June and the hidden dangers of the 6-month diet requirement

[Walter Lindstrom 42]

Last year at this time I posted this Blog about why June is such an important month for patients seeking surgery. http://bit.ly/1SUlolN

I thought it was worth bringing to folks' attention. Here's a snippet:

"By waiting you are RISKING that you might be one of the unfortunate ones whose failure to plan well in June caused them terrible Gloom at the end of the year, even though they thought – and their bariatric program thought – jumping the silly hoops and playing by the insurance plan’s rules was the right thing to do. So if your bariatric program is talking about having you wait and jump through more hoops show them this post and get them to re-think that plan. It could be a terrible but avoidable mistake."

I hope this helps anyone who is being told by their bariatric program that it's better to wait to complete "the diet" before getting submitted to insurance. Sadly, that's usually not the case but you probably won't know until the end of the year. Good luck to all!

[NikkiDoc 312]

I understand some of the point of the article is to make sure to plan so that you don't find out you hae scheduled surgery shortly after your plan has changed to not covering WLS.

However, I don't think that the 6 month supervised diet required by many insurance companies is "absurd". I have seen plently of posters on this forum that were self pay or their insurance company did not have that requirement and a month after deciding they wanted WLS they have it done. A high percentage of time these are the people that were not prepared mentally for the post-op restrictions.

I also view the 6 month pre-op supervised diet as an opportunity to have access to a good dietician or nutritionist that understands what a weight loss surgery patient's diet will be like after surgery. This is your opportunity to have the insurance company pay for that knowledge. Most insurance will not pay for nutritional counseling or dietician unless you have diabetes. But they will pay for those visits as part of the medically supervised pre-op requirements.

That 6 months is the time to start easing into your new eating and drinking habits. Many of us that have done "diets" for years have done many bad or fad diets. Low fat, cabbage Soup, LA weight loss, Medi-fast, South Beach, Atkins, Nutri-system sometimes a combo of some of these at the same time.

The medically supervised diet is that opportunity to have an educated dietician, doctor or NUT help dispell many of the eating myths many of us have come to believe over time.

That 6 month period is the time to go to pre-op support groups or forums like BariatricPal to do the research on what to really expect after WLS.

My insurance did not require me to lose weight on the supervised diet. I just had to show that I made a real effort. I did lose weight during mine. Mine would have taken proof from the last 2 years that I had been working with my PCP or had regularly attended Weight Watchers for 6 consecutive months.

Will there be people who don't take advantage of that time and the knowledge now available to them from their medical professional? Sure there will be. IMO those of the people that are likely to fail in the long run.

WLS is a huge change. Having the psych eval and showing that you are serious about putting in the time it takes to make this tool work for you is not a bad thing. Having the time and knowledge to process how this surgery will permanently impact your life is not a bad thing.

If you just view the supervised diet, the psych test as a pointless hoop then that is what it will be. If you view it as an additional tool then it will be beneficial.

Based on what some posters have said, some surgeons require a certain amount of weight loss prior to scheduling surgery. My co-worker's band surgeon required 3 NUT visits and 3 consecutive support group visits. Those surgeons feel that it is important for their patients and they aren't paying for the surgery like your insurance company.

A few months ago there was a poster on this board that decided to not have WLS since he felt that the basic pre-op testing, psych eval and supervised diet made him feel like a lab rat and it was not worth the trouble. How successful do you think he would have been with following the post-op restrictions, taking his Vitamins, having follow-up visits and follow-up blood work? Did those pre-op requirements weed out somebody that WLS would have been a mistake or at least a mistake at this time of his life?

I went through my 6 month supervised diet.. I finished it up in Sept. My original plan was to have surgery in late October. Well, life got in the way and my husband neede back surgery in early Oct. My surgery had to wait until he was healthy. My co-worker had hip replacement in mid-November. We both could not be out at the same time as we are a small unit. Both of their surgeries were more medically urgent than mine. I had my surgery on 2/2/2015. Was I impatient during the 6 month diet period and during the other delays? Yes, I was. but I made the most of that time. I did a ton of research on Protein shakes, the actual procedures, my post-op diet. I read numerous 1st hand accounts of what to expect those first few days, weeks, months. I feel that that knowledge helped me get through my pre-op liquid diet, my pos op liquid diets, my puree period, that first stall from week 3 to week 6. I knew what to expect.

Do yourself a favor- don't view that 3 or 6 month supervised diet as a hoop that needs to be jumped through. Take advange of those visits and use it as another tool to help you succeed after WLS.