Gain weight to qualify?

[kittydream 2]

I'm pre-op, have been going through the process since Feb. I am 19 lbs away from a 40 BMI. After multiple tests to see if I have one of the very specific co-morbidities that my insurance requires, it turns out I do not. I feel like the wind got knocked out of my sails (or whatever that expression is). I am 19 lbs away from not needing a comorbidity. 19 lbs. Has anyone heard of anyone gaining weight in order to meet the insurance requirements? I mean, I've *been* steadily gaining weight over the years, so I know I will get there eventually. Im just tempted to eat more bacon now.

[630racoon 30]

Oh my gosh kitty dream, a year ago I was in the exact same boat as you, BMI of 37 and no co-morbitiies I was so devastated when the doctor told me no. Now a year later, I have a BMI of 40.2 and high cholesterol. I didn't have as much weight to gain as you but it turned out I did gain it and got a cholesterol problem as well.

My internist told me that without help he knew that eventually I would reach the point of meeting criteria for surgery, as knowing me very well, it is inevitable for some of us. He was right. Don't give up hope. Good luck to you! Stay in touch.

[Ginger Snaps 1,323]

Oh no... did your doctor try appealing or has it been denied? How disappointing...

[judyk 9]

I gained 10 lbs and wore ankle weights to qualify. Also, when my height was measured I scrunched down. That made my height 5'4" instead of 5'6'.

Was it worth it? As of now I say YES. Had my surgery on June 3. No pain after the first day. Just soreness. No problems with eating the liquid foods.

[tammie30 43]

I'm 250lbs.. 5'1, bmi of 47. High cholesterol, diabetic ( with no medications ) hypertension.. I swear it's not cool. I don't like any of this.. Horrible back pains, and shortness of breath. All his drains me out my goodness lol well i should be having surgery at the end of the month., it's so real now. Like it's insane to me that this is all happening so quick so exciting

[RNBSN786 206]

I started my process 2.5 yrs back and I was already diagnosed with co-morbidities myself but I was afraid I would still not get it approved cause I was not 40 bmi. I was like 5-8 pounds away from it so my doc said to gain weight. Which I did but still my insurance at that time denied me cause I was in nursing school and had NYU student health insurance. So I said to myself that once I start working I will start the process again. So last Nov/dec I started the process but this time I had already 40 bmi, a ton of co-morbidities and an excellent surgeon and insurance that got me my surgery. My insurance requirement was 4 visits with the surgeon and then approval. And thankfully it all worked out and had my surgery on march 31. The point is that if you need to gain the weight then just do it so you can get what you want. It will all work out in time...I really mean the time part.'

[Maggy'sMom 42]

My doc and nut says insurance goes by starting weight. Have you been losing since February or did you start the process 19 lbs too little? It would be a shame to have to gain 19 pounds just to qualify. Since you've been in the process for so long maybe submit the paperwork and cross your fingers? Try an appeal if denied. You can always try to gain if you have no other choice.

The insurance process is so frustrating. Every company has different rules. My insurance requires two co-morbidities that can't be controlled with medication or 40 BMI. The worst part is you have to jump through all kinds of hoops and then they can still deny coverage. I think they brainstorm ways to deny coverage. I have to show a weight loss for six months (10 pounds) with no gains. If I show a gain, I have to start the six months over. The RN says don't go below 35. The NUT says follow a 1200 calorie plan. I have to walk this fine line for 4 1/2 more months.

We shouldn't have to play these silly games with our health.

Whatever happens good luck. Please keep us posted.

