BMI not Enough for a Revision - Have YOU made Yourself Heavier?

[betrthnever 107]

Hi Everyone,

I have the band and am trying for a revision to RNY. My BMI is currently 37.5. I was denied last year as the Insurance company told me that I had to be at a 40 BMI for 5 years (the same rules as before I was banded). This seems a bit absurd that I would have to do the same song and dance for a revision. My only real complications have been GERD and lack of weight loss (I am fortunate). My question is - has anyone gained weight or somehow artificially inflated their weight consistently for approval for a short period of time to realize the goal to a revision? I don't want to gain 15 pounds and have keep it on for 4 more years to have the surgery! I feel like it is almost a bullying technique by the insurance company, esp. as it has been shown that the band is ineffective. I also realize that I sound kind of whinny (lol) and in the end I need to blame myself for my weight gain. I also realize that this is kind of an ethical question...but there has to be someone out there who has at least been in my boat? I think I might be beaten up a bit by asking this question...

[VSGAnn2014 12,992]

Half-pound weights -- in your bra, pockets and underwear.

Works.

[betrthnever 107]

Half-pound weights -- in your bra, pockets and underwear.

Works.

Thank you - I feel like this is bordering on an ethical question but one I needed to ask.

[VSGAnn2014 12,992]

Ethical question?

When it's you vs. an insurance company?

Uh uh.

[betrthnever 107]

I have heard of people actually gaining weight to make it work. I don't want to go that route!!

[VSGAnn2014 12,992]

Then don't.

[PaulaWodzisz 9]

Coins and scooching down to lower my height is what I used to get my surgery approved and get to 40%. I have no other medical issues right now (I am guessing if I continued with my 37% BMI I would develop them in short order). I think the hoops are a little crazy when you are talking a few pounds.

[SlimJill 291]

I would do the advice above, hide weights in your bra, pockets, pants, underwear, drink lots of Water before you weigh in! And try to slouch, you could get an inch or two off your height that way which should save you 5-10 pounds.

[betrthnever 107]

My appointment is in 2 weeks. I'm ready for a fight with the insurance company.

Thanks everyone!

[Patk 18]

Don't you think they know about this trick? I don't think the physicians would support fraud. Does the sleeve require the same thing about BMI. It really is absurd that insurances have such requirements. They are the ones who don't have to cover diabetes, hypertension and all the other obesity caused issues after surgery is done.

[Bandista 7,466]

My insurance company required a BMI of 40 and I was under that -- not fat enough for weight loss surgery at 240 and change? Come on! Anyway, I got ankle weights. One thing I could not get clear on is which weight would be submitted to the insurance company -- in a case like this very important to know -- so I had to do it for several weigh-ins which I found quite stressful. Still, it worked. Later when I talked to the surgeon about it he said he would have let me weigh in with my pocketbook or whatever it took, but I'm not sure the nurses would have been on board with that. But just so you know, you're not alone. Good luck to you with your upcoming surgery -- and good for you for doing whatever you need to make it happen!

[VSGAnn2014 12,992]

Fraud ... such an interesting word.

[AngelaWilliamsMD 290]

I used ankle weights and fudged my height a bit to try to qualify for WLS through my insurance. I'm sure it's more common than most people think.

[betrthnever 107]

Wow I honestly didn't realize that this was so common! Thank you for sharing all of your stories!

[VSGAnn2014 12,992]

That wasn't MY story. I just heard about it.