How much pre-op weight loss is TOO much?

[CHM 1,009]

Hi everyone! I'm a 35 year old female new to this site, and I was wondering if it's possible to lose too much weight before insurance approval.

My first appointment was on Sept 22, and at the time I was 355. I was told my insurance required 3 mos on a medically supervised weight loss plan before consideration. They instructed me to lose 20 lbs, eat 1200 cals/day, take in 70-90g of Protein, and start working in some exercise. It took about a week to work down to 1200 cals, but I got there and have worked up to walking my dogs 3x/day.

Now my 3 month follow-up is on Monday (Dec 21- this is when they'll be submitting to insurance) and I'm down 66 lbs (289). I'm getting worried I'm going to be told that I'm perfectly capable of losing weight on my own and turned away. The GP who referred me outright told me last week to forget the surgery and keep doing what I'm doing.

The thing is, I've always been able to lose weight when I get in the right mindset. That's not the problem. The problem is that there are usually YEARS between 'right mindsets', and the mindset is easily broken when I get sick (which of course always happens eventually). Like I told my husband, I'm only doing so well because I'm not TRYING to swim to shore this time - I'm just trying to get to the life raft over there that's going to help me the rest of the way.

What do you guys think? Is there cause for concern ?

[Djmohr 6,965]

As long as your BMI is as high as it is, there will be no problem. They want to see if you can work hard to get the weight off and clearly you can and are. Great job.

As for your GP, clearly they need to get educated on the disease called obesity. Most if not all of us have lost hundreds of pounds over the years, the issue is, it always comes back with a vegeance! Then usually will topple on a few more just to be safe you don't try that again.

Finally as you get older you have damaged your metabolic system so badly that you won't be able to lose anything.

Having WLS provides you with a tool that will always restrict your food volume. You will learn how to put the right foods into it and how often that is. 3 small meals a day and a Protein rich snack once or twice a day to ensure you get all your Protein in.

Now, you can certainly screw this up by not putting the right foods in or grazing all day long. But after going through everything and learning what your body needs to keep a healthy metabolism, chances are you will keep much of the weight you lose off.

Most general practitioners really don't get the whole bigger picture, they simply focus on the initial weight loss.

Seriously shouldn't they be sent back to school to truly learn more about this disease? When you look at our nations obesity growing, I think they should have to learn more about it.

I thank god my nephrologist understood it so well. In my opinion he is my real hero who began to get me thinking about doing something more permanent.

Good luck to you, you are doing fantastic!!!

[goblue9280 481]

Congrats on losing the 66 lbs in 3 months BEFORE SURGERY... that's an amazing accomplishment and should be celebrated! Other than that, I echo @@Djmohr 's excellent feedback.

[catwoman7 11,209]

I lost about that much prior to surgery, too - and our starting weight is about the same. They absolutely won't tell you that they won't approve the surgery because you can lose it on your own. The whole purpose of those supervised diets is to see if you can stick to a plan long term - and you've clearly demonstrated that you can! The only issue with losing too much weight beforehand is if you end up with a lower BMI than what they'd normally approve (like below 35 or 40), but you're not at risk of that. Don't worry about it and lose away! You'll be glad you got rid of a lot of pounds before the surgery - I know I was!

[CHM 1,009]

Thanks to all of you for the feedback. My mind has definitely been set at ease. I know my insurance requires a BMI of 40, or 35 with a comorbid condition. I do have a couple of comorbid conditions but they're under control, so I think I'd want to stay above 40 to be safe. Depending on how long it takes for approval and scheduling, I may have to slow my weight loss if it continues at this rate, but for now it sounds like I have nothing to worry about. Thanks again!