Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Is losing too much weight effect your qualification for surgery?



Recommended Posts

Since my appointment for my colonoscopy last month, I've lost 12 pounds. I have about 15 pounds to go before I can leave the "morbid obese" level. If my BMI drops below 40 and I don't have any underlining conditions, will that effect my qualification for surgery?

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

My understanding is that it's your BMI at your first appointment and not your BMI as you've been prepping for surgery.

Share this post


Link to post
Share on other sites

It really depends on your insurance company and your surgeon.

I would suggest you talk to your patient coordinator about your concerns.

It really depends on your insurance company and your surgeon.

I would suggest you talk to your patient coordinator about your concerns.

Share this post


Link to post
Share on other sites

My insurance company takes the highest weight from the previous year to qualify you. I think that's one year from the time you enter the program, not one year from surgery date.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

my insurance wouldn't let me have the surgery if my BMI wasn't at least 40 when they requested the surgery. They also required me to be in the weight loss program at least 6 months before they would approve me, and I almost went under, so I had to maintain my weight for a couple of months which was a pain in the butt.

Share this post


Link to post
Share on other sites

Right now I'm 285 (I'm 5'8") and my BMI is a 43. In order to leave the 40s, I'll need to be about 265. I'm just scared that by the time I go to the doctor, I'll reach that weight. But we'll see.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

I'd recommend calling your insurance company and getting them to send the policy on weight loss surgery to you. My insurance company had a nurse case manager explain everything to me and send me the policy for my reference. For my particular plan, I had to be over 40 BMI at the first appointment, but during the 3 month weight loss they were fine with me going under 40 BMI.

Share this post


Link to post
Share on other sites

Just had my appointment today. She said I can't go below a BMI of 40 just in case the insurance doesn't go by the starting weight. Kinda feeling discouraged because I'm now about 20 pounds away from being disqualified.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

Just had my appointment today. She said I can't go below a BMI of 40 just in case the insurance doesn't go by the starting weight. Kinda feeling discouraged because I'm now about 20 pounds away from being disqualified.

When a family member had this surgery in December, her doctor was reporting that she was following a strict diet but actually told her NOT to do it so she wouldn't lose too much before the surgery. She's got BCBS of Minnesota. It varies by insurance company, so I'd call yours to ask.

Share this post


Link to post
Share on other sites

I have been worried about this also as I have lost over 10 percent of my weight and am about 10 pounds away from a 40 BMI. It has made it difficult to stay motivated and stick to my diet. My insurance also requires evidence that weight-loss attempts in the year preceding surgery have been ineffective. I have not been able to get a clear answer from my insurance about whether that means if I lose too much on my preop diet they will consider it proof a supervised diet is effective.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      Gearing up for my consult 01/14! Starting to get a little nervous.
      · 0 replies
      1. This update has no replies.
    • Goyafigs

      I had VSG 11.20.24 with Miguel Burch, MD Cedars-Sinai and I am 1 month post-op. 
      · 0 replies
      1. This update has no replies.
    • DaisyChainOz

      🥳 Jan 1 2025 - Day 1 of Pre Op, surgery on the 16th! 😬😅
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×