surgery, but the one thing I lack is "Documented failed weight loss attempts".

What exactly does that imply?..

It's been a long time since i've been to a Dr for weight loss, Last time I went to a dietitian I was 11 I was with them for a year. Now im 24 most of those documents are gone leaving no proof that they even happend. I've been on many diets, pills and weight loss meetings since then but a las no real documentation to prove. What did you have to do to prove you're failed attempts?

[lisacaron 5,075]

@@HalloweenBaby24 most of the time what they need is a list of things you have tried at but have not lost weight with. Things like diet pills, Weight Watchers, Jenny Craig etc.

You would just make up a list and put the years, and if you lost weight how much if you gained it back etc. When you go to the doctor they usually give you a packet with a sheet to fill out that will "document" those attempts.

Some insurance companies will ask that you have a 6 month doctor supervised diet program. Basically you will see your primary Dr. and have them weigh you once a month for 6 months and see if you are losing any weight or not. Then submit the forms to the surgeon and to the insurance company before scheduling the surgery.

Check with the surgeons office that you are thinking of using and ask them for the medical packet they will check with your insurance company and let you know what the requirements are.

Best of luck to you!

[2muchfun 8,927]

Does your insurance require the "Failed diet attempts" or is this something you read somewhere?

For me, I initially needed to document through my PCP that I had made attempts at losing weight in the past with no success. Then, after I did this the insurance company waived the entire requirement for all patients. Check with your ins co?

[HalloweenBaby24 447]

It was something I had read on my insurance website (Bluecross Blueshield of MA) under requirements, But it didn't go into any detail of what exactly they were looking for. Thanks for the information!

[2muchfun 8,927]

I had BCBS Anthem. BCBS is all over the place with requirements. Mine used to make us do the 6 months of supervised nutritionist/dietician visits but 5 months in, they waived this requirement. But every state and every employer will have a different set of rules.

Make sure you're logged in to your own personal profile with BCBS to check your personal guidelines.

[HalloweenBaby24 447]

I just have BCBS, "PPO Plus"

Not sure if that makes a difference.

[lisacaron 5,075]

Give the doctor's office a call and get their per-surgical packet and/or call your insurance company directly and ask them what they require. Often times what you see on the web sites is not what they want. It can be more or less.

Also some doctors offices want you to have all the paper work filled out regardless, they have it for their records if they need it. Sometimes it can happen that insurance requirements change mid-stream.

It's a simple thing, I know it seems overwhelming at first but trust me it's all doable.

[betty_s 476]

I have Anthem BCBS as a state employee of VA. I had to do 12 months of monthly phone calls with a 'health coach' where we would make monthly 'goals' to get me ready for surgery. It was BS, but i stuck with it to get insurance to cover it. I dont wish that requirement on ANYBODY. it was a LONG year, but I'm now 6 days out from being banded

During my initial seminar they asked me to list all of my diets attempts, how much i lost, and how much i gained back, so i documented all my Atkins, south beach, ww, low cal, calorie counting. ( I honestly think this is something SUPER serious, its just to make sure youve made attempts in the past to lose weight)

They also require a history of weight from my PCP, which is just when i would go in with a cold and they weighed me. They asked for 5 years, I had only been going to the doctor for 3, and i was approved anyway.

Edited May 1, 2014 by betty_s

[terrydumont46 1,954]

go to your doctor office or call them. ask them to go through your records and find your highest weight recorded. and than it is mostly your word. writing a letter indicating the wt. loss programs you have tried. if one of them was nutria-system, jenny craig, or weight watchers. the companies will have record your joining. if you bought any books like south beach diet there will be record even with a company like Amazon. but generally I believe your written statement is all they are looking for. good luck. your primary care doctor will back up all your attempts too.

[HalloweenBaby24 447]

That's the place where I might have an issue. I lived in MD most of my life up until 5 years ago, when I moved to NJ I found out I was pregnant (had HB the whole time which they said was because of my weight then) and had an OB the whole time but not a primary care Dr up until a year or two ago who I barely go to (think I've been there twice in 2 years).

[lisacaron 5,075]

That's the place where I might have an issue. I lived in MD most of my life up until 5 years ago, when I moved to NJ I found out I was pregnant (had HB the whole time which they said was because of my weight then) and had an OB the whole time but not a primary care Dr up until a year or two ago who I barely go to (think I've been there twice in 2 years).

You know what...you had an OB Dr. right, you can ask him to sign off on the weights for you. A Dr. is a Dr. even if they "specialize" in one thing or another. See if that will work.

They just want the paper work dot the i cross the t.

My Dr. went back through my records for ever time I was in her office to record the weights and signed off I didn't go in for another 6 months. Some places will make you do it, my doc didn't and it won't hurt to ask your doc the worst they can say is no.

[HalloweenBaby24 447]

@@lisacaron Well the whole time I went to the OB I was pregnant, Wouldn't the insurance use that against me as far as weight goes?..Or do the Dr's not that have to mention that when filling out the form?

I was 192lbs when I got pregnant and 233 at the end of my pregnancy.