[tammie30 43]

<p>My doc and nut says insurance goes by starting weight. Have you been losing since February or did you start the process 19 lbs too little? It would be a shame to have to gain 19 pounds just to qualify. Since you've been in the process for so long maybe submit the paperwork and cross your fingers? Try an appeal if denied. You can always try to gain if you have no other choice. </p> <p> </p> <p>The insurance process is so frustrating. Every company has different rules. My insurance requires two co-morbidities that can't be controlled with medication or 40 BMI. The worst part is you have to jump through all kinds of hoops and then they can still deny coverage. I think they brainstorm ways to deny coverage. I have to show a weight loss for six months (10 pounds) with no gains. If I show a gain, I have to start the six months over. The RN says don't go below 35. The NUT says follow a 1200 calorie plan. I have to walk this fine line for 4 1/2 more months. </p> <p> </p> <p>We shouldn't have to play these silly games with our health.</p> <p> </p> <p>Whatever happens good luck. Please keep us posted.</p>

I'm guessing sigh of relief for me. My bmi is 47. Diabetic hypertension and high cholesterol.... My insurance I have no idea how it goes.. I'm just waiting on my date .. ???????????? my surgeon just had to call the or so happy

[RedWilly 10]

When you go to your doc's office, are you allowed to hold your purse while you weigh? My office was VERY liberal. They understand how valuable this is to people and deal with the frustrations of stupid insurance companies every day. The fight is a hard one for sure. I gained weight an carried a heavy purse. Putting on 19lbs can take longer than you think so be prepared to get creative. In 10 years I bet the BMI will be down to 30 with comorbidities and 35 without. This is such an amazing and life changing surgery!

[Christopher Lazuka 5]

Have to admit that I had to make some adjustments to qualify for insurance coverage. Don't feel bad due to the fact I have given them so much $ over the years. Kept stuff in my pockets for weigh in and bent the knees during my height check. You can find little cheats to help get it covered, although we shouldn't have too. Good luck!

[gabrielle2014 38]

I'm dealing with this now. I went to my workshop last December but I was 25 pounds away from qualifying and no comorbidities. After a bad breakup and losing my job I gained 10 pounds and so now I'm around 15 pounds away from my 40 BMI with my first appt with the surgeon on Sept 17th. The appt sec at his office confirmed that this is the appointment that would determine if I qualify or not. So i'm now trying to gain weight. I feel so disgusting and I haven't gotten on the scale yet but I assume I can get up there. I have also heard of wearing an ankle weight to boost it up a bit and heavy shoes. it feels so wrong to me but I know that in the long run this will be what is best for me.

I'm very nervous about the insurance process but I hear that BCBS of MA and RI are pretty good. I have RI now. So fingers crossed. I've spoken with a few people who have had WLS and two of them said they had to gain a bit of weight and one wore ankle weights just to be sure.

My therapist agrees with me - if I don't have the surgery I will far surpass the qualifying weight within the next few years. So I have to keep my eyes on that and not on how wrong it feels to gain to lose.

[bunnygirl650 16]

I had the lapband surgery in 2010 everything went well I went from 216 to my lowest being 140 then I start having problems with it and had to have it removed in April 2017 at that time I was 160 I wanted to get the sleeve but because I was that weight I didn't qualify even though the only reason I was that weight was because of the band now I have started gaining weight again my Dr has out a consult in for me but I know I am going to have to gain weight I am 180 now I need to be about 195 I have commodity of BP . But I think having to gain makes me scared, because if they dont approve it and know I'm bigger. I have thought of the weights how did you hide them also how where you able to bend your knees without them noticing

[GassyGurl 428]

Does your insurance have a weight history rule? I had to have 2 years of a qualify bmi. I had 4 out of 5, but a few healthier months in 2016 ruined it all for me. NOT COVERED! Ugh, so I paid out of pocket.

Sent from my XT1254 using BariatricPal mobile app

[bunnygirl650 16]

Called and they said no but I might need two cormoditys I just have high BP said she would talk to the doctor. Because she doesn't see my referral yet. So I was trying to lose but I think I'm going to stop. Going on vacation and I know I will gain weight unfortunately. So I pray that they will see me when I get back cause Iknow there will be weight gain

[Frustr8 7,886]

Shame you aren't in Central Ohio like me , I would lend you my purse.👜 I keep so much things in it and it is so heavy,i could neuter a 🏃molester with one blow!